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Healthcare, Recruiting, and the Sequester

For as long as I can remember, industry experts claimed that the healthcare industry was basically guaranteed to remain a consistent and strong job market forever. The thought was there will always be patients and patients will always need healthcare providers. Now, I see that rationale is not quite as sound as we all once believed.

The Federal Sequestration, automatic budget cuts implemented on March 1, 2013, included a 2% reduction in Medicare payments to healthcare providers. If you don’t think 2% is all that significant, you are sadly mistaken. For many hospitals, for example, Medicare is the largest single payer, at times accounting for more than half the facility’s total revenue. In those terms, 2% is a monstrous reduction.

A joint study by the American Medical Association, The American Hospital Association, and the American Nurses Association predicted that the Federal Sequester would undoubtedly result in a decline in healthcare job growth. The impact will not only affect hospitals and physician’s offices, but will have a trickle-down effect including other healthcare vendors, such as suppliers and IT providers.

Unfortunately, we are already seeing the predicted downturn. According to the Bureau of Labor Statistics, healthcare made a “relatively weak” contribution to the job market in both March and April 2013. Further, the American Hospital Association thinks it may get worse, estimating that these budget cuts could lead to 766,000 fewer healthcare jobs by 2021.

All this at a time when healthcare reform hurtles forward and an estimated 32 million new patients will have access to healthcare in 2014. In short, more providers, supplies, and ancillary staff will be required to address this massive influx of patients at a time when Medicare reimbursement will be significantly decreased. CFOs in healthcare are worried, and with all this in mind it is no surprise. This means, every department, in every healthcare organization, will be required to cut costs. Human resources and recruiting departments will be no exception.

Today more than ever, healthcare recruiters need to take serious action to reduce the costs to fill job vacancies. For any newbies reading this post, I am referring to a standard metric, or measurement, called cost-to-fill. The costs-to-fill are the cumulative total of costs associated with recruiting, such as time dedicated to sourcing, sifting through resumes, and interviewing as well as direct costs associated with travel, relocation, costs of employment advertising, and onboarding. In addition to this, one must consider the cost of the vacancy itself. When a job is vacant, either someone needs to pick up that slack in the form of more expensive overtime or the vacancy simply results in additional losses in revenue. In short, vacancies are expensive.

No matter how you slice it, the key to bringing down costs-to-fill is automation. If healthcare providers want to survive, even thrive, they must eliminate the inefficiencies associated with humans performing processes that can be easily automated such as sifting through hundreds, even thousands of resumes to identify the a particular skill set. Unfortunately, healthcare has always been notoriously slow in terms of adopting information technology. The growing acceptance of electronic medical records, however, does seem to indicate that healthcare is beginning to warm up to technology. Still, automating processes in order to create efficiency does not end in the exam room.

Automation through recruitment technology is the key to reducing recruitment’s cost-to-fill. For example, automated candidate screening reduces the number of unqualified candidates that a recruiter reviews in order to find those that meet the organization’s needs. Other features include social recruitment and automated job board posting to healthcare specific job boards that broaden and target the recruiter’s reach. At the same time, recruitment technology facilitates and streamlines the communication between recruiters, candidates, and hiring managers. The combination of broad, yet targeted reach through employment advertising and improved communications ultimately reduces time-to-fill, which subsequently impacts cost-to-fill.

Gone are the days when email folders and filing cabinets could be considered as viable systems for searching and screening candidates. Operational efficiency is among the best ways to improve an organization’s bottom line and remain competitive. Manual recruitment techniques, filled with high resume volumes and no effective way to accept, review, and manage those resumes is a dangerous inefficiency. Without recruitment technology in place, a healthcare organization cannot maximize human capital efficiency.

If you would like to dive deeper into this topic to learn about the costs associated with manual processes and the return on investment associated with automation, download our Free Whitepaper titled: Healthcare Recruitment: Facing the Sequester.


NASCO Contract Security D.C. Summit Brief

On June 12 and 13 (starting with a evening cocktail reception on June 11) NASCO will be holding its 8th Annual Contract Security D.C. Summit. The NASCO Summit is the premier national event focused on the intersection of public policy and the business of contract security. The agenda is packed with sessions and speakers that will address national policy issues, legal issues, labor issues, federal contracting issues, and federal and state legislative issues of interest to contract security employers.


Speakers include, Rep. Michael McCaul, Chairman of the House Homeland Security Committee; Jeff Kessler of Imperial Capital, the leading financial analyst for the security industry; Theane Evangelis Kapur of Gibson, Dunn and Crutcher, who co-wrote the contract security industry’s amicus brief for the upcoming pivotal employee class action case before the California Supreme Court (Duran v. U.S. Bank); various officials from the Federal Protective Service and other DHS agencies, Labor/Employment policy and Political experts from the U.S. Chamber of Commerce; and more. All events including the sessions, two cocktail receptions and a dinner are within a block of each other right off Capitol Hill. Click here for a registration form.

