4 keys to picking the right benefits admin system
Original Post by HRMorning.com
By: Jared Bilski
With HR departments at small companies stretched so thin (many times one staffer handles all of HR), it’s no surprise many small companies are using benefits administration systems for their needs. But with new software vendors popping up every day, how do HR pros find the right system?
At the Dig|Benefits Conference in Austin, TX, Joshua N. Jeffries, a partner with Arkin Youngentob Associates, LLC, outlined the four most important steps small employers should take when selecting an “efficient, cost-effective” benefits administration system:
Selection checklist
Step 1: Define your needs. What are you looking for in a benefits administration system? This step needs to go beyond HR and incorporate all departments within the company. Jeffries reminded HR pros that Benefits has one of the top Profit/Loss (P/L) line items for most businesses. Any soft-dollar spending in this area needs to be justified in your compensation plans.
Step 2: Evaluate your vendor. With the sheer number of vendors out there, this step can seem a bit daunting. But the process is much less intimidating when HR pros break it down into small questions.
Examples: What type of back-end customer support do I need? Is it broker-friendly — in other words, will most brokers be able to use the system easily and effectively? Does the system account for all ACA and other federal and state regs? Does the system offer a mobile component? Does the data make it home? If the system is giving employees easy access to their benefits, it should offer a mobile component for spouses and dependents. After all, most families use smartphones for virtually everything.
Step 3: Understand the implementation process. Obviously, you’ll want the system to be as accurate as possible, so you’ll want to do your homework and find out any vendors with less-than-stellar track records in this area. You’ll also want to find out if the system updates automatically or if that’s a separate undertaking.
Step 4: Change your culture. For many employees, any type of change is difficult. If your benefits administration system alters the way people are used to doing things, which it most likely will, you have to account for that — and find ways to make sure the new system can positively impact your company’s culture. Here, Jeffries lauded the use of employee committees as a means to educate staffers on how everything works and all that workers can get from a new system.
Based on “Platform Power — Solving Ben Admin For Small Businesses,” by Joshua N. Jeffries, as presented at the Dig|Benefits Conference in Austin, TX.
Pet insurance growing as an employee benefit option
Originally posted on https://www.stockhouse.com
An increasing number of companies in North America are offering pet insurance to employees in an effort to attract better hiring candidates, U.S. experts say.
According to Veterinary Pet Insurance president Scott Liles, around 3400 companies and associations offer the benefits as an employee enticement and retention tool.
Nevada's largest employer, MGM Resorts International (NYSE: MGM, Stock Forum), added pet insurance for employees in 2006 and Chipotle (NYSE: CMG, Stock Forum) has been offering the benefits since 2002.
Of the 165 million pets estimated to reside in the United States, only a small portion are covered by pet insurance, but as veterinary costs rise, an increasing number of employers are providing it as part of their benefits package, with Chipotle subsidizing $10 per month, per pet, for up to three per employee.
The organization says only around a hundred employees take them up on the offer, which covers the low end of pet insurance costs of anywhere up to $57 a month, according to a company official talking with UPI.
Pet retailer PetSmart (NYSE: PETM, Stock Forum) offers insurance for employee pets, offering comprehensive coverage for illness and accidents, coverage for tests, X-rays, medication, hospitalization and surgery, a 5 per cent group rate discount and enrolment fee waiving, and death benefits.
-Chris Parry, Stockhouse.com
Job satisfaction beats salary
Workers willing to exchange money for being happy on the job
Originally posted by Andrea Davis on https://ebn.benefitnews.com
Even in the face of a turbulent economy and competitive job market, 68% of working Americans would be willing to take a pay cut to work in a job that better allowed them to apply their personal interests to the workplace. Moreover, almost one-quarter of workers (23%) would take a pay cut of 25% or more. The results come from a survey of 1,000 working Americans conducted by Philips North America. (see the infographic on page 41 for more survey results.)
Old paradigm gone
"Seven percent were willing to take a 50% pay cut. That's a life changing number but it's something people were willing to give up to have a career opportunity that was really consistent with their passions and goals," says Russell Schramm, Philips' head of talent acquisition for the Americas. "The whole paradigm of getting your degree, getting a job, making money regardless of what you're doing, is gone."
Forty-eight percent of workers who are able to leverage personal interests in the workplace say they are very satisfied, according to the survey.
"In talent acquisition, we talk a lot about what makes a person accept a position or leave a position and we're seeing, more and more, that meaningful work and work that is relevant to them and their personal passions is becoming more prominent," says Schramm, adding that one of his biggest challenges is being able to identify those personal passions and interests in the candidates who come in for interviews.
