Healthcare Issues & Trends

Advice & Insights for healthcare's Leaders & HR Professionals


Modern Healthcare Inducts Don Wegmiller into “Health Care Hall of Fame”

Posted on January 31, 2013 by Gallagher Integrated

INTEGRATED Healthcare Strategies is proud to share that Don Wegmiller, our former President and current Chairman Emeritus, is being honored for his many achievements with an induction into Modern Healthcare's “Health Care Hall of Fame”!

One of the healthcare industry's most prestigious recognition programs, the "Health Care Hall of Fame" honors individuals who have made outstanding contributions to the healthcare industry in this country and around the world.  Past awardees include Doctors Charles and William Mayo, founders of the Mayo Clinic; Dr. Michael Debakey, noted international heart surgeon, and fellow 2013 inductees, Dr. Denton Cooley, heart transplant surgeon, and Sister M. Maurita Sengelaub, past president of the Catholic Hospital Association (now the Catholic Health Association) and the first woman to hold that position.

A prominent figure in healthcare for over 40 years, Don Wegmiller is a recognized leader and innovator in hospital, clinic, and integrated system development and operations improvement, pioneering new concepts for multi-hospital systems.  Don continues to provide the healthcare industry with insights and guidance through his dynamic and charismatic approach to health care leadership.  He was recently elected as Chairman of the Scottsdale Institute, an association of advanced healthcare-delivery systems aimed at sharing best practices for information technology-enabled quality improvement.

A small sample of Don Wegmiller’s past recognitions include: first recipient of the Robert S. Hudgens award; named as one of “Healthcare’s 100 Most Powerful People” by Modern Healthcare; awarded the B’nai B’rith National Healthcare Award; and ranking on the “Who’s Who in America” and “Who’s Who in Healthcare” lists.

We look forward to honoring Don Wegmiller, along with the two other 2013 inductees, at a ceremony on March 10, 2013 at the Hilton Chicago in conjunction with the American College of Healthcare Executives' 2013 Congress on Healthcare Leadership.  Look for the profiles of the 2013 inductees that will be published in the March 11, 2013 issue of Modern Healthcare.

INTEGRATED has been privileged to have Don’s leadership in our organization, and we are pleased that he is receiving this honored recognition of his many achievements!

See the Modern Healthcare announcement

Two Steps to Help Healthcare Organizations Manage the Changes of Healthcare Reform

Posted on January 21, 2013 by Kevin Haeberle

Most healthcare organizations are already preparing for the inevitable changes that will come with healthcare reform  -  from short- and long-term cost reduction plans, to fundamentally new ways to deliver healthcare services.  As healthcare leaders identify areas for change, then develop and implement plans, the need for significant change management practices may be easily overlooked.
 
Ignoring this critical component may limit the success of otherwise well thought-out plans.  From our work helping healthcare organizations across the nation manage significant changes, we recommend  two straightforward change management steps that can lead organizations to the outcomes they desire to attain.
 

Step One:  Let Employees, Middle Management, and Physicians Catch-Up
 
Significant change can take months, or even years, to evolve from the initial discussion to full implementation.  During the early stages, often ideas and concepts are discussed at a senior leadership retreat, board meeting, or even during informal encounters among executives.  Typically, there is a lengthy period of time invested in gaining acceptance for the change, followed by debates over competing ideas on how to move forward, a sharing of opinions and thoughts on implementation strategies, and finally the building of consensus.
 
Most senior healthcare leaders are people of action.  They also feel pressure to start implementing change as soon as possible.  The months spent “politicking” to get a plan ready to move forward simply builds up the pressure to move quickly once a consensus among senior leaders and board members has been reached.  It is during this time that problems occur.
 
Commonly, the parties not included in the initial consensus-building – the directors, managers, employees, and key physicians -  are simply not ready to embrace the change, just as many of the senior leaders or board members may not have been initially.
 
 It is natural for senior leaders to be anxious about time already wasted and feel the need to move forward quickly.  However, it is critically important to guide middle managers, employees and physicians from the beginning stages and allow them adequate time for thought and discussion so they both understand and accept the need for the change, and the implementation approach.
 
Clearly, a well thought-out plan that will effectively communicate the change is essential, but when time for discussion and understanding by managers and employees is by-passed, we have found that there is little acceptance and higher levels of  resistance.
 

Step Two:  Emphasize What is Staying the Same, Not What is Changing
 
From almost forty years of gathering and analyzing information on hundreds of thousands of healthcare leaders, one commonality seems to exist - most individuals whose career path led them to senior leadership positions are change agents.  These leaders are not only open to change, they seek it out.  They see a stagnant environment as unresponsive to the natural changing world, and a non-changing workplace is seen as unchallenging, and even boring.  This attitude towards change is essential for the success of a healthcare organization since senior leaders are responsible for identifying the needs of the organization both today, and five and ten years into the future, and to plan for that future and move the organization forward.
 
