Healthcare Compliance is mandatory, but also so confusing. Providers today seem stuck with one of two choices; first, ignore compliance, or do as little training as possible in hopes of staying out of trouble, or second, dedicate enormous amounts of money and time to stay current. There doesn’t seem to be a third choice out there for providers to have their staff trained in current regulations, and not have to spend thousands of dollars to accomplish this. The following tips will allow you to realize there is another choice.For the better part of my career, I’ve been working almost exclusively in healthcare compliance and government regulations where I’ve taken thousands of calls from healthcare professionals with different compliance related questions. The calls come from every state and from nearly every specialty. Some of my favorites questions include: “Do we need to burn used needles in the back parking lot?” “Can HIPAA give a fine to my employee for smoking?” “Is it OK for me to draw my own blood?” Some of the questions were shocking and others just made me laugh, however, the most common question I receive is: “How do I know when I am compliant?” I’ve learned that what providers and their staff are really asking is “How do I know when I’ve done enough to avoid an audit or survive one it when it happens?”Years of observation have taught me that a majority of those working in healthcare today view compliance as something to check off your list, or finish. If you view compliance this way, you’ve set yourself up for frustration. This frustration usually leads to ignoring or disregarding compliance, then mistakes, followed by audits and fines. Ignoring compliance will cost you. Some providers disregard compliance thinking that because some training took place years ago they are still protected. Even if you took a couple of minutes to train a new hire, DO NOT make the mistake of thinking past training equals protection today.Three major events usually trigger an audit. They are: injuries, state specific crackdowns, and complaints. Complaints are by far the audit-triggering leader, with the majority of complaints coming from your own employees. Training must remain current, and occur at least every year, especially if you have high turnover. A disgruntled employee is the best candidate to file a complaint against you.The reality is you’re never done when it comes to compliance, BUT you can reach a point where you can be confident you’ve done enough to avoid most audits and survive one if it came to your way. Those who pay no attention to compliance because they have never been audited are typically the ones who receive the largest fines. To feel confident, you must establish a “foundation for protection.”Whenever I get a call about a very detailed or complex compliance issue, I first try to determine what kind of foundation is in place. I do this because if the foundation isn’t in place, you have bigger problems than getting the answer to a complex question. This doesn’t mean you should ignore complex details that surround compliance- they can get you into trouble, but rather pay attention to them AFTER your foundation is in place. You wouldn’t install a stained glass window onto a home before the foundation was secure. Here are three steps to help you determine if you have a secure foundation.1. Have you established a current, written training program?
2. Have you trained EVERYONE in your office at least every year?
3. Have you documented training AND verified your staff understood it?I’m not saying that if you do these you’ll never be audited. You can’t always control what your staff or patients do. I am saying that if you’ve set up a secure foundation using the steps above, you can feel confident that you’ll avoid most audits, AND if you’re unlucky enough to be audited you should do well. Having helped providers get through audits, and after interviewing several compliance auditors, I’ve learned a lot. I know what auditors look for and the common mistakes that will bring them to your practice.Finally, I’ve attended many national health information conventions and group compliance trainings. Most attendees usually leave with mounds of paper and no clue about what to do to protect their practice, or how to avoid audit-triggering mistakes. Perhaps you’ve attended a similar training and had this experience. Maybe you have tried to train your staff yourself and felt overwhelmed by the process. You don’t need to spend a lot of time or money to become compliant.
A fortune 500 client (who will remain anonymous) is a global manufacturer and marketer of high-quality foods and simple meals including soup, baked snacks, and healthy beverages. This company employs over 8000 workers and provides employee benefits. This company, like many other employers was struggling with healthcare costs and related medical quality issues linked to employee lifestyle. Many employees have recently been diagnosed with high cholesterol and blood pressure. Many of these diagnoses have been linked to obesity.Business Challenges
The challenge this company is facing is that three percent of the employee population drove over 50% of healthcare costs. A key strategic decision was made to actively involve consumers through their medical decision making process.A Strategic Approach
The challenge of informing employees about their medical decision making has now been outlined. A strategic approach is to be initiated to reach these goals. The following tips outline was used in consideration when approaching the goal.• Employees must trust the source in order to be successful.