For more information on this topic please email Jeff DiDomenico at Valiant or Click Here for a free assessment.


Attention Employers: I-9 Deadline is Near!

The Alliance is bringing you a friendly reminder that the May 7th deadline for incorporating the newly revised I-9 form is approaching! Be aware that employers who are not using the revised I-9 for employees hired after this date may incur a penalty.


The Alliance recently hosted a seminar ‘The New I-9 & How it Affects You’ with speaker Alka Bahal of Fox Rothschild LLP. The seminar reviewed and explained the new revisions, how to execute the new I-9, how to successfully comply and much more. If you were unable to join us, you can access the seminar information here. We hope you are able to join us for future events!

The Alliance will keep you updated on this issue as we continue to provide our members with the education, information and access to expert consultants they need to keep in compliance and avoid fines. Join The Alliance today!

For more information on this topic please email Rick Casmass at Valiant or Click Here for a free assessment.


2014 Obama budget, good news & bad news on FUTA

The fiscal 2014 budget presented by President Obama on April 10th includes proposed changes to FUTA taxes that could affect employers bottom line, both in a good and a bad way.

First there is a proposed suspension of the FUTA tax credit reduction for 2013 and 2014. During 2012 nineteen states were deemed to be credit reduction states because they could not pay back their loans to the federal government and that cost employers in those states anywhere from .003 to .009 of the first $7,000 in wages for each employee ($21 – $63) in the credit reduction state.

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Affordable Care Act Update- Pay or Play

By: Scott Sinder

Yesterday, I participated in the IRS hearing on its proposed employer “shared responsibility” (aka “play or pay”) rules. The most interesting take-away may be a little terrifying. Although you would expect disagreement re how the rules should work, there also was widespread disagreement re how the rules as proposed actually do work as written. In response to many of the rule critiques asserted by witnesses, IRS representatives would point out that the critiques were based on a misunderstanding of the proposed rules.

In my view, the regulators were always right. If the so-called “experts” are having these interpretational difficulties, it may be a heavy load to expect executives that need to focus on their businesses to master the intricacies in their spare time.


Two other things really impressed themselves on me during the hearings.
First – with respect to the variable hour safe harbors – the regulators clearly intend that hourly workers who do not consistently work a full time schedule will get their coverage through the exchanges and not through employer plans. One regulator noted that it does not seem advisable to require hourly workers who are full time for a month or two and then part time again to be lose their exchange premium subsidies (which would happen if they were eligible for “affordable” employer provided coverage for those two months). Even labor representatives had to agree with that sentiment even though their instinct is to require the employer to offer as much as possible to as many as possible. The real lesson here is that the variable hour employee safe harbors are a powerful tool and that they are intended to be a powerful tool. Employers with part-time/variable hour work forces should be sure they are effectively deploying these tools.

Second – one of my personal focal points is on the wellness opportunities under the legislation. As you may recall, under new rules that have been issued, an employer can reward employees who participate in health condition based wellness programs with incentives worth up to 30% of the premium value (including both the employer and employee contribution) (up to 50% for tobacco cessation programs) or they can punish at the same levels for non-participation. The big question is the extent to which the post-wellness participation premium rates can be used as the basis for an employer’s premium affordability calculations.

The advocacy on this issue is intense – advocates for allowing that (like me) argue that wellness is the only part of the legislation that can be deployed to help bend the health care cost curve; opponents maintain that these programs can be used to discriminate and can disadvantage lower wage workers who have less time to devote to wellness initiatives. It is unclear where the regulators will come out on this. At the moment, though, I read the rules to allow wellness programs that punish to use the basic, pre-punishment premium in the affordability calculation. Employers are allowed to rely on the proposed rules until at least 2015 and if you are considering structuring a premium based wellness program, you may want to focus more on punishing non-compliance than on rewarding compliance so you can maximize the utility of the program for your bottom line.

This update was written by Scott Sinder – a member of the Washington, D.C.-based law firm Steptoe & Johnson, LLP and he is the Chair of the firm’s Government Affairs & Public Policy Practice Group. For more information visit: http://www.steptoe.com.

For more information on this topic please email Rick Casmass at Valiant or Click Here for a free assessment.


Affordable Care Act Update – Pay or Play

By: Scott Sinder

Yesterday, I participated in the IRS hearing on its proposed employer “shared responsibility” (aka “play or pay”) rules. The most interesting take-away may be a little terrifying. Although you would expect disagreement re how the rules should work, there also was widespread disagreement re how the rules as proposed actually do work as written. In response to many of the rule critiques asserted by witnesses, IRS representatives would point out that the critiques were based on a misunderstanding of the proposed rules.

In my view, the regulators were always right. If the so-called “experts” are having these interpretational difficulties, it may be a heavy load to expect executives that need to focus on their businesses to master the intricacies in their spare time.


