Regional Hospital a 400bed community hospital was struggling

Regional Hospital, a 400-bed community hospital, was struggling with recruitment and retention issues. These issues were occurring in spite of area labor statistics that indicated that there was a sufficient supply of skilled healthcare workers to meet their needs. Regional\'s HR director undertook a comprehensive analysis of the recruitment and retention issues with the support of the board and senior management of the hospital. The HR director utilized information from a recent employee satisfaction survey and exit interviews. From those sources she learned the following: Current employees believed that Regional\'s benefit program was not competitive in comparison to other hospitals and companies in the area. For the employees who voluntarily resigned from Regional in the last 12 months, benefit issues were critical. They reported receiving employment offers that included lower healthcare insurance premiums; employer paid dental insurance; higher accruals on paid time off; and sign-on bonuses. Regional\'s healthcare competitors were aware of Regional\'s less-competitive benefits package and would aggressively recruit Regional employees, noting the differences when interviewing Regional employees. Given the findings from the HR director, what additional benefits plans should be considered by Regional Hospital? What would be the advantages and disadvantages to increasing the competitiveness of the benefits plan at Regional Hospital?

Solution

(1):Answer
Life Insurance
Life insurance protects you and your family if you die or a covered family member dies. Regions
offers the following which may differ by employee group or union:
• Employee basic life insurance – paid by Regions Hospital
• Additional optional coverage – paid by the employee:
• Employee optional life insurance
• Employee accidental death and dismemberment (AD&D) – if elected applies to
both basic and optional life insurance
• Spouse or domestic partner life insurance
• Spouse or domestic partner AD&D – if elected for employee coverage applies for
spouse
• Child Life Insurance
Basic Life Insurance
As a benefits-eligible employee, Regions Hospital provides you with basic group term life
insurance at no cost to you. The benefit amount depends on which employee group or union
you are a part of:
• Non-contract employees are provided basic life equal to your annual salary rounded to the
closest $1,000 up to a maximum of $400,000.
• Operating engineers, ADAP and pharmacists are provided basic life equal to your annual
salary rounded to the closest $1,000 up to a maximum of $100,000.
• AFSCME Service Workers and Business office clerical union employees are provided a
benefit equal to your annual salary rounded to the closest $1,000 up to a maximum of
$50,000.
• Residents are provided a benefit equal to your annual salary rounded to the closest $1,000
up to a maximum of $50,000.
Optional Life Insurance Coverage
All benefits-eligible employees may choose optional life insurance and AD&D coverage for the
employee and for his/her spouse or domestic partner and their dependent children. AD&D
insurance provides a benefit if you have certain injuries or die because of a covered accident. The
chart on the next page shows the coverage available and the rate chart will help you to calculate your cost.
Rules Governing the Order of Benefit Determinations. Other than those benefits described in paragraphs H, I and Jof this Part One, Section V, the rules in this paragraph D.1 shall be applied in the order in which they are listed todetermine which of your Health Plans is primary and which is secondary (and, if applicable, which would come third).
a. Rule 1 - Health Plan without COB provision is primary. If one Health Plan contains a provision for
coordination of benefits (“COB”) and the other does not, the Health Plan without the COB provision is primary.
b. Rule 2 - Health Plan covering you as an employee is primary. If one Health Plan covers you as an employee,
and the other Health Plan covers you as a dependent, the Health Plan covering you as an employee is primary.
c. Rule 3 - When both Health Plans cover you as a dependent child, the Birthday Rule applies.
Birthday Rule: The Health Plan covering the parent whose birthday occurs first in the calendar year is primary. If
both parents have the same birth date, then whichever Health Plan has covered a parent for a longer period of time
shall be primary.
Exception to Rule 3: Rule 3 does not apply if the dependent child’s parents are divorced or legally separated.
d. Rules 4 - 7. When a dependent child’s parents are legally separated or divorced, and each parent has a Health Plan
covering the child as a dependent, the following rules apply:
i. Rule 4 - Order or decree determines which Health Plan is primary. If a court order or decree directs one
parent to be financially responsible for the child’s health care expenses, that parent’s Health Plan shall be
primary for the child.
ii. Rule 5 - Custody determines which Health Plan is primary. If Rule 4 does not apply, and one parent has
custody of the child and has not remarried, the Health Plan of the custodial parent is primary for the child.
iii. Rule 6 - Remarried Parents. If Rule 4 does not apply, and one parent has custody of the child and has
remarried, and the child is also covered as a dependent under the stepparent’s Health Plan, then the Health Plan
of the custodial parent shall be primary for the child, the Health Plan of the stepparent shall be secondary for