• Target the top 21 expensive and complicated conditions, mostly heart disease related.
• Employees must have access to medical products and research information specific to their diagnosis.
• Phone and internet service that provides comprehensive decision support.* These tips were formulated for this company however they can be used for all companies looking to save money in health care costs.Health Care Saving Conclusion
After initiating these tips for a successful strategic approach, this fortune 500 client was able to achieve a $3:1 ROI in healthcare costs saving. This fortune 500 company also saw that 88% of its employees became more involved in decision making, 76% improved communication with doctors, 85% improved peace of mind as a result of the new information gathered. Finally and most importantly, 93% of employees indicated that requesting this information saved them time in researching their illness.
Congress is working diligently to get a combined bill for President Obama to sign before the end of 2009. If it happens, we’ll have made history and we’ll begin a trend that it will be impossible to get away from in the future. Unfortunately, it’s unlikely that the bill we’ll get will be what we expected. Here are some of the most important parts of the healthcare bill.Higher income families will see higher taxes – Healthcare reform will certainly raise taxes on those with the highest incomes. In fact, there is an outright extra tax for the higher incomes, and it goes directly to fund the healthcare program.There will be very little help for anyone for another three years – Most of the benefits of the program begin in 2013 or 2014, though there would be some money available to the uninsured whose health is frail right now.The ban on pre-existing conditions will be three years out. Both the House and Senate plans will prohibit insurers from denying coverage or charging higher premiums due to poor health, but the benefits don’t begin until at least 2013.Everyone will eventually have to have health insurance. At some point all Americans are required to carry insurance or face fines.Younger people will see their premiums go up – Today, private insurers charge lower premiums for people in their 20’s because they rarely have health problems. Under the new plans, these people will see their rates raised dramatically.Rates may still not be affordable for many families. – Middle class families will likely see their insurance coverage become more affordable than it is today. However, according to recent polls the reduction in premiums will not be significant enough to really make healthcare affordable for many families.There’s likely to still be changes and compromises to the bill before it leaves Congress. If you’re interested, stay tuned day by day to see how the bill really ends up.
Diagnostics is an important component of improved value chain in the Healthcare Sector, which enables accurate detection of health risks and diseases in earlier stages thereby improving treatment and disease management, while cutting subsequent health problems and their associated costs. With improving economic indicators for India, healthcare spend has also witnessed a rise. Though diagnostic tests comprise a very small percentage of the total medical expenditure, they account for 60-70% of all treatment decisions. Additionally, with the advent of molecular diagnostics, there is growing focus on diagnostics for early detection of diseases.Industry on a fast growth trackThe healthcare industry in India is growing at a rapid pace and it is poised to become one of the dominant participants of the Indian economy. According to a Yes Bank and ASSOCHAM report, the Indian health care industry is estimated to grow at 23% p.a. to USD 77 billion by 2012 from the current USD 35 billion. The sector has grown at the rate of 9.3% from the year 2000 to 2009.Of the sum, diagnostic and pathology services would account for USD 2.5 billion in 2012, more than double its estimated current size of USD1 billion. The growth in the segment is expected to be driven by the consolidation in the industry and increasing insurance penetration among the country’s population. Healthcare facilities, inclusive of public and private hospitals, the core sector, around which the healthcare sector is centered, would continue to contribute over 70% of the total sector and touch a figure of USD 54.7 billion by 2012 The diagnostics and pathology testing market in India represents one of the most lucrative markets in the world. The market has seen a robust growth in past few years.IVD and MolecularThe Indian In Vitro Diagnostic market is estimated