Our newest survey indicates that many part-time workers are confused about how the Affordable Care Act will affect them when it goes into affect in January, 2014. Our survey of 2,066 US adults, reveals that although the majority of workers (71%) have heard of the Act, many are confused about what the impact will be for them. And only 8% indicate their employer has communicated to them about the Act. As I've written about before, employers are generally paying a lot of attention to what they need to do to get ready. According to our survey, though, educating employees about how the Act is likely to affect them is not a focal area.

Organizations have a lot of work to do to get ready for complying with the Affordable Care Act in January 2014. Our survey found that 44 percent of part-time workers do not use an automated system to capture their time and 64 percent report their part-time employers don't use an automated scheduling solution. This means that a lot of folks are doing this work manually, and they'll have a hard time complying with the look- back and reporting requirements of the legislation. Perhaps more troubling, 36 percent of workers say that the hours they work are different from the hours they are scheduled to work, which could present a liability issue for employers.

According to Paul DeCamp, partner, Jackson Lewis LLP and former Administrator of the U.S. Department of Labor's Wage and Hour Division, “There are a lot of interesting data points in this survey and many of them should be of interest to employers around the country. Overwhelmingly, part-time workers are confused about how the Affordable Care Act will impact them in virtually every way and only 8 percent have heard anything about it from their employers. Organizations need to start a dialogue with employees to begin to shed light on this important issue and empower them with information as it becomes available.”

Our board member, Dr. Tim Porter-O'Grady, is similarly concerned saying “As with other segments of the population surveyed, it appears as though part-time employees are also uncertain and confused by the elements and implications of The Affordable Care Act. Their uncertainty relates very much to lack of familiarity with the details of the Act as it applies to full and part-time employees as well as how the act changes the landscape of health service. However, I'm not certain that the survey verifies that employees are any more knowledgeable and clear about their current health insurance coverage. The survey indicates the need for policy leaders and employers to generate clear and accurate information regarding health insurance coverage and the impact of ACA on the lives of their employees.”

Survey Key Findings:

You can learn more about how workforce management technology can help with ACA compliance here. In the meantime, though, start thinking about employee communications as a critical element of your strategy.

This week I spoke with our board member, Dr. Tim Porter-O'Grady about the implications of the Affordable Care Act (ACA) for healthcare providers and for employers.  If your organization employs more that 50 full time equivalent employees, you are no doubt already grappling with what you'll need to do to comply with the act.

Tim, who consults with healthcare providers around the country, has a deeply informed perspective on what the ACA will mean for workers and employers.  In our conversation, Tim reflects on the increasing responsibility that healthcare providers have to ensure their services are delivering the best possible outcomes for the money spent even as the pressure is applied to employers to ensure that employees can get the heath services they need at an affordable cost.

You can listen to a podcast of our conversation here: PPACA compliance podcast

In order to ensure compliance with the ACA and the drive toward evidence-based medical practice, both healthcare providers will be increasingly dependent on technology to track costs and predict outcomes.  Other resources that might be useful to you and your organization in understanding the ACA:

Navigating the Affordable Care Act: Avoiding Penalties  and Minimizing Costs - Kronos Webinar on March 6 at 11:00 am PT/2:00 pm ET

Mercer Report:  Health Care Reform After the Decision.  Mercer surveyed 1,215 US employers shortly after the Supreme Court decision last summer upholding the act.  This report provides a brief overview of the provisions of the act relating to employer responsibility for providing employees with affordable health insurance as well as those employers' assessments of the financial impact the Act will have on business.

As Ben Franklin famously noted, "An ounce of prevention is worth of pound of cure".  What's your organization doing to prepare for the ACA?  And what are you doing to help employees manage their own health?

We're all going to be hearing lots more about the Patient Protection and Affordable Care Act in the coming year as organizations grapple with its full implications.  According to Paul DeCamp, partner, Jackson Lewis LL, "Many organizations had been taking a wait-and-see approach to PPACA compliance. Now that the election is over, it would be prudent for employers to get a strategy in place and develop tools and processes to comply before the 2014 deadline."

