Who’s the Boss of Workplace Culture?


bossWho’s the Boss of Workplace Culture?

HR professionals, managers, and employees have very different opinions about workplace culture: who drives it, what’s important to creating a great culture, and what can destroy it, according to a study by Kronos Inc. and WorkplaceTrends.com. The survey reveals the following:

Who Defines Workplace Culture?

  • About one-third of HR professionals say that the head of HR defines the culture while only 10% of managers and 3% of employees agree.
  • 26% of managers say their executive team defines the culture while only 11% of HR professionals and 9% of employees agree.
  • 29% of employees say the employees define workplace culture while only 9% of HR professionals and 13% of managers agree.
  • 40% of Millennial employees say that employees define the culture – an indication of an evolving view of workplace culture where employees feel they have more power.
  • 28% of employees say that no one defines the workplace culture while only 5% of HR professionals and 7% agree.

What Improves Workplace Culture

Employees say that the three things that matter most to having a good workplace culture are pay (50%), coworkers who respect and support each another (42%), and work-life balance (40%). HR and managers are off base on their assumptions. HR professionals say the top three things that matter to employes are managers and executives who lead by example, employee benefits, and a shared mission and values. Managers say say that what matters most to employees are managers and executives who lead by example, a shared mission and values, an emphasis on taking care of customers. Twenty-five percent of HR professionals and 29% of managers say that pay is a top factor in how employees view workplace culture.

What Kills Workplace Culture

HR professionals and managers say that a high-stress environment and company growth are the most damaging to workplace culture. Employees say that not having enough staff to support goals, dealing with unhappy/disengaged workers who poison the well, and having poor employee/manager relationships are most damaging.

Other Factors

The survey also reveals that technology, job hopping, and Glassdoor-like pressure have changed the culture. Forty-three percent of HR professionals and 39% of managers say that using technology to improve culture is the biggest difference compared to a decade ago. Forty percent of HR leaders say there is more pressure to maintain an attractive culture for recruiting because more information about organizations can be easily found on sites like glassdoor.com. Twenty-three percent of HR professionals and 22% of managers say that their employees switch jobs too much to establish a solid culture.
Seventy-two percent of HR professionals and 61%, managers say that training and development improve workplace culture. Forty-five percent of HR professionals and 46% managers say that getting feedback from employees and acting on it improves workplace culture.

Dan Schawbel, founder, WorkplaceTrends says, “Among all of this interesting data, what struck me most is that 40% of Millennial employees believe that employees create the workplace culture, compared to 29% of employees. This is important. Each generation changes the workplace as they rise up the ranks. Millennials…believe the power to impact workplace culture lies predominantly with the people who do the work. HR professionals and managers should take note of this, look for ways to involve employees in the development of workplace culture, and be on the lookout for disengaged workers who may be poisoning the well – they wield more power than you may think.” For more information, visit workforceinstitute.org.


Employers Seek Answers as Opioid Deaths Escalate

Sixty-one percent of all narcotic-related deaths result from prescription and non-prescription use of opioids. There are more than three deaths per hour in the United States from opioids. A new report from Lockton finds that failures in our workers’ compensation systems have permitted unnecessary prescriptions and contributed to these troubling trends.

Keith Rosenblum, senior strategist with Lockton Companies says, “Contrary to medical treatment guidelines, approximately one-third of sidelined workers with new low-back injuries get opioids during the first six weeks after injury and usually at the first doctor visit. Research suggests that receiving two opioid prescriptions during this early time frame is associated with a doubling of the risk of disability at one year.”

Fourteen states have passed or are creating legislation to have closed formularies for workers’ compensation to control unnecessary narcotic prescriptions to treat acute and chronic pain. “It is certainly a significant step in the right direction but it’s not enough to address the root causes of the chronic pain predicament,” says Rosenblum.

Rosenblum said, “Employers are not without recourse. The outdated biomedical model of pain management has now been replaced by the bio-psychosocial model of pain management, which considers the whole person—physical and emotional—and addresses the source of pain, permitting physicians to treat their chronic pain patients more effectively.” For more information, visit lockton.com.