to be USD 300 million as of 2008-09. The IVD market scenario has seen major development in the last 4-5 years and India should very soon catch up with the rest of the world. IVD revenue in India is primarily driven by labs contributing 65%, while hospitals contribute 35% share. The market is divided into Public & Private customers and the industry is made up of MNCs, Indian corporate and the unorganized players. Some of the big players are also entering the IVD businesses with emerging opportunities.Molecular diagnostic has been strongly developing during the past five years, with a growth rate of 15%. Molecular diagnostics or the analysis of DNA and RNA at the molecular level – is a fast-growing market, driven by the growing understanding of the human genome. Although a small part of the In-Vitro Diagnostics (IVD) market, molecular diagnostics market is one of the two growth drivers of the IVD industry. India has made major progress over the recent years in acquiring competence and credibility in using most sophisticated cutting edge biotechnology tools to understand disease pathogenesis at molecular level. Many institutes and universities have already extensive research exchange and international cooperation initiatives ongoing. Solid basic research is being carried out but there would be more need for applied research.Industry segmentsThe diagnostic and pathology market is around 2% of the overall healthcare market. The diagnostic market has been growing at 15-20% and by all indications shall continue to grow for another 10 years at this rate. The In Vitro-Diagnostic Market accounts for about 38% of the total global medical devices and diagnostic market. The Indian IVD market is estimated to be USD 330 million as of 2008-09. The IVD market scenario in India has seen substantial developments in the last 4-5 years and these changes shall continue for decades to come. In a very short time, India is poised to catch up with the global IVD market.
Outsourcing has become an indispensable part of organizations who strive for quality outputs. It has made the work environment flexible in many aspects. Earlier domestic outsourcing was hugely popular but now the trend of global outsourcing is catching up as well. Experts are scattered all across the globe and not just within a country, keeping this thing in mind organizations are connecting with service providers who offer their expertise irrespective of their location; this is the concept of global outsourcing. The healthcare sector can hugely benefit from this type of outsourcing below are the reasons why.Systematic approach: In an industry like healthcare having systematic processes in place is the need of the hour. Every bit of information is crucial, loss of which can result in severe discrepancy in the work flow. Outsourcing takes care of such aspects and channelizes the work and makes sure there are no loop holes left out.Expertise: With global outsourcing, it is possible to get the best of the companies for every task. For instance if a pharma company decides to launch a herbal product for a target audience in UK, they can choose to outsource the research work to India as the country produces many herbal products and has developed a niche as far as the herbal products are concerned. On the other hand the market research can be outsourced to UK firm as they would known the local market the best. There is a wide scope for such work segmentations that global outsourcing makes possible.Cost effective: Outsourcing and cost cutting go hand in hand no doubt about this fact the same applies in terms of healthcare outsourcing too. Adding expertise and value and keeping the costs minimal is an important aspect of global outsourcing.Value Creation: Healthcare sector revolves around a lot of crucial information and requires highly skilled experts to handle it. With global outsourcing coming into the picture a lot of value creation can take place. Companies across the globe putting in their efforts to achieve a common goal are surely going to add value to the work flow.Business Expansion: Outsourcing gives companies the opportunity to discover their potential and expand their reach. When companies around the world are carrying out the outsourcing work expansion becomes a bit easy.With the evolving needs of consumers the manufacturers have no option but to match up with the increasing demands and make customer satisfaction their prime motto. The healthcare industry is growing by leaps and bounds year on year and the procedures getting complex. In such a scenario global outsourcing will not just help in easing the process but also creating value.