So what does this have to do with catfish and Manti Te'o? My heart goes out to this guy, but I'm flabbergasted by how wide the gap was between perception and reality here.  And just as his ignorance of the facts is causing him grief, ignorance of the law isn't going to protect organizations from the consequences of non-compliance with the provisions of the PPACA.

I don't know about you, but I'd never heard the term "catfishing" before this week.  The expression comes from the movie Catfish, and refers to getting duped by people who fake their identities online.  According to a character in the movie, catfish were mixed with codfish when they were shipped live in saltwater aquariums in order to keep the codfish more lively and their flesh thereby more tasty.  The character is basically defending an identity faker on the basis that she served as a "catfish", making life more interesting for those around her.

As the daughter and granddaughter of men who made their livelihood selling codfish, I'm calling foul on the catfish story.  Codfish was salted and dried for transportation, shipped whole on ice, and eventually filleted and quick-frozen for shipment when the technology became available in the 1920's.  I don't believe codfish were ever transported across the US live in salt water aquariums.  So, just saying, check your facts.

Here are some truth-telling items you may want to check out from this week:

I enjoyed  this interview on HR Bartender with our board member Andy Brantley where he shares his insights about how entry level employees can chart a career path- great competencies for anyone in any job (or in life in general!)

The top 5 reasons why people will leave their jobs this year according to Forbes.

TLNT on how to have a winning team in 2013

Love this article: making the software engineers take some of the customer service calls - that's one way to do it!

How to Get Employees Motivated After the Holidays http://ow.ly/gVvgP via @WF_Institute

Coaching Employees To the Next Level http://ow.ly/gVuF7 via @HRBartender

A lot of Kronites attended the National Retail Federation conference this week.  Check out the items below for more information about how retailers are differentiating themselves via workforce management.

Check out some pictures from the #Kronos booth: http://ow.ly/gRnQ0 #NRF13

#Kronos Sponsors #NRF13 Session on the Benefits of Investing in Labor http://ow.ly/1R7hdv

Visit the #Kronos booth and donate to #SandyRelief http://ow.ly/i/1mV7n #NRF13

#Kronos Helps #Retailers Manage in the Moment with Workforce Tablet Analytics http://ow.ly/1R7fLq #nrf13

Our board member Dr. Tim Porter O'Grady submitted the following guest blog interpreting the radical transformation of the US healthcare system required by the Patient Protection and Affordable Care Act.  Technology can help, but the biggest changes will begin with linking process to outcomes via intelligent process design and meaningful analytics.

Now that the Supreme Court has ruled on aspects of the Patient Protection and Affordable Care Act, the healthcare system is in overdrive as it attempts to reconfigure itself within the context of the Act (PPACA). The central driver for both the formation of the act and the response of the healthcare system has been the accelerating, some would say spiraling, costs of healthcare. In 2009, the gross domestic product percentage devoted to health care was just over 17%. In 2008 it was just over 16%; in 2001 it was under 15%. Clearly, the accelerating costs of providing contemporary healthcare and its growing portion of the gross domestic product have made continuing the existing tertiary care late stage engagement model impossible to sustain. As a result of the passage of the PPACA, major recalibration of the way health services will be provided over the next two decades is underway with shifts in policy, regulation, and program design. Growing emphasis on terms such as "value" and "accountability" are shifting the focus of healthcare away from emphasis on "process and volume" toward "product and value".

The rising public and private costs of healthcare are insupportable by governments, employers, small businesses, and individuals. At the same time, costs of health service are rising and despite high levels of spending in healthcare, measures of impact, outcome, quality as tested by quality-of-life indicators such as health status, life expectancy, and infant mortality compares dramatically unfavorably with other developed nations. While advances in clinical technology have progressed significantly in the United States, providers lag notably behind the European Community, Australia, and New Zealand in the use of electronic health information systems. On top of these realities, the average annual health insurance premium for a family hovers around $14,000, nearly 55% greater than the family costs for healthcare in 2000.

