Nurse Staffing Levels Make the Difference in Patient Care

Nurse and author Theresa Brown illustrates a critical element of hospital care in The New York Times: the availability or lack of proper nurse staffing. A properly-staffed hospital floor – one with a manageable nurse to patient ratio – allows nurses to fulfill their more mundane responsibilities without sacrificing their role as first responders to patient issues. An improperly-staffed floor, however, will see larger numbers of patient injury and infection. For patients, adequate nurse staffing can make the difference between life and death.

A House bill introduced in April cites research that directly links nurse staffing levels to patient outcomes, in terms of patient satisfaction as well as patient mortality and cost to healthcare providers. Despite nurses comprising a hospital’s largest labor cost subset, hospitals can more than offset the cost by avoiding a number of far more costly “adverse patient events” that may result from low staff levels.

While there is concern that hospitals will balk against potential regulation of this kind, hospital executives by and large are more worried about the quality of patient care than about the cost. Hiring temporary nurses is as costly as employing permanent staff, but it may provide the opportunity to avoid many of the hidden costs associated with permanent employees – especially an estimated 12-13 percent of costs associated with non-productive time.

The need for capable, talented nurses will only continue to rise, and temporary nurse staffing agencies are well poised to expand their business by filling open positions. PRN Funding has the tools to help your staffing agency grow while maintaining a steady cash flow.

Find out more about PRN Funding’s nurse staffing factoring programs.

Temp Nurse Staffing Agency Settles Wage Claims

A temp staffing agency for nurses, U.S. Nursing Corp. agreed to pay $1.77 million to settle a class-action lawsuit filed by California employees.

More than 2,500 nurses were involved in the suit that alleged the nursing staffing agency violated California labor law by taking out 30-minute meal breaks from its nurses’ time sheets. The break time was deducted whether or not the nurses took a break or recorded a break on their time sheets. The suit also claimed the staffing company paid nurses weekly instead of daily, and failed to pay them for travel time. The California Labor Code requires the nurses to be paid daily.

U.S. Nursing admitted no liability. The affected nurses received an average settlement award of $645 each. The staffing company must also pay $15,000 to the California Labor and Workforce Agency and $77,000 in back payroll taxes.

Employers Shift Health Care Cost Increases to Employees

Kaiser Family Foundation released their 2013 Employer Health Benefits Survey last week. One of their primary findings, according to Bloomberg Businessweek, is that small business owners are providing healthcare benefits to their employees at close to the same rate as they were last year, belying the contention by ACA opponents that benefits would decrease.

However, they are doing so in what Kaiser Family Foundation CEO Drew Altman calls it “a quiet revolution in health insurance from more comprehensive to less comprehensive with higher deductibles.” Higher out-of-pocket costs for employees are seen to offset the rising costs on the employers’ end of providing the healthcare.

Though premiums for family plans only increased by four percent since last year, they have still increased at a higher rate than employees’ take-home pay. Higher premiums, higher deductibles, and comparably lower paychecks are likely to cause concern among families facing a difficult time paying for medical care.

While it isn’t yet clear if these higher-deductible plans will meet the ACA’s requirements for affordable care, in the short run the added financial strain may very well extend beyond the policyholders to their healthcare providers. Hospitals and other medical facilities may delay or withhold payment of invoices as they wait for their patients to pay, creating a gap in cash flow that will be difficult for many small businesses to overcome.

Get ahead of the problem with medical receivables factoring. Same-day cash advances will allow you to continue providing excellent service to medical providers and stop rising healthcare costs from sinking your small business.

The Affordable Care Act Defines Full-Time Employment

As provisions of the Patient Protection and Affordable Care Act (ACA) continue to take effect, there is considerable friction over the ACA’s definition of a “full-time employee” and its implications for providing health coverage to those employees. The Fair Labor Standards Act defers to employers to define full-time employment; however, the ACA bases its definition of full-time employment on the Internal Revenue Code of 1986: “an employee who is employed on average at least 30 hours of service per week”.

Such a designation, opponents argue, may cause employers to choose between providing healthcare to a greater number of employees and cutting full-time employees’ weekly hours by at least 25 per cent to force them below the full-time threshold. Senator Susan Collins (R-ME) has introduced the “Forty Hours Is Full Time Act of 2013” on two separate occasions in an attempt to revise the IRC and, by extension, the ACA. Economist Casey Mulligan argues in The New York Times, however, that passage of such a law would actually cause more employers to cut their employees’ hours and result in more of a taxpayer burden.

According to Mulligan, it is easier for an employer to cut an employee’s hours from, say, 45 to 39 without drastically affecting the work schedule. Projections of employer cost between full-time, part-time at <30 hours and part-time at <40 hours show that the difference in a 39-hour work week and a 40-hour work week is almost negligible for employers; meanwhile, the employee becomes eligible for ACA tax incentives to purchase private insurance on the marketplace – costing the taxpayer more – and ends up with an increase in take-home pay at the same time.

