HOURLY VS. OUTSOURCE: STAFFING ALTERNATIVES FOR HEALTHCARE ORGANIZATIONS

HOURLY VS. OUTSOURCE: STAFFING ALTERNATIVES FOR HEALTHCARE ORGANIZATIONS

TURNOVER

Perhaps one of the greatest challenges of maintaining an hourly staff is turnover. Employees are increasingly conscious of competitive compensation, less committed to staying with the same employer for a prolonged period of time and more focused on opportunities for growth.

Employees paid at an hourly rate are very aware of their compensation structure and are prone to leave an organization for a “better” offer elsewhere. Even if the new position is $1 more an hour, some staff members are likely to depart an organization for higher pay. The Internet age has allowed employees to quickly find and assess potential job options, including a compensation comparison. It can be difficult for the current employer to negotiate and keep a person on staff after they see a higher-paying position.

Here Today, Gone Tomorrow

The ability to quickly locate various employment opportunities has also created a culture of frequent movement between employers. Hourly staff are often less loyal to their employer, even when the work environment is positive. Additionally, we’ve experienced a shift in the broader American culture toward always looking for the “next best thing.” In the era of smart phones, we are constantly shifting our attention and focus, and the same has become commonplace for employment.

INTRODUCTIONThe constant state of change in healthcare can be both positive and a challenge at the same time.

While we relish innovation in treatment protocols and medicine, healthcare practice staff bear the burdens of increasing regulatory pressures, “red tape” administrative requirements and managing the day-to-day operations of a healthy practice.

As the business of medicine evolves, it is imperative for healthcare professionals to be flexible and adapt to change. With limited resources and increased scrutiny on patient satisfaction and experience, staff must be focused on spending less time on a computer screen and more time interacting with patients. Staffing an attentive practice, however, comes with hurdles. Frequently, hourly staff who support providers in a cost-effective manner come with a set of associated challenges. Experienced practice administrators and providers have learned there’s both an art and a science to having the correct personnel resources executing the appropriate tasks, and that aligning staff to the many needs of the office is crucial to an efficient, profitable and compliant practice.

CHALLENGES OF MEDICAL OFFICE STAFFINGSupport staff outnumber providers in nearly all medical practices, and most are paid hourly.

Hourly employees give rise to unique considerations and issues in running an efficient, profitable and compliant medical practice. Balancing the management experience across new generations of employees with a shifting healthcare industry creates quite a challenge for medical organization staffing.

Employees are increasingly conscious of competitive compensation, less

committed to staying with the same employer for a prolonged period of time and more focused on opportunities for growth.

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HOURLY VS. OUTSOURCE: STAFFING ALTERNATIVES FOR HEALTHCARE ORGANIZATIONS

An additional challenge of supporting hourly staff members is the need to provide opportunities for advancement. As organizations aim to fill specific staffing needs, it is difficult to reward and advance an employee when the practice has other roles occupied. Unless another employee departs, there may not be the near-term prospect of promotion. When hourly employees don’t see the opportunity for advancement within an organization, they will begin to seek new opportunities where they can find the growth or role they desire.

The Hidden Costs of Turnover

With turnover comes expense in various forms. If the vacant position cannot be filled immediately, other staff members are left to cover the role, creating an overflowing workload for employees who are already stretched in their duties. Additionally, there are only so many hours in the day, so duties are prioritized, and inherently some responsibilities drop. Cross coverage for a length of time leads to burnout, resentment and employee disengagement, and other hourly staff members may soon begin looking for other employment opportunities — a “domino effect” of the worst kind.

Beyond the “all-hands-on-deck” approach, there are other considerations. Each time a new staff member enters an organization, they require immediate training and some level of hand-holding to acclimate to their role. In an era where there is 18.79% turnover,1 a lot of time and resources are spent on training frequently by resources that could be better utilized elsewhere. On average, practices must fill 1 in 5 hourly jobs each year. Training also has monetary cost considerations and can be a burden to the organization not only through time but through actual training spend and lost revenue.

On average, practices must fill 1 in 5 hourly jobs each year.

Today’s employment culture includes all of these issues for hiring and maintaining an hourly staff, including heightened awareness of compensation, decreased employee loyalty and a lack of opportunity for advancement, leading to an increase in turnover and taxing practice administrators to train and retrain constantly.

Risk

Beyond the more predictable issues associated with turnover, practices have an additional consideration when it comes to employing hourly staff — regulatory risk. A recent MGMA study indicated the majority of practices spend up to $70,000 annually per provider to comply with new and existing federal regulations.2 With high turnover rates of hourly employees, it can be difficult to ensure all staff members have the appropriate education, knowledge and experience for handling sensitive data like protected health information (PHI). Even so, the organization is responsible and liable for the actions of their employees, hourly or otherwise.

Qualifications for hourly positions are often less demanding than for more senior roles, and as practices scramble to fill open spots, they may feel forced to lower standards or skip important steps in the hiring process. The need to fill vacancies quickly, combined with more accessible job requirements and potentially lower hiring scrutiny, leaves a gap in risk management for medical practices. It only takes a single employee, even an honest, well-meaning person, to be the cause of a breach. Hourly positions often require some unencumbered access to PHI, access that unfortunately is accompanied by risk.

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HOURLY VS. OUTSOURCE: STAFFING ALTERNATIVES FOR HEALTHCARE ORGANIZATIONS

While most hourly employees are trustworthy, practices also face those who are not. A disgruntled employee in Beverly Hills, California, stole patient information on more than 15,000 patients.3 In Bowling Green, Kentucky, a single employee stole billing information including the social security numbers of 160,000 patients, the largest breach thus far in 2017.4 Unfortunately, there are numerous examples of a single person inappropriately accessing or stealing sensitive information, a risk that imposes huge financial and reputational risks to the practice.