State Finalizes Medical Provider Network Rules

The California Dept. of  Insurance has issued final regulations that include requirements for health insurers to create and maintain adequate medical provider networks. “These regulations go into effect immediately because they address a number of critical problems consumers have faced with insurers when seeking timely access to care,” says Insurance Commissioner Dave Jones. He had issued temporary emergency regulations, which have been in effect since late January 2015. The regulations require health insurers to do the following:

  • Include enough numbers and types of providers in the network to deliver covered services.
  • Adequately provide for the treatment of mental health and substance use disorders.
  • Include an adequate number of primary care providers and specialists with admitting and practice privileges at network hospitals.
  • Monitor and adhere to new appointment wait time standards.
  • Regularly report information about the networks and changes to the networks to the Dept. of Insurance for review.
  • Maintain accurate provider network directories available to the public and update them weekly.
  • Arrange out-of-network care at in-network prices when there are insufficient in-network care providers.


Healthcare Advocacy Experts Offer Key Services in San Diego

Viveesa, a new, private healthcare advocacy firm, is now available in the San Diego area. For individuals, the advocate serves as the point-person for communicating with providers before the first visit takes place and until care is concluded. They can even accompany patients to medical visits. The menu of services includes handling administrative medical paperwork, setting up appointments, coordinating care, overseeing insurance claims and billing, reviewing and negotiating medical bills, sourcing the latest research and resources when needed, and interfacing with family members and care givers. Viveesa advocates help clients find health care providers, including traditional, integrative, holistic, and mental health professionals. Patients who try to resolve complex medical-care issues through their company’s human resources department may encounter difficulties, finding instead that HR personnel do not understand the intricacies of medical billing or insurance reimbursement. Viveesa also provides services through employers. For more information, visit viveesa.com



The National Assn. of Fixed Annuities is sponsoring a webinar Thursday, March 31 at 8:30 a.m. PT It will feature the top 10 fixed annuity compliance issues in the coming year and beyond. For more information, visit NAFA.com.



Insurers Must Transform to Serve the Digital Native Generation

Research from PwC reveals that 71% of consumers have used digital research before buying a policy. About 26% of consumers purchase their plans online, with this number set to continue rising, particularly among the Millennial generation.

Most insurance companies use an eCommerce model to sell traditional offline services in an online store. Savvy insurers are developing more personal and longer lasting relationships by using digital capabilities to improve their customers’ knowledge base. Nitin Rakesh, CEO and president of Syntel says that insurers can understand consumer sentiment better by engaging with them through social media. Raskesh says that digital natives expect an omni-channel experience that allows them greater accessibility to anytime, anywhere services – something that may be difficult for traditional insurers to deliver.

A recent report from IDC states that two-thirds of CEOs will focus on digital transformation strategies throughout 2016, which underscores the importance of these decisions. In the past, these strategies were the dominion of CIOs,. Rakesh says, “With many insurers stuck with business critical legacy systems, the biggest challenge is to keep pace with digital innovations while maintaining and automating business critical legacy systems. Automation allows for faster and more cost-efficient transformations.” For more information, visit pwc.com.

Best Practices for Customer Engagement

The average customer distrusts insurance companies. To overcome this challenge, insurers are targeting customer segments. They want to be perceived as the consumer’s partner in care by continually engaging members, according to a report by IDC Health Insights. Jeff Rivkin of IDC says that the customer relationship has become paramount for insurers as health insurance benefits and pricing become commoditized due to the Affordable Care Act (ACA). There is emerging demand for an integrated customer engagement strategy, which enables automated interactions, shared communications, appropriate transactions, and information transparency among the health plan, the provider, and the consumer. Recently, insurer engagement has expanded into social networking and connected devices.

On the horizon are systems that address data on claims, enrollment, and payment administration. Systems will also address patient care coordination, behavior, events, mental health, health records, and psychographic profile data. There is a great need for true native insurer-customer relationship management (CRM) applications, and the market is responding to this demand, according to the study. IDC Health Insights says that this new personalization must be tempered by a healthy respect for privacy and security. Otherwise, the customer experience could revert back to the adversarial claims-based days of the past. “Customers now have choice and will switch insurers if their experience deteriorates; they expect more, like other retail or financial experiences they have,” Rivkin says. For more information, visit idc-community.com/health.