We have also gathered data on what motivates healthcare employees and middle managers, and unlike senior leaders, most healthcare employees and middle managers resist change and prefer predictability and structure.  This natural focus on the “now” is a needed quality and essential to the success of the organization since the day-to-day delivery of care requires following process and procedure – every time, in the same way.  Whether it is called protocols, procedures or Joint Commission Standards, healthcare relies on employees and managers to desire the “same” every time.
 
Therefore, we have a dilemma when an organization needs to make fundamental changes. Senior leaders like and want change – most employees, managers and physicians, do not.  Even with this built-in conflict, the less dramatic changes still occur on a regular basis in healthcare, but typically with much gnashing of teeth, a senior presence to push through the resistance and plenty of committee meetings.  However, fundamental, large-scale change has much more difficulty overcoming this dilemma.
 
It may sound simple, but one solution is to focus less on the change and more on what stays the same.  Senior leaders and those managers and employees who find change exciting often extol the virtues of the change, singing praises of what will be different and better in hopes of creating excitement about the change.  Unfortunately, these efforts can instead have the unintended consequence of increasing anxiety and resistance.
 
Finding the right balance and knowing your audience is the key.  A recent “change” situation provides a good example.  The leaders of a major health system were perplexed because they were facing high resistance from employees and middle managers as they planned to move to a newly constructed hospital.  The senior leaders were both excited and proud of all the work and effort it took to have the beautiful new hospital reach completion.  They had developed an extensive communication plan to focus on the changes and improvement and how all the efforts and expense would lead to a new and better workplace and patient care environment.
 
The communication plan was implemented, with the focus on communicating the virtues of the new hospital and how much was going to change – which seemed so self evident since the “old” hospital was built in the 1950s.  The more the leaders communicated how much better the new hospital was going to be, the more the resistance increased.  Senior executives had difficulty understanding why the employees and middle managers were not as excited as they were in moving to what was clearly a better work and patient care environment.  Senior leaders faced the same common thought most of us hold – we are excited, what is wrong with everyone else?
 
After much discussion about the differences in motivation between senior leaders and most employees and middle managers, the health system modified its approach and began to incorporate into the communications messages on what was going to be the same after moving to the new hospital, and how many of the same processes would continue.  Even though the “old” hospital was outdated, drab and needing to be replaced, the senior leadership began talking of the “traditions” of the old hospital and how to move some of those to the new facility and how to start new traditions. They found a balance between moving forward and minimizing the anxiety of change.
 
For those of us who find change as part of the challenge of work, the next five years in healthcare will be exciting as we look to find different ways to deliver care and service under the new demands of health care reform.  Understanding that the majority of employees, physicians and middle managers do not embrace the challenge of health care reform the same way, and never will, is one of the keys to success as we move forward.  Recognizing this fundamental difference and developing a communication strategy and approach focused on moving the employees and managers forward will be much more successful than trying to convince employees and managers to be more comfortable with change.

Healthcare Industry News Update: Minimum Wage Increases

Posted on January 17, 2013 by Gallagher Integrated

As authored by Debbie Weber, Vice President, INTEGRATED Healthcare Strategies

The New Year has once again brought new and revised legislation.  And for ten U.S. states, it also brings an increase to minimum wage of between 10 and 35 cents.  The boost will raise the income of approximately 1 million workers as of January 1, 2013. 

  • Arizona
  • Colorado
  • Missouri
  • Montana
  • Ohio
  • Oregon
  • Rhode Island
  • Vermont
  • Washington
  • Albuquerque, NM
  • Santa Fe, NM  - effective March 2013
  • San Francisco, CA
  • San Jose, CA – effective March 2013

While minimum wage increases are always viewed as a positive occurrence by the general workforce, they create issues for HR professionals that may initially go unforeseen.  A minimum wage increase frequently impacts entry-level staff employee wages by creating compression between the beginning of the non-exempt (hourly) pay structure and the current incumbents.

Another unintentional consequence of an increase to minimum wage is the resulting tendency for employers to inappropriately create an additional pay grade, eliminate the lowest entry level pay grade, or move entry level positions into the next pay grade in response to the increase.  While some of these options may work, they won’t necessarily be the most effective or best long-term solution for the organization.

If your healthcare organization is one of the ten states listed below where the minimum wage rate was increased, it is critical you review and assess your organization’s staff exempt and non-exempt compensation and payroll practices for compliance with the Fair Labor Standards Act (FLSA).

