Why ASCs Should Partner with HR / Staff Management Firms

MedHQ was recently consulted by a colleague about a growing healthcare management company. With over 100+ employees in ten facilities across the Midwest, the management company expects to double by the end of the year and is looking for systems to help manage the growing employee base.

To assist with the growth, the management company is looking for an applicant tracking system (ATS) to assist in tracking candidates throughout the application and interviewing process, as well as a human resources information system (HRIS) to manage offer letters, tax forms, compliance issues and more. In addition to that, the management company will likely transition to larger payroll company by the end of the year.

The question the healthcare management company posed was, “Should we build it, or should we buy it?”

Many companies opt to build the systems themselves because they are unsure if traditional PEOs, long-term staffing companies and HR Outsourcing (HRO) firms in general can resolve all their concerns while also maintaining a high standard of employee satisfaction. However, once a company reaches significant growth, outsourcing day-to-day human resources operations can free up valuable time and resources. Or, on the other hand, perhaps the company has a wonderful HR team internally that helped them get to where they are currently. For either scenario, we could make the case for HRO (“Buy”) instead of investing further in the internal HR function (Build).

If the growth has outpaced the internal operations, an HRO firm delivers an out-of-the-box solution that handles the areas mentioned with technology operated by HR and payroll professionals that have full proficiency in their roles. There are many good ATS and HRIS platforms; at least as important is how they are set up and how well the staff is trained and practiced in using the systems.

For development of an internal HR function, the question is whether it’s best to focus some or any of the executive management attention and capital investment in a support function. What creates value for a company? Likely that it includes developing relationships and delivering top clinical care to more and more patients – these and similar areas is likely what gets executive management’s focus and most capital investment.

At MedHQ we specialize in the healthcare industry, and because of this, can better understand our clients unique HR needs. Currently, we use PrismHR, which happens to be built specifically for the HR outsourcing industry. This system is automating our employee onboarding (paperless), benefits enrollment (paperless) and, of course, handles payroll. We have integrated PrismHR with our time and attendance system and we have an applicant tracking system as well. PrismHR just recently added a CRM capability to its core platform and we’re going through the implementation of that component now – this capability is going to greatly enhance our service to employees through more effective case and task management.

As an HR Services company, we will continue to invest in the best solutions that hit the HR market because these investments will drive value in our company. We find, however, that companies that opt to build internal solutions are susceptible to having those systems atrophy due to lack of ongoing investment.

What an HRO firm is and what it isn’t: HRO’s handle back office matters that are extensive – we break it down to a dozen or so areas and 100 or so separate activities – but almost entirely in a “support” mode. Management (the customer’s management team), on the other hand, is the “front office”. The HRO handles the essential or basic HR functions, while Management supervises and develops the organization. An HR Generalist fits well within the typical service model of a HRO, while an organizational development consultant is best fit within Management Consulting. A HRO’s leverage is its size and risk sharing model. The size creates efficiencies for the customer; the risk sharing removes barriers that get in the way of a customer’s growth.

Lastly, when it comes to culture, we would consider the development of a company’s culture to be the responsibility of the Management team. While we love to work on culture-supportive programs, we believe that for an organization to intentionally create a culture requires top leadership to spearhead the effort.

Interested in learning more about MedHQ’s unique HR services, click here.

Steps to Take to Manage Involuntary Terminations

Every ambulatory surgery center needs a professional, dedicated staff to provide excellent patient care and operate efficiently. Successful ASC leaders are thorough in recruiting and hiring employees who are the best fit for their team, and modeling the culture they want to see in the organization.

But despite these efforts, there will still be times when an employee is not working out, and an involuntary termination is the best course of action. This is a delicate situation that can cause financial strain and employee stress for an ASC. Research suggests that a single termination, poorly handled, can cost $80,000 to $125,000 in legal fees and severance, compared to expenses of $5,000 to $10,000 when managed properly.

The following human resources best practices will mitigate risks associated with involuntary terminations.

Have direct conversations about performance and behavior.