This story is not meant to scare you, though some of what you will learn may do that. It is intended to give you a clear picture of the state of U.S. pensions, social security, health insurance and Medicare, and what that means to your health and wellbeing in your retirement years. So if you are intending to retire in the next 20 years, pay attention. And if you’re not intending to, pay attention anyway. The impact of the current retirement and healthcare systems will reach far beyond the Baby Boomer generation.To set the scene, let’s recount a portion of a story told by Jim Jubak (financial guru) about his father.The voice on the other end of the phone was angry. There’s something wrong with my retirement check, the man said. His monthly pension check, which had netted him $350 a month for years, was suddenly just $180 — a drop of nearly 50%. Coping with the incredible shrinking retirement; Jubak’s Journal, March 26, 2004That excerpt was from a phone call between Jubak his father a few years ago. It seems the company his father had worked for for many years, and from which he had retired, had increased the amount Jim’s father had to pay for health insurance by $170 a month – WITH NO NOTICE! That increase cut his monthly pension nearly in half! AND there was no promise from his former employer that that would be the last increase in payout he would see!It’s a despicable way to treat anyone. But it serves as a perfect example of what IS happening to many retirees today, and what promises to happen even more (given the state of healthcare in the U.S.).But that is not all. Healthcare for retirees is getting hit from all possible angles. While employers are targeting pensions and health insurance payouts for BIG cost cutting measures, the federal government is lowering Medicare funds and shrinking social security checks (meaning social security payments are not staying in step with inflation). And to top it all off, healthcare costs are on the rise again. Consumer group Families USA estimates that the prices of drugs used most by the elderly have climbed nearly 3.5X faster than inflation between January 2002 and January 2003.*Pfizer’s (PFE, news, msgs) Celebrex pain killer is up 23% while their cholesterol drug, Lipitor, is up 19%.**Any way you look at it, you are and will-continue-to pay more for healthcare, and get far less back far into your retirement years.Jubak’s advice to retirees, his father included (I assume) was to fortify your investment portfolio to hedge against the downturn in pension and social payments (payments that will be outpaced by inflation) and the upturn in YOUR CONTRIBUTION to medical care.If you want further investment advice, click over to Jubak’s column. But if you want to find out what you can do immediately to supplement missing health services or to get a lower rate on individual services, keep reading.There are options besides Medicare and private health insurance. They are called Consumer Driven Health programs. And what it amounts to is free trade in healthcare.Consumer Driven Health works like this. For a small monthly fee, far less than insurance company rates (monthly fee run as low as $19.95 per month and may cover your entire household), you receive discounted rates on the very health services insurance companies are cutting. And the discounts are sizable. One company reports up to 80% savings to its members for dental care alone. What’s more, anyone can join. No one is turned down for any reason, including preexisting health or dental conditions.So if your health and wellbeing are important to you, look into CDH to find out what you can do to take care of your health long into retirement, regardless of the changes that occur with government programs and your employer retirement benefits and pension funds.*Coping with the incredible shrinking retirement; Jubak’s Journal, Jim Jubak, March 26, 2004.
Applying for a job in healthcare is a little different from typical corporate job. One of the reasons for this is that healthcare has its own unique culture and ethos. Therefore, if applying for a position in the industry, you need to take this into account when preparing your resume and cover letter.Here are some tips for creating a winning resume:1. Having a good clear Career Objective is particularly important in the healthcare field. You should aim to demonstrate your knowledge of the healthcare industry and that you have a particular career path in mind. You must aim to show that you are qualified for the position that you are seeking – even if you are new to healthcare – for example by pointing to your education and, as applicable, any practical work or previous experience.2. Certifications and licenses are crucial in the health field. Be sure to list all that you have, including any continuing education courses that you have, and any government regulations which you are compliant with. As far as licenses are concerned you should list any city, state or federal licenses that you have, including their valid dates.3. Technical skills are also very important in the health field. This of course includes not only things that are directly related to patient care, but also supporting technologies, including computers and software. Don’t be shying about listing all your technical qualifications and skills, including computer skills.4. You should also mention any training that you have done, or any courses that you have taken. As with technical skills, you need limit it those that are directly related to patient care. For example, if you have done any training in management, ethics, communication, etc., you should list it on your resume.5. Where possible you should try to quantify your previous experience. For example, you could mention the number of patients or clients that you took care of at previous job, or if you were in a senior position, the number of people in your team, etc.6. There is a lot of terminology and jargon that is specific to the health care industry. Where necessary you should use the propre medical terms, rather than trying to substitute common phrases which don’t really fit. That said, you don’t want to use jargon excessively or unnecessarily – it is quite likely that your first contact will be a recruiter, who though perhaps broadly familiar with industry terminology, doesn’t have a detailed knowledge of every last medical term.