If you would like further insights or discussion on this post, please contact Debbie Weber at 816-795-1947 or at debbie.weber@ihstrategies.com.

Healthcare Industry News Update: American Taxpayer Relief Act of 2012

Posted on January 17, 2013 by Gallagher Integrated

As authored by Debbie Weber, Vice President, INTEGRATED Healthcare Strategies

Our blog is dedicated to communicating issues and trends that affect the healthcare industry, and to that end, we stay abreast of government legislation that pertains to hospitals and health systems.  Following are some key highlights of the new legislation that Congress recently passed which will impact human resource and payroll policies and procedures.

On January 1, 2013 Congress passed the, American Taxpayer Relief Act of 2012 (ATRA), and President Obama signed the bill into law on January 2, 2013.  The bill permanently extends a number of tax provisions and it revises tax rates for some.

ATRA impacts all citizens in some way, but the amendment to the H.R. 8 bill contains a number of provisions that are of significant importance to HR professionals.

Here’s what Healthcare HR executives should know:

  • The 2 percent payroll social security tax cut was not extended.
  • Employer-provided education assistance was permanently extended. This allows an employee to exclude from income up to $5,250 per year in undergraduate and graduate education – regardless if the education is job related.
  • Permanently extends the increase in the monthly tax exclusion for transit and vanpool benefits. 
  • If available in their benefit plans, permits participants in 401(k)s, 403(b)s and similar defined contribution requirement plans to elect to transfer amounts to a designated Roth 401(k) account, at any time, with the transfer treated as a taxable qualified rollover contribution.  Previously, unless the plan allowed in-service distributions, the plan had to be amended to specifically allow a distribution for the traditional 401(k) into the available Roth option. 
  • Extends federal emergency unemployment benefits for one year.
  • Reinstates and extends the Work Opportunity Tax Credit through 2013.
  • Reverses a $600 deduction in the $3,000 credit for child and dependent care that was set to take effect January 1, 2013.

Resource:  ‘Fiscal Cliff’ Law Affects Payroll Tax Withholding and Employee Benefits by Stephen Miller, CEBS SHRM On-line, Jan. 2013

Additional changes to the laws are expected to be announced at the end of March 2013, when sequestration provisions require lawmakers to decided on further negotiations related to deficit reduction, and the extension of the debt limit or further borrowing authority.  The INTEGRATED Healthcare Issues and Trends blog will post updates and analysis as they become available, so be sure to check back for updated information  If you would like new posts emailed to you instantly, you can subscribe to our blog– just enter your email in the top right entry box located on this page.

If you would like further insights or discussion on this post, please contact Debbie Weber at 816-795-1947 or at debbie.weber@ihstrategies.com.

2013 Healthcare Compensation Surveys

Posted on January 16, 2013 by Gallagher Integrated

INTEGRATED Healthcare Strategies is excited to announce the kick-off of our 2013 National Healthcare Compensation Survey season!  We've been conducting compensation surveys for the healthcare industry for over 20 years, and we're looking forward to another year of providing a trusted resource for benchmark compensation data to help our clients make better, more informed decisions for their total compensation and reward plans.

Read the full announcement

Our compensation surveys offer comprehensive pay data on executive, director, manager, staff, nursing, advanced practice provider and medical director positions - and we even develop custom surveys.

The first survey to open in 2013 is our National Healthcare Leadership Staff Compensation Survey, taking participation on January 17.

Following is a listing of participation and publish dates for all our INTEGRATED 2013 Healthcare Compensation Surveys.

NATIONAL HEALTHCARE STAFF COMPENSATION SURVEY - Co-sponsored with ASHHRA!
Participation opens: January 17, 2013
Participation deadline: April 5, 2013
Publication: June 28, 2013

NATIONAL NURSING COMPENSATION SURVEY
Participation opens: January 24, 2013
Participation deadline: March 29, 2013
Publication: May 10, 2013

NATIONAL HEALTHCARE LEADERSHIP COMPENSATION SURVEY - Co-sponsored with ASHHRA!
Participation opens: February 14, 2013
Participation deadline: May 10, 2013
Publication: August 30, 2013

MEDICAL DIRECTOR COMPENSATION SURVEY
Participation opens: April 1, 2013
Participation deadline: June 7, 2013
Publication: August 30, 2013

ADVANCED PRACTICE CLINICIAN COMPENSATION SURVEY
Participation opens: July 11, 2013
Participation deadline: September 27, 2013
Publication: December 27, 2013

For more info, download our brochure or email comp.surveys@ihstrategies.com.  

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