When an employee is not meeting expectations or is behaving in an inappropriate way, management must step in and address the problem early on. A direct, private conversation with the employee should focus on specific examples of what is happening, and what needs to change going forward. Is there a reason for the employee’s behavior? Has something, such as a new work process or a problem at home, triggered this change? Leaders in the organization are responsible for starting this conversation, exploring possible solutions, and setting next steps.

Follow a progressive discipline process.

Progressive discipline is designed to bring unacceptable behavior or poor performance to an employee’s attention and outline the changes necessary to avoid involuntary termination. For example, if a manager notices an ASC employee who has a problem with arriving for work on time or missing shifts, this process might look like this:

  • First incident: Manager clarifies job expectations and responsibilities, and issues a verbal warning about the consequences of missing work
  • Second incident: Manager pulls the employee aside when the employee has arrived at work 40 minutes late, emphasizing that this is the behavior that must change, and documents the issue in writing, using a formal written reprimand
  • Third incident: Manager involves human resources and a determination is made as to whether an Employee Consultation or a final formal written reprimand is the next step. (In some situations, a suspension or demotion may be warranted)
  • If an Employee Consultation is scheduled, the employee and manager will have the opportunity to review the fact. After consideration of facts, a decision is made regarding involuntary termination.

Diffuse the impact on remaining employees.

When an involuntary termination is necessary, it’s important for leaders to take proactive and professional actions to make the transition as seamless as possible. The conversation that ends the staff member’s employment should be brief and respectful; it will not be a surprise, as it is a culmination of many previous steps and conversations. Immediately after a termination, management must inform the remaining staff of the change and prevent rumors from spreading. Leaders need to be prepared with a plan – answering questions, sharing what they need from employees in the short term, and showing that they are working to fill the vacancy as quickly as possible.

Learn how MedHQ uses its expertise to help ASCs mitigate HR risks.

Alleviating Hostile Work Environments & Harassment Claims

Ambulatory surgery centers rely on a highly skilled, experienced, and engaged workforce to run efficiently in a change-driven industry. These healthcare professionals have demanding and fast-paced jobs, and they need to work in a safe and supportive environment in order to provide the best patient care.

ASC leaders are responsible for creating a culture where all employees are treated with kindness and respect, regardless of gender or other characteristics. The following best practices aim to mitigate risks associated with sexual harassment, general harassment, and a hostile work environment.

Adopt a “top-down” approach.

ASC leaders must model the standards and behaviors they want to see in their organization. It is their duty to define and enforce clear harassment policies, both in formal guidelines and casual everyday conversations. An employee handbook should outline in writing the processes and procedures to be followed if a harassment claim is filed. And leaders should talk often about the behaviors they expect, and those they won’t tolerate.

Be proactive about addressing risks.

Negative interpersonal behaviors can sour a work environment quickly. Leaders must be proactive about preventing them, incorporating steps such as:

  • Online and in-person training about unacceptable behaviors
  • Frequent conversations about shared beliefs and values
  • Positive recognition of those demonstrating company values
  • Programs to strengthen culture
  • Leaders demonstrating desired behaviors
  • Zero tolerance policies for harassment

Address problems early on.

To foster a positive work environment, employees must feel supported in speaking up about any complaints they have. Whether they are bothered by an uncomfortable incident or an ongoing pattern of harassment, they need to have a safe space to air their concerns. This may involve a short, in-the-moment conversation when someone says something improper. Or it might require more official protocols. Especially with delicate situations, managers shouldn’t hesitate to involve human resources experts who can guide productive discussions, facilitate conflict resolution, and follow up with additional actions.

Learn how MedHQ utilizes its expertise to help ASCs mitigate HR risks.

New White Paper by MedHQ Delivers Proactive Strategies to Mitigate High-Risk HR Events for Surgical Facilities

When it comes to high-risk human resources events, ASCs need to ensure they understand how improperly handling adverse events in human resources (HR) can significantly derail workforce productivity, cost tens of thousands of dollars and cause upward pressure on insurance rates. To assist with that effort, a new guide from MedHQ titled, How to Mitigate Your ASC’s Top 5 HR Risks, provides ASC leaders practical and proven strategies to implement at their facilities.