The arguments above suggest that business owners need not shy away from expanding or offering full-time benefits to their employees in an attempt to cut costs; rather, service providers in medical industries may find themselves at an advantage. After all, some facilities will choose to scale back their in-house staff and rely on outside contracts, leaving a great opening for vendors to expand their own businesses.

Healthcare factoring can help those companies close the gap between their own cash flow and expenses, and ease the strain of expansion by providing the capital to cover increased overhead. Find out how PRN Funding’s accounts receivable factoring program can be tailored to your company’s needs.

2014: Expect a Busy Year for Healthcare Staffing Agencies

Thanks to a slowly improving economy and the implementation of the Affordable Care Act on the horizon, those in the healthcare staffing world need to be prepare their recruiting strategies.

Healthcare workers, especially physicians, nurses and clinical staff, are growing more confident about their job prospects and may be seeking more lucrative employment offers. The physician shortage will undoubtedly make it tough on the healthcare staffing industry as well.

In order to meet medical staffing demands, certain states are allowing APRNs, physician assistants and other mid-level healthcare providers to step in. Giving mid-level providers more freedom and responsibility will help off-set the physician shortage and open up more career opportunities.

Although healthcare hiring appeared to be slowing in July, medical staffing should prepare for a fast rebound in 2014. Make sure your staffing agency is ready to handle the demand. Discover the ways healthcare staffing factoring can ensure your cash flow remains stable despite rapid growth. PRN Funding has spent more than a decade in the healthcare services industry, and we can design an accounts receivable factoring program specifically for your staffing firm.

Learn more about accounts receivable factoring for healthcare staffing agencies.

Cash Flow Strategies for the Medical Transcription Industry

Medical transcription service organizations (MTSOs) rely on cash, and for many smaller sized MTSOs, a strong cash flow is crucial for survival. Anything that has a negative impact on cash flow can break a MTSO; learning to recognize threats to your business’s cash flow and how to navigate them can be the difference between your business failing or surviving.

“It’s the nature of healthcare. [Hospitals] have to carefully manage cash flow in order to make sure they can cover their obligations. Revenues are constantly being squeezed, so one way to manage that is to pay vendors slowly,” said Philip Cohen, founder of healthcare factoring firm PRN Funding, who observes that it’s not uncommon to see net 90-day payment conditions. “Any well-run business can manage a slow-pay situation as long as they understand it going into the relationship. Where MTSOs get themselves into trouble is when they expect to get paid in 30 days and instead get paid in 90.”

Getting a credit report on any potential client before signing a commitment is the best way to get an accurate reading on the client’s payment history as you’re about to effectively lend them money.

Problems in cash flow arise when the MTSO fails to account for float time between gaining a new client and receiving the first payment. MTSOs usually pay medical transcriptionists and other personnel biweekly but bill clients monthly, which means the amount of cash coming in isn’t timed well with the amount of cash the MTSO is expected to pay out on a shorter timeline.

For some MTSOs, medical transcription factoring is a viable option that can help improve cash flow, relieve the pressure of scrambling to free up capital to pay employees, and let you focus on you’re the growth and success of your business.

Read the entire article to here for more ways that MTSOs can maintain a healthy cash flow.

Obamacare Out-of-Pocket Caps Provision Delayed

Another important provision of the Affordable Care Act has been postponed. The provision that would set caps for out-of-pocket insurance costs will be delayed for more than one year. Under Obamacare, the limit on out-of-pocket costs like deductibles and co-payments was not supposed to exceed $6,350 for individuals and $12,700 for a family. Now, it appears that a one year grace period has been granted to some insurers which enables them to raise limits, or in some cases, set no limits until 2015. Also, if a drug plan doesn’t currently set out-of-pocket limits, they won’t have to impose any until 2015.

The delay will leave some consumers paying much more for health insurance and drug coverage. The lag allows many group health plans to maintain separate out-of-pocket limits.

Why the health care reform delay? The New York Times reported that federal officials wanted to provide insurers and employers more time to comply because they used “separate companies to help administer major medical coverage and drug benefits, with separate limits on out-of-pocket costs. In many cases, the companies have separate computer systems that cannot communicate with one another.”

The chief executive of the National Health Council said the delay will “disproportionately harm people with complex chronic conditions and disabilities.” For those with chronic illnesses like cancer, out-of-pocket costs can swell to tens of thousands of dollars each year. The same applies to prescription drug plans. Many patients will have to wait for access to affordable prescription drugs because of the out-of-pocket cost cap delay. The American Cancer Society noted that some new cancer drugs can cost more than $100,000 per year.

Obamacare still affords some consumer protections. Consumers can’t be denied insurance or face higher premium costs due to pre-existing conditions. Subsidies may be available to help bring down costs as well.

Affordable Care Act Could Lower Insurance Costs for Some Small Businesses

Numerous small business employers and owners are worried about their insurance costs rising under the health law next year. However, for some businesses, especially those with older workers or those who have employees who have been ill, costs may actually decrease according to business owners and insurance brokers.