"Empowering my team to look at not just what's on the résumé, but [to] look at beyond what's on the résumé [is important]," he says. "What is the motivating driver? What is this person interested in? How are they going to apply that to Philips?"
Talent acquisition is rapidly shifting, he says, "from a transactional, requisition-based process to a much more qualitative process where we're looking for people with a deeper set of skills above and beyond the hard skills that are just required to do the job."
Career path regrets
Forty-one percent of those who don't apply personal interests through their work regret their career path, whereas only 23% of workers who are able to do so regret theirs. More than half (51%) of those surveyed have never changed career paths to integrate their work and personal life in a more meaningful way.
"The survey was our way of understanding what motivates people in the labor market," says Schramm, of the reasons for conducting the survey. "We wanted to understand some of those things that really drive talented individuals in the labor market so we could develop and deliver a workplace reality that would be attractive to those folks."
Now What? Employer Benefits Obligations Post-DOMA
Originally posted by Stephen Miller on https://www.shrm.org
On June 26, 2013, the U.S. Supreme Court, in United States v. Windsor, found unconstitutional Section 3 of the federal Defense of Marriage Act (DOMA), which had prohibited the federal government from acknowledging marriages between same-sex couples. Same-sex marriages were recognized as legal by 12 states and the District of Columbia at the time of the ruling. In a related case, Hollingsworth v. Perry, the court ruled that those challenging a California state court decision that made same-sex marriage legal in California (by overturning a state ballot initiative known as Proposition 9) lacked standing to do so—a finding that will restore legal same-sex marriage in the state.
“The Windsor decision is as many expected," Roberta Chevlowe, senior counsel in law firm Proskauer's employee benefits practice center in New York, told SHRM Online. "While the court held that Section 3 of DOMA (which defines 'marriage' and 'spouse' as excluding same-sex partners) is unconstitutional on equal-protection grounds, the decision does not force same-sex marriage on the states, which appear to continue to be free to define marriage as they wish and not recognize same-sex marriage."
For employers, "the Windsor decision means that there is much work to do with regard to the employer's benefit plans, even for employers who do not operate in states that recognize same-sex marriage," Chevlowe added. "On the health benefits side, among other things, employers will need to revisit the definition of 'spouse' in their plans to ensure that the definition is consistent with the employer's intent, in light of the decision. Employers may also need to cease imputing income to employees for the value of the health benefits they provide to same-sex spouses. With regard to qualified pensions, plan language and procedures will need to be considered because same-sex spouses have additional rights to federally protected benefits."
In addition, "Employers should expect that employees will immediately start asking questions about their rights with regard to various employee benefits, and employers will need to consider carefully the scope of the decision and various issues relating to the implementation and effective date of the decision with regard to these issues,” Chevlowe said.
Expanded Obligations
In an e-mail, Todd Solomon, an employee benefits partner at law firm McDermott Will & Emery LLP in Chicago, identified the following as key benefits implications for private-sector organizations (but not necessarily state government and church employers) now that Section 3 of DOMA has been struck down.
For a legally married couple who live in a state where same-sex marriage is recognized:
- Federal laws governing employee benefit plans will require companies to treat employees’ same-sex and opposite-sex spouses equally for purposes of the benefits extended to spouses.
- Employers with self-insured welfare plans (meaning benefits are paid out of the company’s general assets) may not have to extend spousal-benefit coverage to same-sex spouses, because federal law does not require spousal welfare-benefit coverage and because state insurance law mandates do not apply to self-insured plans. However, employers that continue to provide benefit coverage only to opposite-sex spouses "are almost certain to face legal challenges under federal discrimination law," Solomon advised.
- Employees will no longer have to pay federal income taxes on the income imputed for an employer’s contribution to a same-sex spouse’s medical, dental or vision coverage. And workers can pay for same-sex spouses’ coverage on a pretax basis under a Section 125 plan.
- Businesses will have to offer COBRA continuation coverage to same-sex spouses.
- Employers with pension plans will be required to recognize same-sex spouses for purposes of determining surviving-spouse annuities. Same-sex spouses must also agree to receive payment of their deceased spouse’s pension benefits in a form other than a 50 percent joint and survivor annuity, with the same-sex spouse as the beneficiary.
- Organizations with 401(k) plans will have to recognize same-sex spouses for purposes of determining death benefits, and same-sex spouses must consent to beneficiary designations.