the child, and the Health Plan of the non-custodial parent shall determine benefits third.
iv. Rule 7 - Joint Custody. If Rule 4 does not apply and the parents have joint custody of the dependent child,
the Birthday Rule applies.
e. Rule 8 - COBRA coverage is secondary. If another Health Plan covers you as an employee or dependent, and this
Plan covers you as a qualified beneficiary under COBRA, then the other Health Plan covering you as an employee
or dependent shall be primary.
f. Rule 9 - Laid-off or retired employees. If one Health Plan covers you as an active employee or as the dependent
of an active employee, and the other Health Plan covers you as a laid-off or retired employee or as the dependent of
a laid-off or retired employee, then the Health Plan covering you as an active employee or the dependent of an
active employee shall be primary. Exception to Rule 9: In the event that one Health Plan covering you does not
have a provision regarding laid-off or retired employees, and both Health Plans are secondary according to their
respective benefit determination rules, Rule 9 shall not apply.
g. Rule 10 - Health Plan covering you longer is primary. If Rules 1-9 above do not establish the order in which
benefits are to be determined, the Health Plan which has covered you for the longer period of time shall be primary,
and the Health Plan which has covered you for a shorter period of time shall be secondary.
1. Physical Exam. A physical exam by the provider for members 2 years of age or older. The provider decides howextensive this exam should be, based on Plan guidelines. The Plan does not cover physicals for travel outside theUnited States, or for employment, extracurricular activities, camps or recreational activities.
2. Well-Child Care. Well-child care provided by the provider for members through age The provider decides howfrequent and extensive it should be, based on Plan guidelines.
• For newborns, inpatient “well baby” services, including the initial physical are only covered when the baby isenrolled in the Plan. Newborn services will only be covered if the newborn is enrolled in the Plan as adependent within 30 days of his/her date of birth.
3. Routine Immunizations. Routine immunizations recommended by the American Academy of Pediatrics and/or U.S.Preventive Services Task Force and/or U.S. Public Health Service for people in the United States. However, the Plandoes not cover immunizations for travel outside the United States, or for employment, school sports,extracurricular activities, or recreation activities. Flu shots are covered. Persons requiring flu shots for employmentshould contact their employers occupational health office. Tetanus shots, Gardasil (human papilloma virus) and meningitis vaccine for college students are covered as recommended by the provider. The shingles vaccine , flu shot,and the pneumonia vaccine are also available under the Express Scripts Pharmacy benefit from local pharmacies at nocharge for members age 14 and older.
4. Routine Sight, Speech and Hearing Screenings for Children. Routine screenings of vision, speech and hearing formembers through age 17. In the event of a diagnosis of hearing loss, the Plan does cover the initial audiometric exam.However, the Plan does not cover testing or fitting for hearing aids, or hearing, occupational, or educational therapy,except for children under the age of 22.
5. Well Eye Exam. One eye exam per calendar year. The exam includes routine screening for eye diseases andassessment of the need for corrective lenses. A prescription for corrective lenses may be given, but the Plan does notcover the cost of the lenses Fitting for contact lenses is not covered by the Plan. However, any prescription given during the well eye exam can betaken to the practitioner who will be fitting the contact lenses.
Coordination of Benefits (COB)
cash balance pension plans
legal regulation of retirement
age discrimination
early retirement
social security
emergency services
ambulatory patient services
hospitalization
laboratory services
consumer exclusions
time off benefits
medical and sick leave
paid time off and extended illness banks
organizational incentives
(2):Answer
Advantages :
Grown in popularity
Incentives do work
Develop clear,understandable plan
clearly link performance results
Save money and energy to the employees, improve service quality
Although suicide rates unchanged but increase health society
customer satisfaction
Save money due to the combined re-sources, buying power grew and achieve expanded access to health information
Increase the number of outpatient visits and reduce inpatient days. cost growth was negative in periods of time
Disadvantage:
Not grown in popularity
not incentive then not do work
Lack of access to adequate care
specialty care, acute, surgical and so on, Increase partici-pation of the private sector in the financing was not adequate and do not increase clinical activities
Dysfunction and de-creased well-being of hospital employees
Decrease job satisfaction, increase absenteeism and weakened mental status among employees
Job satisfaction and mental capacity decreased among survival of downsizing
Quality of service re-mains unchanged - increase workload and decrease in mental ca-pacity of employees
Dysfunction and de-creased well-being of hospital employees
Impact on the quality was low but costs was reduced
un experienced employees inclined to leave organization more than experiences