Employees Worry About the Future of the Health Care System

Confidence about today’s health care system has remained fairly level among American workers in recent years, but they are worried about the future according to a survey by the Employee Benefits Research Institute (EBRI). The survey reveals the following:

  • 47% of workers are extremely or very confident about their ability to get the treatments they need today; 33% are confident when they look out over the next 10 years; and 26% are confident when they consider the Medicare years.
  • 42% are confident that they have enough choices about who provides their medical care today; 30% are confident when they look out over the next 10 years; and 25% are confident when they
  • consider the Medicare years.
  • 30% of workers are confident that they can afford health care without financial hardship today, 25% are confident when they look out over the next 10 years, and 24% are confident when they consider the Medicare years. For more information, visit EBRI.org.

Physicians Are Optimistic About New Payment Models

Physicians are cautiously optimistic about new payment and delivery models, such as pay-for-performance, patient-centered medical homes, and accountable care organizations, which tie reimbursement to quality and performance outcomes. Physicians say that these models may deliver better patient care and more efficient medical practices. Fifty-five percent of physicians participate in an alternate payment model, and more than one-third of them have been doing so for over three years. Eighty percent are open to an alternative payment system. Only 41% of physicians say that the fee-for-service model is optimal for delivering positive patient outcomes. That figure drops to 28% among doctors under 35. For more information, visit businessgrouphealth.org.


What Consumers Are Saying About Obamacare and Cancer Coverage

When consumers talk about Obamacare online, cancer is the most frequently discussed health condition, according to a report by Treato. Online, consumers discuss cancer 2.5 times more often than any other health condition. When discussing cancer, the leading topics are breast, lung, and colon cancers. Online discussions about Obamacare generally skew negative among cancer patients, but those who are positive express extreme gratitude. Twenty percent of patients and caregivers on cancer forums express gratitude and 48% have various criticisms about Obamacare.

Conversations about the downside of Obamacare’s cancer coverage generally fall into two categories: dissatisfaction with coverage and frustration with the lack of plan options. Consumers discuss the challenges of deciphering insurance rules to get the coverage they want, and confusion about subsidies, exclusions, inclusions, and co-pays.

Consumers are also complaining that certain groups are gaining more from Obamacare. The strongest criticisms are about women having access to more preventative screenings and more coverage for conditions, such as for breast cancer, and the poor getting free coverage. Consumers are also critical of other health conditions getting less coverage than cancer.

Consumers complain about losing good private insurance plans because of Obamacare and paying more out-of-pocket for cancer treatment. Many say that Medicare and Medicaid are simpler to access and easier to understand. Those who like Obamacare cite preventative screenings, coverage of pre-existing conditions, removal of lifetime limits on coverage, and the affordability of coverage. For more information, visit treato.com.


Express Scripts Slows Increase in Drug Spending

Express Scripts says that it has slowed drug spending increases despite price inflation of greater than 20% on more than one-third of brand-name medications in 2015. For Express Scripts members, average monthly copayments decreased 3.2% Change in drug spending was flat or negative for 30% of Express Scripts clients in 2015. Express Scripts Hepatitis Cure Value Program lowered the cost of therapy by 50%, saving insurers $1 billion while providing curative treatment to nearly 50,000 patients.

Glen Stettin, M.D., chief innovation officer at Express Scripts said, “Drugmaker consolidation, price hikes ahead of impending patent expirations, and hyperinflation on older medications without therapy class competition…contributed…to increased drug spending. Fortunately, insurers…can leverage the generic availability of specialty medications like Gleevec (imatinib), which experienced a three-fold price increase over the past 10 years before it lost patent protection last month. [Insurers can] also tap into the potential $39.7 billion in savings from biosimilars over the next five years.”

Hepatitis C treatment was a leading driver of record drug spending in 2014. However, insurers enrolled in Express Scripts’ Hepatitis Cure Value Program provided curative therapy to all hepatitis C patients, not just those with the most severely damaged livers. In 2015, these insurers lowered the cost of curative therapy by 50%. In addition, the Accredo specialty pharmacy delivered industry leading persistency rates for Viekira Pak (ombitasvir/paritaprevir/ritonavir; dasabuvir) and Harvoni (ledipasvir/sofosbuvir) of 93% to 94%, compared to 83% to 92% at other retail and specialty pharmacies.

Plans that leverage competition among similar drugs in the same therapy class are keeping down costs while maintaining quality. Leveraging competition to maximize brand rebates helped insurers control spending. Drug manufacturer rebates increased in 2015, contributing to a 2.7% decrease in the 2015 drug trend.