- Employees must be permitted to take family and medical leave to care for an ill same-sex spouse.
"The above rules only apply to same-sex spouses who were married in and live in a state where same-sex marriage is legal,” Solomon clarified. “The big open question is what happens to same-sex spouses who live in states such as Florida or Texas," which don't recognize same-sex marriages. "No one can answer the question until additional guidance is issued. It is possible that the answer can vary for different purposes—for example, state of residence will likely carry the day for tax filing and imputed income purposes, but it is possible the IRS could say that 'state of celebration' governs for pension plan purposes. In the meantime, it appears that employers can choose either approach, but it will be imperative to amend plans to add clear plan language to document the employer's approach."
The decision "will affect retirement plan administration because plans will have to obtain the consent of the same-sex spouse to permit a waiver of the qualified joint and survivor annuity (QJSA) form of benefit or for any other purposes for which the consent of an opposite-sex spouse is required," in states that recognize same-sex marriages, concurred Leslye Laderman and Marjorie Martin, principals at Buck Consultants LLC. "It is unclear from theWindsor ruling whether employers will be required, or permitted in the case of the QJSA, to recognize same-sex spouses of employees living in states that do not recognize same-sex marriages as spouses for purposes of these laws. Additional guidance is needed."
Retroactive Benefits
Another question is whether employees can claim benefits retroactively—for instance, seeking past tax relief for spousal health care benefits—if they've been married to their same-sex spouse in a state that recognizes same-sex marriage. Solomon observed: "It is certainly not clear yet, but I would think employees should be able to amend tax returns for open years to claim refunds. And employers should be able to get refunds of FICA taxes for prior open years."
Retroactivity “is one of the most important practical questions facing employers and plan sponsors" following the DOMA ruling, added Joanne Youn, an ERISA and benefits law attorney at Caplin & Drysdale in Washington, D.C. "While the court did not specifically address retroactivity broadly, the decision arose out of a claim for refund of estate taxes paid by a same sex-spouse in a prior tax year. The IRS has authority under existing law to grant relief from retroactivity; however, even if it were to do so, its authority would not extend to other statutes affecting employee benefits, such as ERISA. The decision itself references the fact that over 1,000 federal laws contain provisions specifically applicable to spouses that may be affected and should be coordinated. Therefore, I would expect that additional guidance will be issued in the coming months.”
Deferring to State Law
Rita F. Lin, a partner at Morrison Foerster in San Francisco, said that many federal laws governing spousal benefits do not contain a statutory definition indicating which law governs whether an individual is “married.”
"Typically, federal laws defer to state law on this issue,” Lin explained, “but it will often be an open question under choice-of-law principles whether the applicable state law is the law of the state in which the couple was married or the state in which the couple currently resides. Some federal statutes (e.g., Social Security) look to whether a couple is married at the time that benefits are sought, which may suggest that the law of the state of current residence will apply. Others (in the immigration context) look to the state where the couple was married."
Lin revealed that there are "rumors that the administration may be considering an executive order that directs federal agencies, in interpreting federal statutes, to treat the state where the marriage celebration occurred as the governing state for purposes of determining whether couples are married.” She added: “I would note that, though there may be some short-term confusion, this is not technically a new issue. The states vary in their definitions of marriage on issues like common-law marriage, first-cousin marriage and age of eligibility, so this could always be an issue when married couples move to a new state that does not recognize their marriage. Of course, the issue is now going to be presented on a much larger scale than before, so we may see an attempt to resolve this in a more uniform fashion."
Presidential Action
Similarly, Hunter T. Carter, a litigation partner at Arent Fox in New York and Washington, D.C., said: "The president is crucial to implement the Supreme Court decision overturning DOMA, and employers will be watching to see what the president does. Everywhere he can do so, President Obama is expected to approve regulations and interpretations that apply the term 'spouse' to same-sex couples who were legally married, regardless where the couple was from or has moved."
Changing regulations that define "spouse" may take longer than an executive order, Carter said, "but again, President Obama will be crucial. Currently, the IRS and Social Security determine marriage status by where the couple lives, not where they married, so anyone in the 38 states that don't yet recognize or allow same-sex marriage will be unmarried for IRS and Social Security purposes until regulations can be changed. This is true even though they are otherwise identical to their neighbors who may have married in another state, like New York, which also allows same-sex marriage. Other agencies will not need to change, like the Defense Department, which interprets marital status based on where the couple was married."