Continue Reading…


10 Ways Military Veterans are Ideal for Physical Security Sector

By: Jerold Ramos

Military veterans transition seamlessly into virtually all types of careers and sectors, but as a U.S. Navy veteran and talent acquisition professional for America’s leading physical security services company, I believe that the physical security industry can be a match made in heaven for transitioning veterans.

Despite a recessionary climate, which makes getting started in many industries challenging, the need for security officer services is rising dramatically. “Demand for security officer and patrol services is forecast to rise at an annual rate of 4.6 percent through 2014 to $25 billion,” states the Freedonia Group Private Security Servicesreport. “The number of officers employed by private security firms is expected to increase 2.6 percent per year to 740,000 in 2014.”


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The Empowerment Zone

Tax season is in full swing and it is time to make sure you are not leaving any money on the table. At TaxBreak, we are committed to finding our clients all the credits and incentives that they qualify for. We make it our mission to reduce income taxes that your business owes, which means more money to go back into your bottom-line. One very important incentive, The Empowerment Zone Employment Credit, is curtail to take advantage of this season. If not handled correctly, you could lose an entire year of credits that you rightfully deserve.

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Important Notice!!

On Friday, March 8th, 2013, the IRS released Notice 2013-14 which extended WOTC submission deadlines through April 29, 2013, for all 2012 and first quarter 2013 hires. This is great news for YOU! Now, if you had late submissions during 2012, or pre-qualified new hires for which forms were not submitted at all, you can still receive tax credit certifications if all WOTC forms are signed and submitted to us by April 29, 2013. This applies only to those potentially qualified for the non-veteran target groups. Veteran-only target groups can be submitted through the extended deadline if hired during the first quarter of 2013 only (1/1/13 – 3/31/13).


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Rising From The Ashes: Unions At a Crossroads

Unions are continuing to feel negative vibes from all sides. From poor membership numbers – now only 10% of workers are enlisted in traditional unions – to flat out jarring litigation like Right To Work Laws that were recently passed in states like Michigan, there isn’t a PR firm in the world that could be paid enough to paint unions in a positive light. In the private sector, union numbers have dipped to 6.6 percent. This is alarming, as unions were once heralded as the primary cause of the rise of the working class, the primary advocate for worker’s benefits and education, and helped to set general standards for work days, minimum wage, and health protection.

Times have decidedly changed, which is the nature of the post-millenium working world. No longer are workers looking for 9-to-5, traditional clock-in/clock-out jobs. Workers have given way to entrepreneurs, self-employed business owners, contract workers, and job-hoppers. The simple and rigid rules of unions, though well intentioned, simply do not apply to these types of employees. It makes sense: when these unions were in their early days, they could never have had the foresight that would have allowed them to adapt to such a drastic lifestyle change. Someone who works from home, or telecommutes, or wishes to choose their hours operates under a markedly different set of criteria than those who work in the traditional nine-to-fiver unions.

It’s evident that there will always be representation for workers. What isn’t evident is how worker’s representation will work to adjust to the new nature of the American worker.

Here are some possible alternatives on the horizon:

Freelancers Union

With the advent of blogs, social media, and the 24 hour news cycle, and contract work we’ve seen a massive influx of freelance writers, artists, bloggers, construction workers and the like. The Freelancers Union, which now comes close to a quarter of a million enlisted, provides all of the standard advocacy one would expect from an organized union.

An Increase In Employer Respect

Any business owner or corporation will tell you how they despise the idea of a union, which is their prerogative and makes sense. However, it is important for these employers that use non-Union workers to keep their employees forever pleased. B corporations – as they’re called – take extra care to involve their employees in important decision making, provide outstanding benefits, and generally take care of their employees in a way that make them not even want to think about joining a union. This is a utopian, glorious view of how things should be… and if they were, Unions never would have been an idea in the first place.

An Entreprenurial Shark Tank

This model may be the very embodiment of capitalism. Startups have never had the spotlight shone on them any brighter. The employees of these new companies are as at risk as the people who put the company in motion. It is certainly dog-eat-dog – if you aren’t wholly qualified, you don’t have a shot to be a “venture laborer”

A Union Networked

The reality is that we’ll be seeing a little bit of this and that from each of the above ideas. New union structures have so many new things to account for. Depending on your wealth, job, experience, and work sector, a specific set of rules will apply to you. This is where unions are failing at the moment – they were crafted with a very specific kind of laborer in mind, jobs that many of us wouldn’t dream of taking in the new millennium. That said, the most unskilled, uneducated and untalented workers will still find refuge (or a shot at justice) within our legal system.

Unions aren’t dead – they can’t be, and they shouldn’t be. However, they do need to adapt and change and understand that those they are representing have drastically different needs today than they did in the early 1900’s. While collective bargaining is important, it seems that the antiquated core of union leadership around the country is too rooted in a structure that their constituents are simply disinterested in maintaining.

For more information on this topic please email Jeff DiDomenico at Valiant or Click Here for a free assessment.