Launched in 2003, MedHQ assists ASCs with improving revenue, enhancing company culture, and taking time-consuming tasks off the plates of administrators, allowing them to focus on the high-value priorities of running and managing surgery centers. Since 2011, MedHQ has tracked a “Top 10” of HR risk management issues, assigning a monetary risk factor to each event. Today, the company has hundreds of such events in a database, and helps clients gain the benefit of that history.

“In an environment of rapid change, ASC leaders are already stretched thin,” says Tom Jacobs, Co-Founder and Chief Executive Officer of MedHQ, the leading provider of human resources staffing and onsite management services focused specifically on the ASC market. “This topic matters for ASCs and out-patient healthcare businesses because HR risks divert the attention of senior management, distracting them from their goals to improve the quality of care, and improve business results.”

MedHQ’s Vice President of Human Resources, Rita Hernandez-Figi works with ASCs nationwide to provide the business insight they need, so organizations can keep their focus on their patients. “When it comes to preventive practices, it’s all about being proactive vs reactive. An experienced HR team knows how to craft a job description, recruit the right candidates, and implement an interview process that brings candidates with the best skills and fit to the top.”

Hernandez-Figi uses her deep expertise as she addresses the top five high-risk HR events including: FMLA/ADA interactions, workers’ compensation claims, involuntary termination, sexual harassment and hostile work environments.

For ASCs, the key to success with high-risk events is to leverage an expert HR skill set to mitigate risks by aligning HR best practices to business strategy and integrating competent HR execution into every day operations.

ASC leadership interested in more tips and recommendations for leveraging accurate, insightful leadership counsel can download the full white paper here.

How to Mitigate FMLA/ADA Interactions

For many busy healthcare executives, employment practices matters are often secondary to more immediate problems. But while employee/employer challenges might not seem pressing in the moment, if they aren’t addressed, they can become critical and costly in the future. Executives must anticipate and mitigate these risks before they damage an ASC’s reputation, finances, or work environment.

One of the top employment risk management issues is the intersection of the Family and Medical Leave Act (FMLA) and the Americans with Disabilities Act (ADA), which oftentimes comes on the heels of a workplace injury and workers’ compensation insurance claim. The following action steps are designed to help ASCs make plans to protect their employees and their organization.

Understand the rules.

FMLA and ADA, along with worker compensation laws, exist to establish protocols for employees and organizations to follow in specific scenarios. The regulations are intended to safeguard all parties involved. Healthcare executives should have a comprehensive understanding of the laws and their parameters. Under which circumstances does FMLA or ADA – or both – apply?

Outline clear job descriptions.

Every position within an ASC must have a detailed job description that outlines its essential tasks and responsibilities. This is a vital element of managing the interaction between FMLA and ADA; it prevents misunderstanding and clarifies expectations.

Negotiate accommodations.

With a concrete description in place, it is easier to separate mandatory job functions from tasks that may allow for flexibility. This clarity facilitates an FMLA/ADA discussion and minimizes cause for dispute. For example, an office manager with a back injury may be able to negotiate reasonable accommodations for the job, such as delegating filing and moving boxes to another employee. But for a nursing position, accommodation may not be possible if this condition makes essential functions of the job – like lifting a patient – impossible.

Determine next steps.

Conversations about FMLA/ADA issues should happen early and often. It’s especially important for ASC executives to manage situations carefully when an employee is nearing the end of the 12-week, FMLA-allowed leave. This intersection point between FMLA and ADA is where ASCs often make mistakes, putting them at risk for claims. Every situation is different, so assumptions are dangerous.

Executives must work with employees to determine medical limitations, essential job functions, and options for returning to work. Sometimes it’s possible to temporarily restructure a position, or offer a short-term, modified description of job duties. In other scenarios, there isn’t as much room for adaptability. HR professionals are valuable resources in this phase, bringing their expertise to the process.

Learn how MedHQ helps ASCs mitigate HR risks.

10 Ways to Save $10,000 in Human Resources: Better Unemployment Claims Management

As ambulatory surgery centers (ASCs) face more competition in the marketplace and falling reimbursements, they need to operate as efficiently as possible. Saving money on HR-related costs is one way they can thrive.