Supreme Court Issues Decision in U.S. Airways vs. McCutchen
Source: https://ebn.benefitnews.com
By Andrea Davis
The Supreme Court ruled 5-4 last week that James McCutchen, a U.S. Airways, Inc., employee does not have to pay his health plan back all of the money he recovered following a car accident.
The case raised the issue of whether a benefit plan administrator is entitled to full reimbursement for payments made to a plan participant injured in an accident where the participant sues and recovers damages from a third party.
According to the decision, the health plan has a right to be reimbursed, but McCutchen should be able to charge his health plan for part of his lawyers’ fees.
“The Court basically said two things: the plan is a contract between the employer-plan sponsor and the employees and, pursuant to that contract, if the plan says ‘we’re going to recover, dollar for dollar, what we paid you as soon as you recover, regardless of the circumstances,’ that should be enforced,” says Myron Rumeld, a lawyer with Proskauer. “That’s the broad proposition the employer community is taking from the case.”
Secondly, and more specific to this particular case, “the majority of the justices said ‘look, in this case, we don’t find the plan language so clear as to whether it was intended to mean a recovery before taking into account the attorneys’ fees that were spent, or after,’” says Rumeld. “… in this particular case [the justices said] ‘we’re going to limit the reimbursements to take into account the fact the plan should pay a share of the attorneys’ fees that were spent to generate the recovery. That’s called the common fund doctrine.”
Rumeld believes the decision is favorable for plan sponsors for two reasons. “The simple reason is it creates more certainty. It tells employers that if you draft your plans a certain way and you make them clear enough, you don’t have to worry you won’t get your own terms enforced … there’s certainty in knowledge. You can draft the plan document and know it’s going to be enforced,” he says. “It also means that if you want to have the ability to recover dollar for dollar what you paid, you’re going to have the ability to do that if you draft it into the plan language.”
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Upper-income Seniors Face Medicare Hike
Source: https://www.benefitspro.com
By Ricardo Alonso-Zaldivar - Associated Press
President Barack Obama's new plan to raise Medicare premiums for upper-income seniors would create five new income brackets to squeeze more revenue for the government from the top tiers of retirees.
The administration revealed details of the plan on April 12th after Health and Human Services Secretary Kathleen Sebelius testified before the Congress on the president's budget. The details had not been provided when the budget was released earlier in the week.
The idea of "means testing" has been part of Medicare since the George W. Bush administration, but ramping it up is bound to stir controversy. Republicans are intrigued, but most Democrats don't like the idea.
The plan itself is complicated. The bottom line is not: more money for the government.
Obama's new budget calls for raising $50 billion over 10 years by increasing monthly "income-related" premiums for outpatient and prescription drug coverage. The comparable number last year was $28 billion over the decade.
Currently, single beneficiaries making more than $85,000 a year and couples earning more than $170,000 pay higher premiums. Obama's plan would raise the premiums themselves and also freeze adjustments for inflation until 1 in 4 Medicare recipients were paying the higher charges. Right now, the higher monthly charges hit only about 1 in 20 Medicare recipients.
House Budget Committee Chairman Paul Ryan, R-Wis., asked Sebelius about the new proposal last Friday, noting that it would raise significantly more revenue. Part of the reason for the additional federal revenue is that Obama's 2014 budget projects an additional year of money from the proposals. The rest of the answer has to do with the administration's new brackets.
Starting in 2017, there would be nine income brackets on which the higher premiums would be charged. There are only four now.
If the proposal were in effect today, a retiree making $85,000 would pay about $168 a month for outpatient coverage, compared to $146.90 currently.
Under current law, the next bump up doesn't come until an individual makes more than $107,000. Under Obama's plan, it would come when that person crosses the line at $92,333. If the plan were in effect today, the beneficiary would pay about $195 a month for outpatient coverage under Medicare's Part B, rather than $146.90.
The top income step — currently more than $214,000 — would be lowered to $196,000. And individuals in the new top tier would pay 90 percent of the cost of their outpatient coverage, compared to 80 percent currently.
The administration did not provide a comparable table for the effects on married couples.
The impact on monthly premiums for prescription drug coverage is hard to calculate, since different plans on the market charge varying premiums.
Sebelius told lawmakers the Medicare proposals in the budget are intended to strike a balance between cutting health care spending to reduce the deficit and maintaining services for people who depend on them.
"This proposal would improve Medicare's long-term financial stability by reducing the federal subsidy for people who can afford to pay more for their coverage," said Medicare spokesman Brian Cook.