Specialty medications accounted for more than 37% of drug spending in 2015, and are expected to reach 50% by 2018. Spending on specialty medications increased 18% in 2015.

Biosimilars or non-brand alternatives, for Remicade (infliximab) and Humira may reach the U.S. market in 2017. In addition, their approvals for use in multiple indications provide opportunities for insurers to consider indication-based reimbursement to help control their impact on pharmacy budgets.

Among non-specialty therapy classes, diabetes was the most expensive, with an increase in spending of 14%, driven equally by increases in utilization and unit costs.

Total drug spending is expected to increase from 6% to 8% annually from 2016 to 2018, net of rebates. Specialty spending, led by inflammatory conditions and new discoveries for cancer, is expected to increase an average of 17% annually over the next three years.

Among the ACA exchanges, per-member-per-year spending for traditional and specialty medications was less than the commercially insured population in 2015. However, the increase in spending was 15% from 2014 to 2015 for the exchange population, which was higher than the trends among commercial, Medicare, and Medicaid populations. An 8.6% increase in prescription utilization was the primary driver for the spending increase, a trend that may be due to newly insured beneficiaries fully using their new prescription drug benefit. Julie Huppert, vice president of Health Care Reform, Express Scripts said, “Trends in this market should settle as benefit usage stabilizes, and plans learn more about their patients and implement additional proven pharmacy management programs.” For more information, visit Lab.Express-Scripts.com.


Medicare to Enforce Profiteering at the Bedside

In the guise of “value pay” or “value purchasing,” the new Medicare payment system will reward doctors for not ordering services. This amounts to “a corporate or government agency profiteering, i.e., taking advantage of a situation to make a self-serving profit by corrupting the provision of care,” writes Robert Geist, M.D., in the spring issue of the Journal of American Physicians and Surgeons. The following is a summary of his comments:

            Advocates of managed care have long believed that cost control necessitated a switch of professional loyalty from patients to corporate populations. Previously forbidden and unethical, the corporate practice of medicine has been legalized. Federal laws against kickbacks and self-referrals have also been overridden. Medicare is turning doctors into bedside rationing agents..

The enabling act is the “doc fix,” the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA), which replaced the Sustained Growth Rate (SGR) formula and its yearly threats to drastically cut doctors’ pay.

MACRA’s Merit-Based Incentive Payment System (MIPS) hides its agenda to deny care behind euphemistic double-speak, such as “bonus opportunities”—meaning bribes to gatekeepers. As George Orwell wrote in 1946, “Political language…is designed to make lies…truthful and murder respectable.”

What happens to the ethical integrity of a nation and its professionals when leaders create a system where doctors are bribed to restrict care at the bedside for the benefit of third-party insurers?

“Value pay” conveys an image of social concern, but it actually gives enormous contracting power to insurers—the “power to transfer insurance risk and the black hat of profit-driven rationing of care to providers at the bedside.

The government regulator is supposed to guard against such consequences, but has been co-opted into collusion. The Obama Administration has winked at and abetted rotating chairs between the CMS regulator and the regulated HMO industry management. When former Medicare regulator Marilyn Tavenner became CEO of the industry trade association, President Obama promptly nominated Andrew Slavitt, an HMO (UnitedHealth Group) executive, as the new interim CMS regulator. The system is creating a conflict of interest between doctors and patients. Geist concludes that a good end, such as cost control never justifies corrupt means, a scandalous system of legalized profiteering at the bedside.



Health and Well-Being Scorecard on International Employers

HERO and Mercer launched The HERO Health and Well-being Best Practices Scorecard. The free Scorecard, allows employers to evaluate their health and well-being efforts based on best practices compiled by industry leaders. The domestic version of the Scorecard has been available since 2008.

The Scorecard asks employers about their support for employee health and well-being, program offerings, integration of health and well-being programs with other areas of the company, strategies to encourage participation (such as communications and rewards), program costs, and outcomes. After submitting the online scorecard, the employer immediately receives an email showing their best practice scores in six areas that contribute to employee well-being. For more information, visit hero-health.org.


Retirement Age Predictor

AboutLife is offering a recommendation engine that identifies opportunities to close the gap in customers’ retirement needs, making it possible to retire four to nine years earlier, on average. Users can connect with hand-picked certified financial advisors to answer questions about retirement planning, without the cost and commitment imposed by the traditional financial planning model. For more information visit aboutlife.com.