MedHQ has worked with over 70 healthcare facility partners to find HR savings that also deliver the benefits of improving employee satisfaction and reducing risk.  Through the process, MedHQ gleaned a host of key findings that guided the creation of the MedHQ 10-Point HR Audit (10-Point HR Audit). The 10-Point HR Audit identifies inefficiencies that, when addressed, can result in six-figure savings for a healthcare facility.

One money-saving strategy the audit identified is to better manage the unemployment tax. When an unemployment claim is filed, states lean heavily in favor of the employee. However, there are things a surgery center can do to keep claims minimal.

States have different taxable wage formulas and the rate at which wages can be taxed can vary from 1-7%.

“The tax rate percentage can be negotiated to a lower rate,” said Tom Jacobs, MedHQ CEO. “And not all employers stay on top of this. MedHQ has audited centers with an unemployment tax rate as high as 9% or as low as 3%.”

Centers can save $3,500 – $10,000 annually by better managing unemployment tax.

Click here to download the MedHQ white paper, “10 Ways to Save $10,000 in Human Resources.”

About the MedHQ 10-Point HR Audit
It takes approximately one or two hours for back office staff to gather the information necessary for the 10-Point HR audit. Typical savings = six figures. Request your risk-free 10-Point HR Audit today. If MedHQ fails to identify $25,000 in savings, the audit is free.

10 Ways to Save $10,000 in Human Resources: Outsource Prep Work For Open Enrollment

As ambulatory surgery centers (ASCs) turn over every stone to find the efficiencies that will help them stay competitive in a changing marketplace, looking hard at HR practices is an excellent place to find savings.

 

One of the simplest ways for an ASC HR department to save money is to outsource the work that is necessary to prepare for the employee benefits open enrollment period. Administering an open enrollment period can take weeks of preparation, costing the department 40-80 hours of productivity.

 

MedHQ has worked with over 70 healthcare facility partners to find HR savings that also deliver the benefits of improving employee satisfaction and reducing risk.  Through the process, MedHQ gleaned a host of key findings that guided the creation of the MedHQ 10-Point HR Audit (10-Point HR Audit). The 10-Point HR Audit identifies inefficiencies that, when addressed, can result in six-figure savings for a healthcare facility.

 

Productivity lost on open enrollment preparation and administration can be even higher for surgery centers with more employees and high turnover. More efficient open enrollment preparation, combined with outsourcing the time it takes to evaluate and decide upon benefits renewal, has a pair of advantages:

 

  1. Outsourcing open enrollment work can save a center up to $10,000each year
  2. And, it allowscenter management to stay focused on high-value priorities

 

Click here to download the MedHQ white paper, “10 Ways to Save $10,000 in Human Resources.”

 

About the MedHQ 10-Point HR Audit
It takes approximately one or two hours for back office staff to gather the information necessary for the 10-Point HR audit. Typical savings = six figures. Request your risk-free 10-Point HR Audit today. If MedHQ fails to identify $25,000 in savings, the audit is free.

10 Ways to Save $10,000 in Human Resources: Maintaining a Strong Company Culture Can Save Thousands of Dollars

Ambulatory surgery centers (ASCs) must be able to operate at maximum efficiency.

Falling reimbursements and more competition for patient volume have squeezed revenue, and proactive centers must find ways to save money. One way to accomplish that is to keep HR costs in line.

MedHQ has worked with over 70 healthcare facility partners to find HR savings that also deliver the benefits of improving employee satisfaction and reducing risk.  Through the process, MedHQ gleaned a host of key findings that guided the creation of the MedHQ 10-Point HR Audit (10-Point HR Audit). The 10-Point HR Audit identifies inefficiencies that, when addressed, can result in six-figure savings for a healthcare facility.

One way ASCs can save money and keep employees happy is by maintaining a strong company culture. A strong company culture attracts and retains good employees.

“Centers will foster a stronger culture by recruiting a group of 20 – 40 people who have similar values rather than a group with varying values,” said MedHQ CEO Tom Jacobs. “A strong company culture accompanied by good HR practices, good compensation plans, and good benefits work together to reduce employee turnover.”

An HR partner like MedHQ can perform a trio of duties to help ASC HR departments build stronger cultures.