There is simply no longer any doubt that major change toward higher levels of accountability from providers and a more clearly delineated health outcome needs to be more firmly embedded in a transformed health system. As all services generally become more "user-driven", emerging models of health service must also reflect "user" or "patient-centered" approaches to delivering service. At the same time, services must result in a net aggregate positive impact on sustainable health status of both individuals and populations. With this reality as a centerpiece for healthcare design, providers must now focus their efforts within a different context in a way that demonstrates the convergence between discernible and intentional processes and their goodness-of-fit with clearly delineated and measurable health impact and outcome.

The challenge with this shift away from process emphasis is reflected in the esteem that providers have for their own good process. Indeed, indicators and measures of productivity have historically been driven by workflow, time and motion, and physical efficiency measures. This overarching emphasis on process and productivity has done much to focus on efficiency but has had little discernible impact on effectiveness. Emerging understanding of the character of professional work and judgment-based decision-making points to the inestimable value of assessment-reflection-evaluation as a foundation for delineations of value-defined productivity. The factors that now emerge as important in professional work more emphatically advance the value of creating a goodness-of-fit between effective process and relevant outcome. Indeed, the structure of service payment in the provision of healthcare will reflect how the convergence between effort and effect demonstrates best practice. Comparative effectiveness data will now compare and contrast the variety of service settings devoted to addressing particular health concerns or the health of specific populations. It is here where the shift in the minds and efforts of providers from volume to value will be most challenging.

The historic vertically constructed and compartmentalized service infrastructure in healthcare that insulated providers within the walls of their own clinical categorization and role boundaries now must become more porous. Individual disciplines must now configure in a more intentional and enumerated interface with a community of other disciplines who play a determined and articulated role in a complex mosaic of population specific health-generating activities. Financial and service success in a value-driven equation now depends on the intensity of interface and relational effectiveness between each member of the service team and the aggregated convergence of effort they all exhibit in the achievement or advancement of particular health outcomes for given populations or services. In order to both achieve and sustain this quality and value paradigm several key dramatic systems and role changes must occur:

  1. Providers in each discipline will need to create a common understandable language which clearly elucidates their specific roles and contribution to the team's collective effort in the individual patient experience.
  2. Organization of healthcare services now must configure around a “health script” in a way that relates to advancing the health of specific persons or populations.
  3. Provider communities must be constructed and effectively configured to work conjointly both in defining unique discipline-specific contributions and collective impact and values achieved by the convergence of mutual effort.
  4. Patient “users” must now be incorporated as members of the clinical team demonstrating their commitment and accountability for their own health and for their role in contributing to the health of the community.
  5. Measures of quality and value (including financial) will now be deeply embedded in indicators of aggregated community health and wellness sustainability.

There has not been as dramatic and broad a systems shift in health services perhaps since the introduction of Medicare. Both broad and deep changes in the configuration and payment of healthcare services will call for different delineation of clinical work, relationships, productivity, effectiveness, integration, and impact. This cycle of change is early in its dynamic and it is far too soon to determine the extent of viable change and the degree of its impact. For the cynics, it may imply nothing more than rearranging the deck chairs, and for the optimists, the achievement of meaningful and sustainable community health.

As always, reality lies somewhere in the midline between these two extremes. However, what is not sustainable is an increasing acceleration of costs for health service and a concomitant decline in health status. What results in this dramatic health system transformation will, as usual, not look anything like what is imagined at its initiation. Innovation, creativity, availability to change, and adaptation will be the usual attributes that characterize successful transformation. Re-languaging health service, recalibrating service design, and evaluating provider and programmatic impact and value will be necessary for all participants and will require evaluating effectiveness within a just-in-time frame. Never having reconfigured in process and innovated on the go, healthcare leaders will have to demonstrate new competence and capacity for network management, emergent dynamics, collective enterprise, and new financial/payment arrangements. For everyone in America we are at the “Nike moment” in health transformation and it is now time to “just do it”.

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