Obama to Propose Cuts to Social Security
Source: https://www.benefitspro.com
By Jim Kuhnhenn
President Barack Obama's proposed budget will call for reductions in the growth of Social Security and other benefit programs while still insisting on more taxes from the wealthy in a renewed attempt to strike a broad deficit-cutting deal with Republicans, a senior administration official says.
The proposal aims for a compromise on the Fiscal 2014 budget by combining the president's demand for higher taxes with GOP insistence on reductions in entitlement programs.
The official, who spoke on a condition of anonymity to describe a budget that has yet to be released, said Obama would reduce the federal government deficit by $1.8 trillion over 10 years. The president's budget, the first of his second term, incorporates elements from his last offer to House Speaker John Boehner in December. Congressional Republicans rejected that proposal because of its demand for more than a $1 trillion in tax revenue.
A key feature of the plan Obama now is submitting for the federal budget year beginning Oct. 1 is a revised inflation adjustment called "chained CPI." This new formula would effectively curb annual increases in a broad swath of government programs, but would have its biggest impact on Social Security. By encompassing Obama's offer to Boehner, R-Ohio, the plan will also include reductions in Medicare spending, much of it by targeting payments to health care providers and drug companies.
Obama's budget proposal also calls for additional tax revenue, including a proposal to place limits on tax-preferred retirement accounts for wealthy taxpayers. Obama has also called for limits on tax deductions by the wealthy, a proposal that could generate about $580 billion in revenue over 10 years.
The inflation adjustment would reduce federal spending over 10 years by about $130 billion, according to past White House estimates. Because it also affects how tax brackets are adjusted, it would also generate about $100 billion in higher taxes and affect even middle income taxpayers.
The reductions in the growth of benefit programs, which would affect veterans, the poor and the older Americans, is sure to anger many Democrats. Labor groups and liberals have long been critical of Obama's offer to Boehner for including such a plan.
Administration officials have said Obama would only agree to the reductions in benefit programs if they are accompanied by increases in revenue, a difficult demand given the strong anti-tax sentiment of House Republicans.
That Obama would include such a plan in his budget is hardly surprising. White House aides have said for weeks that the president's offer to Boehner in December remained on the table. Not including it in the budget would have constituted a remarkable retreat from his bargaining position.
Obama's budget, to be released next Wednesday, comes after the Republican-controlled House and the Democratic-run Senate passed separate and markedly different budget proposals. House Republicans achieved long-term deficit reductions by targeting safety net programs; Democrats instead protected those programs and called for $1 trillion in tax increases.
But Obama has been making a concerted effort to win Republican support, especially in the Senate. He has even scheduled a dinner with Republican lawmakers on the evening that his budget is released next week.
House Republicans, however, have been adamant in their opposition to increases in taxes, noting that Congress already increased taxes on the wealthy in the first days of January to avoid a so-called fiscal cliff, or automatic, across the board tax increases and spending cuts.
Congress and the administration have already secured $2.5 trillion in deficit reduction over the next 10 years through budget reductions and with the end-of-year tax increase on the rich. Obama's plan would bring that total to $4.3 trillion over 10 years.
As described by the administration official, the budget proposal would also end a loophole that permits people to obtain unemployment insurance and disability benefits at the same time.
Obama's proposal, however, includes calls for increased spending. It would make pre-school available to more children by increasing the tax on tobacco.
Less than half of small businesses offer benefits
Source: https://eba.benefitnews.com
By Tristan Lejeune
Less than half of U.S. small businesses offer benefits to employees, according to research from LIMRA released this week. The firm finds that 47% of those with two to 99 employees offer benefits, the lowest level in two decades.
In its survey of 754 private small businesses, LIMRA spoke to the individuals who made or shared decision-making regarding business insurance and employee offerings. Samples were weighed by company size, industry and region based on U.S. Census Bureau data.
Seventy-eight percent of small American businesses are family-owned, LIMRA reports, and such firms had a sharper decline in benefit penetration (47% down to 40%) than non-family-owned ones between 2005 and 2012. Female-owned businesses, which accounted for a quarter of the total, tend to be smaller, produce less revenue and are less likely to offer insurance benefits than male-owned firms (37% versus 50%).
“The recession has had an impact on smaller employers’ ability to offer benefits, particularly those with fewer than ten employees,” says Kim Landry, LIMRA Product Research analyst. “The weak economy caused a lot of small firms to close, while the new firms cropping up to replace them are less likely to offer benefits. Many small businesses are also hesitant to add new benefits until the economy improves.”
Landry says that among those who do still offer benefits, health care and pharmacy remains the most popular by far, as well as the most common.