  1. Help surgery centersdefine their culture and leverage it when hiring top talent
  2. Conduct behavioral interviewing and organizinga peer-reviewed recruiting process
  3. Identify employeeswho are a good fit not only for a particular job but for the company culture

Reducing turnover by one full-time employee translates to $10,000 – $12,000 in savings related to replacement costs. If a center has a 30% annual turnover rate and 30 employees, that’s nine people per year. If the center can cut that rate in half, that equals considerable savings, both in terms of employee recruiting and training.

Click here to download the MedHQ white paper, “10 Ways to Save $10,000 in Human Resources.”

About the MedHQ 10-Point HR Audit
It takes approximately one or two hours for back office staff to gather the information necessary for the 10-Point HR audit. Typical savings = six figures. Request your risk-free 10-Point HR Audit today. If MedHQ fails to identify $25,000 in savings, the audit is free.

10 Ways to Save $10,000 in Human Resources: Controlling Compensation Costs Helps ASCs Compete

One way an ASC’s HR department can help a center operate more efficiently in a competitive marketplace is to cut down on costs by utilizing fair compensation programs that will draw desirable and qualified employees. This strategy will also cut down on costly high turnover rates, which can force surgery center management to be in perpetual hiring mode.

 

MedHQ has worked with over 70 healthcare facility partners to find HR savings that also deliver the benefits of improving employee satisfaction and reducing risk.  Through the process, MedHQ gleaned a host of key findings that guided the creation of the MedHQ 10-Point HR Audit (10-Point HR Audit). The 10-Point HR Audit identifies inefficiencies that, when addressed, can result in six-figure savings for a healthcare facility.

 

To find compensation savings, MedHQ developed and utilizes a 100-question job analysis guide to understand how much a job is ‘worth’ relative to other jobs. Each job is scored and compared to ASC association data to determine pay. When employees understand the thoughtful, fair process, they are more satisfied and turnover is less likely. Two benefits are:

 

  1. Centers can save $10,000- 12,000 per person by minimizing unwanted turnover
  2. Centers can also save on related replacement costs including advertising,hiring temporary and permanent placement agencies, as well as onboarding new employees.

 

“A good process is to score each job well and then use data from credible sources such as the Ambulatory Surgery Center Association regarding the average pay for specific positions, keeping in mind the same job may be weighted differently at different centers,” said Tom Jacobs, MedHQ CEO. “MedHQ uses the data as a starting point, then takes into account information gleaned from the 100-question job analysis guide to structure compensation guidelines for each surgery center.”

 

Click here to download the MedHQ white paper, “10 Ways to Save $10,000 in Human Resources.”

Becker's ASC | MedHQ

Join MedHQ at Becker’s Annual Meeting: The Business and Operations of ASCs

MedHQ is honored to be attending the 23rd Annual Meeting: The Business and Operations of ASCs hosted by Becker’s ASC Review.

The conference takes place Oct 27-29 at Chicago’s Swissotel, and offers attendees over 100 sessions to choose from. There will be over 200 total speakers, including physicians ASC administrators speaking on a variety of topics. All told, more than 1,000 attendees are expected at the event, which focuses on business, clinical and legal issues faced by ASCs.

Tom Jacobs, CEO of MedHQ, is looking forward to attending the conference and speaking with colleagues about how back office management services, such as human resources (HR) and accounting functions at surgery centers can be given proper attention and provide maximum cost savings. As the ASC market continues to mature, streamlined and cost-conscious HR functions are now a necessity.

“MedHQ is here to help. Small and mid-sized companies don’t usually have access to the expertise of a full human resources or accounting team,” said Jacobs. “For healthcare organizations, this expertise is critical, as more than revenue is at stake. An inefficient HR department, for example, not only wastes money at your facility, but patient satisfaction, surgeon satisfaction, employee satisfaction and the reputation of the entire organization takes a hit.”

Stop by Booth 54, and we can discuss how to cut unnecessary costs from your surgery center’s HR department.

Want to learn more ways to save? Click here to download the MedHQ white paper, “10 Ways Surgery Centers are Wasting Money in Human Resources.”

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