In addition to the obvious forms of risk, hourly staff could also pose a threat to your reimbursement rates through impacts on patient satisfaction and patient engagement. In a recent shift of the healthcare reimbursement model, patient engagement and satisfaction play critical roles in federal and commercial payer reimbursement. Hourly staff who may be overburdened and disengaged are part of your patient experience. In the era of online reviews, it is simple for a patient to complain about support staff, in turn damaging the organization’s reputation and possible reimbursement capitalization.

While any employee can have either a positive or negative impact on a medical practice as a whole, hourly employees create unique regulatory and reputational risks for a healthcare practice by the nature of their employment relationship. As practices seek to mitigate risk and improve their staff and patient engagement, they have a few other cost-effective options.

The need to fill vacancies quickly, combined with more accessible job requirements and

potentially lower hiring scrutiny, leaves a gap in risk management for medical

practices.

THE STAFFING SOLUTIONTurnover is inevitable for medical practices, and remaining staff can only cover the duties of a departed employee for so long.

To address the employee job opening, an organization can do one of three things: hire for the position directly, utilize a staffing agency to fill the role or outsource the duties of an hourly employee to a business associate.

In many cases of an hourly employee opening, a practice administrator will work to hire someone to fill the open position. Of course, utilizing internal staff to hire for the position takes considerable money and time. For the practice to hire, the administrator has to create and post the position, review applicants, select and interview candidates, run the chosen applicants through background and other checks, put a hire letter together and only then see if the employee ultimately accepts the position. When a practice administrator carries out these duties, they are typically taking unplanned time away from other critical duties which support the business. The practice may lose money as they invest in the process, and they certainly lose time while hiring.

Alternatively, an organization can utilize a staffing agency to find potential candidates. In many situations, the agency will take care of some of the steps of identifying and clearing potential candidates, but the practice will still need to interview and hire the best ones. This process utilizes less of the practice’s time but is more costly, as the practice typically pays a retainer or fee to the agency and often an additional fee upon identification and hire of a candidate. When a staffing agency actually places an employee onsite as a contractor and maintains their employment, the practice pays the agency, who in turn pays the employee, but only after taking their cut. This method also costs significantly more than maintaining the employment internally. Overall, utilizing a staffing agency can save the practice time and some administrative tasks but will carry a higher cost — especially if that employee doesn’t stay in the position long enough to make up for the cost — and it will not eliminate the aforementioned risks associated with hourly employees.

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HOURLY VS. OUTSOURCE: STAFFING ALTERNATIVES FOR HEALTHCARE ORGANIZATIONS

Upon departure of an hourly employee, a practice has a third choice — outsourcing the position to a business associate. In many instances, external entities exist to perform many of the tasks practice employees do — just at an offsite location. Technological advancements have allowed business process outsourcing (BPO) to thrive in a remote environment while remaining secure and efficient. In addition to tackling the staff workload, a business associate can absorb HIPAA liability, a major incentive to many organizations who face ongoing compliance concerns. Additionally, a BPO partner typically has subject matter experts in specific medical administration areas like records processing, meaning they can process on your behalf from an informed and experienced position.

Furthermore, these partners can devote employees to specific workflows, meaning the business associate’s employees can give full attention to the task at hand. They are not being interrupted by the provider, a pharmacy phone call or a patient need — they are carrying out a specific job quickly and efficiently. Often, choosing a remote team to handle tasks will free up time of practice employees, allowing them to focus on patient-facing tasks. Services performed by a BPO partner nearly always cost less than hiring an hourly employee. When hiring is overwhelming, a practice could turn to business process outsourcing as a means to replace and supplement their current staff.

When replacing an hourly employee, medical practices should weigh the pros and cons of hiring, using a staffing agency or utilizing a business process outsourcing partner.

1“3 Factors Driving High Turnover at Your Hospital — and What to do About Them,” Becker’s Hospital Review, 2016. Available at http://www.beckershospitalreview.com/human-capital-and-risk/3-factors-driving-high-turnover-at-your-hospital-and-what-to-do-about-them.html.

2MGMA Regulatory Burden Survey Report, MGMA, 2017. Available at http://www.mgma.com/getattachment/Government-Affairs/Advocacy/Advocacy-(1)/MGMA-2017-Regulatory-Relief-Survey/MGMA-Regulatory-Relief-Survey-Results.pdf.

3“Two Breaches Rock Beverly Hills Physician Practice,” HealthData Management, 2017. Available at https://www.healthdatamanagement.com/news/two-breaches-rock-beverly-hills-physician-practice.

4“Inside Theft Breaches Data at Med Center Health,” HealthData Management, 2017. Available at https://www.healthdatamanagement.com/news/inside-theft-breaches-database-at-med-center-health.

Technological advancements have allowed business process outsourcing (BPO) to thrive

in a remote environment while remaining secure and efficient.

WE CAN MAKE THIS EASIER FOR EVERYONEMedical back offices are busy enough - let us help. ScanSTAT Technologies is a proven business associate for practices to address their document management and release of information needs, while minimizing HIPAA liability. ScanSTAT is proud of our team of extensively trained staff who remain focused on their process area. No interruptions, no drinking your coffee, no taking up space in your office.

The healthcare data experts at ScanSTAT are ready and waiting to take on your administrative needs so you can remain focused on patient care.

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ScanSTAT makes it easier for hospitals, healthcare systems, and medical practices to manage health information. We provide everything from streamlined Release of Information services to faster, more accurate document filing, prior authorizations, chart abstraction, insurance verification, and more.

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