Under a stipulation of the Affordable Care Act (ACA), which goes into effect in January, insurers will be forbidden from setting rates for healthcare coverage based on the health status of employers or their employees are at businesses with less than 50 or 100 workers, depending on the state. Rather, the rates will be announced on government-run health insurance marketplaces, or online exchanges, which are meant to extend the additional costs of insuring higher-risk policyholders, like those with prior sicknesses or pre-existing medical conditions.

A survey conducted in April by The Wall Street Journal and San Diego-based executive mentoring group Vistage International Inc., found that 12% of 783 businesses with less than $20 in yearly revenue believe their insurance premiums will be cheaper or stay roughly the same under the ACA. Similarly, a survey by eHealthInc. done in February found that 11%of 259 small business employers, most with less than 10 workers employed at their businesses, said they think their rates will go down next year.

Some business owners say costs could go down if the exchanges produce cheaper rates on individual plans, which would lead some employees to drop their employer-sponsored plans completely.

Both early renewals and self-funded plans will end up keeping more groups off the exchanges, which will reduce the savings for high-risk policyholders. Besides that, any savings from the exchanges will be contingent on whether they’re up and running by Oct. 1, the deadline for offering coverage that will be effective come January.

The federal government’s own health-insurance exchange for small businesses, called the Small Business Health Options Program, or SHOP, which it will supervise in 33 states, isn’t expected to be fully operational and available until 2015.

Obamacare Greatly Boosting Areas of Healthcare Staffing

Obamacare has been receiving plenty of criticism due to accusations that the health care law will hurt employees by eliminating positions or reducing hours to part-time. While the actual effects are still relatively unknown, staffing recruiters and HR professionals are confident that Obamacare will help drive job growth in certain areas.

Since PRN Funding works with numerous healthcare staffing companies, let’s take a look at the positions that are prepping for fast growth in the healthcare realm.

1. Nurse practitioners and physician assistants
Due to an increased demand for routine checkups and preventative medicine, physician services are set to increase at least 2 to 3 percent by next year. Nurse practitioners and physician assistants can perform similar services for the fraction of the cost of a doctor. Not to mention, general physicians are still in short supply and take much longer to enter the workforce. The Bureau of Labor Statistics (BLS) predicts the demand for PA’s will swell by 30 percent and staffing for registered nurses will increase 26 percent by 2020.

2. Medical billing coders
Healthcare IT staffing will be huge. Combine the requirements for healthcare facilities to transition to electronic health records and comply with a new medical coding system (ICD-10) with millions of newly insured patients and you have a recipe for lots of jobs to fill.

The International Classification of Diseases (ICD-10) will include a staggering 69,000 diagnostic codes and physicians will be required to submit claims with the new codes starting Oct. 1, 2014 if they want to get paid. Lots of healthcare IT staffing will be necessary to build these codes into the electronic health records software. According to Staffing Industry Analysts, medical coding is one of the hottest jobs right now.

3. Occupational therapists
Occupational therapists make appropriate modifications to the homes and workplaces of the disabled to accommodate their mobility needs. Since Obamacare prohibits insurance companies from denying coverage, more disabled people will be able to take advantage of health insurance coverage. The BLS forecasts a 43 percent spike in occupational therapy employment by 2020.

4. Wellness and fitness coaching
The need for health education specialists is expected to rise by 37 percent in 2020, according to the BLS. Many employers will want to encourage healthy lifestyles, so the demand for workplace wellness programs will skyrocket.

Aside from healthcare staffing, Obamacare is also expected to help spur career growth for payroll service providers, computer programmers, lawyers, insurance consultants, customer service reps and human resources professionals.

5 Tips for Choosing a Medical Staffing Agency

Medical staffing agencies can be a great way to help you expand your job opportunities as hospitals and other healthcare institutions tap talent to fill in for permanent employees, which can potentially lead to a more permanent career for you. By hiring from a reputable medical staffing agency, the employer is assured that they meet the necessary qualifications, which means you picking the right medical staffing agency to sign up with crucial. Here are some tips on choosing the right medical staffing agency for you:
1. Do your research and look into a variety of agencies. You can actually register with more than one agency and you may find you prefer one over the other and decide to remain with them after trying out a few different ones.

2. Don’t feel pressured. There’s no need to sign a contract right away or feel pressured to take a specific assignment either. Wait for the right staffing company and job, rather than settling for one you won’t be happy with, even short-term.

3. Find out how often the agency gets jobs opportunities. There’s no point in signing with a medical staffing agency that won’t open doors for you because they don’t receive many job openings. Be sure the agency receives ample assignments, and find out how many are in your field.

4. Meet the people working for the agency. Since those employed by the staffing agency will be the ones helping you through the process of finding temporary medical staffing employment, they should have a clear understanding of the position you’re looking for. If they don’t, you won’t be happy with the results.

5. Choose an agency that has your best interests in mind. The best medical staffing agencies will look out for you, provide support and understand what sort of jobs are the right fit for you. If they aren’t willing to do so, they aren’t an agency worth sticking with.