Often times when hospital and health system leaders discuss the Patient Protection and Affordable Care Act, it is from the perspective of a provider organization, concerning reimbursements and avoiding penalties, for instance.
But healthcare executives also need to know how the PPACA will affect them as employers. That's what Christopher Ryan, the vice president of strategic advisory services for ADP, discussed at the Becker's Hospital Review 6th Annual Meeting in Chicago May 7.
"As employers, you'll be held as accountable as someone who is making cars or any other [employer] in the U.S. economy," Mr. Ryan cautioned healthcare executives. "It's very important."
From Mr. Ryan's point of view, the PPACA presents three main challenges to hospitals and health systems as employers.
1. One of the major changes posed to employers from the PPACA is the new definition of a full-time employee. Under the law, an employee is considered full-time, and therefore eligible for healthcare coverage, if he or she has 30 or more hours of service each week, which includes paid time off and unpaid leave. To be in compliance with the healthcare reform, hospitals need a way to track all of this data for each employee to fill out forms for the government. The data comes from human resources, payroll, benefits and other facets of the organization, so breaking down traditional silos is critical.
Additionally, hospitals need to be able to prove that they offered coverage to all PPACA full-time employees. "The IRS is putting the burden of proof on the employer," he said, and if healthcare employers cannot prove this, they could be subject to penalties.
2. The other major challenge for healthcare organizations as employers will be avoiding the excise tax coming on "Cadillac" health plans in 2018. "Hospital and healthcare personnel are among the largest consumers of healthcare," Mr. Ryan said. "Nurses and doctors consume more healthcare than almost any other employee group."
To avoid this tax, Mr. Ryan said some healthcare organizations may want to transition into a high deductible plan. If an employer wants to go this route, he recommends instituting a transition plan to educate employees about how to use high deductible health plans. "If this is something you're contemplating doing, you need to be planning that now," he said.