“These benefits provide an opportunity for small business owners to obtain coverage not only for their employees, but also for themselves and their families,” notes Landry. “We also found dental and vision coverage to be common offerings among small businesses, as these products tend to be very popular with employees.”
Life insurance also is offered frequently, because of its low cost and ease of administration, LIMRA reports. Accident insurance and short- and long-term disability, however, have what LIMRA calls fairly low penetration rates.
Census Bureau data reveal that 35% of the U.S. workforce is in small businesses, which account for 98% of American companies.
Top 5 issues facing physicians, patients in 2013
Source: https://www.benefitspro.com
By Kathryn Mayer
As health reform continues to changes the landscape of our country’s health system, what’s to watch in this new year? A lot, industry insiders say.
Lou Goodman, president of The Physicians Foundation and CEO of the Texas Medical Association, says 2013 will be “a watershed year” for the U.S. health care system. Most of those changes will have a big impact on both patients and the physicians caring for them.
“It’s clear that lawmakers need to work closely with physicians to ensure we're well prepared to meet the demands of 30 million new patients in the health care system and to effectively address the impending doctor shortage and growing patient access crisis.”
The Physicians Foundation identified five issues that are likely to have a significant impact on patients and physicians in 2013.
1. Ongoing uncertainty over PPACA
Despite the Supreme Court decision upholding most of the provisions in the Patient Protection and Affordable Care Act and the re-election of President Obama, considerable uncertainty persists among patients and physicians regarding actual implementation of the act. Much of the law has yet to be fully defined and a number of key areas within PPACA—including accountable care organizations, health insurance exchanges, Medicare physician fee schedule and the independent payment advisory board—remain nebulous, the foundation says. Their research found that uncertainty surrounding health reform was among the key factors contributing to 77 percent of physicians being pessimistic about the future of medicine. In 2013, physicians will need to closely monitor developments around the implementation of these critical provisions, to understand how they will directly affect their patients and ability to practice medicine.
2. More consolidation
Consolidation means bigger, but is bigger better? Large hospital systems and medical groups continue to acquire smaller/solo private practices at a steady rate. According to the foundation's report pertaining to the future of U.S. medical practices, many physicians are seeking employment with hospital systems for income security and relief from administrative burdens. But increased consolidation may potentially lead to monopolistic concerns, raise cost of care, and reduce the viability and competitiveness of solo/private practice. As the trend toward greater medical consolidation continues across 2013, it will be vital to monitor for possible unintended consequences related to patient access and overall cost of care.
3. A scramble to fix the doctor shortage
In 2014, PPACA will introduce more than 30 million new patients to the U.S. health care system, a provision that has considerable implications relative to patient access to care and physician shortages. According to the Foundation’s Biennial Physician Survey, Americans are likely to experience significant challenges in accessing care if current physician practice patterns continue. If physicians continue to work fewer hours, more than 47,000 full-time-equivalent physicians will be lost from the workforce in the next four years. Moreover, 52 percent of physicians have limited the access of Medicare patients to their practices or are planning to do so. As the 12-month countdown to 30 million continues across 2013, physicians and policy makers will need to identify measures to help ensure a sufficient number of doctors are available to treat these millions of new patients – while also ensuring the quality of care provided to all patients is in no way compromised.
4. Erosion of physician autonomy
The Physicians Foundation believes that physician autonomy – particularly related to a doctor’s ability to exercise independent medical judgments without non-clinical personnel interfering with these decisions – is markedly deteriorating. Many of the factors contributing to a loss of physician autonomy include problematic and decreasing reimbursements, liability/defensive medicine pressures and an increasingly burdensome regulatory environment. In 2013, physicians will need to identify ways to streamline these processes and challenges, to help maintain the autonomy required to make the clinical decisions that are best for their patients.
5. Growing administrative burdens
Increasing administrative and government regulations were cited as one of the chief factors contributing to pervasive physician discontentment, according to the Foundation’s 2012 Biennial Physician Survey. Excessive “red tape” regulations are forcing many physicians to decrease their time spent with patients in order to deal with non-clinical paper work and other administrative burdens. In 2013, physicians and policy makers will need to work closely together to determine steps that will effectively reduce gratuitous regulations that negatively affect physician–patient relationships. According to a recent Foundation report, the creation of a Federal Commission for Administrative Simplification in Medicine could help reduce these regulations by evaluating and reducing cumbersome physician reporting requirements that do not result in cost savings or measurable reductions in patient risk.