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2019 Forecast...
1. Addressing Student Loans: Student loan debt continues to
reach record highs and it even exceeds credit card debt and
auto loan debt. More than one-third of employees overall
(and 55% of millennials) said student loan repayment is a
must-have benefit, according to a Unum study. With only 4
percent of employers currently offering employees some
form of assistance to repay student loans, 2019 is going to see
employers and the industry itself finding ways to offer student
loan refinancing and repayment benefits.
Medicare To Cut Payments To Nursing Homes
Whose Patients End Up Back In The Hospital
By Jordan Rau - National Public Radio
The federal government took a new step this week to
reduce avoidable hospital readmissions of nursing home
patients. The move targets the homes’ bottom lines by
lowering a year’s worth of payments to nearly 11,000
nursing homes, and giving bonuses to nearly 4,000 others.
These financial incentives, determined by each home’s
readmission rates, significantly expand Medicare’s effort to
pay medical providers based on the quality of care instead
of just the number or condition of their patients.
Until now, Medicare mostly limited these kinds of incentives
to hospitals, which have gotten used to facing financial
repercussions if too many of their patients are readmitted,
suffer infections or other injuries, or die.
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“To some nursing homes, it could mean a significant
amount of money,” says Thomas Martin, director of postacute
care analytics at CarePort Health, which works for
both hospitals and nursing homes. “A lot are operating on
very small margins.
The new Medicare program is altering a year’s worth of
payments to 14,959 skilled nursing facilities, based on how
often their residents ended up back in hospitals within 30
days of leaving.
Hospitalizations of nursing home residents, while
decreasing in recent years, remain a problem: Nearly
11 percent of patients in 2016 were sent to hospitals
for conditions that might have been averted with better
medical oversight.
These bonuses and penalties are also intended to
discourage nursing homes from discharging patients
too quickly — something that is financially tempting as
Medicare fully covers only the first 20 days of a stay and
generally stops paying anything after 100 days.
Over this fiscal year, which began Oct. 1 and goes through
the end of September 2019, the best-performing homes will
receive 1.6 percent more for each Medicare patient than
they would have otherwise. The worst-performing homes
will lose nearly 2 percent of each payment. The others will
fall in between.
For-profit nursing homes, which make up two-thirds of
the nation’s facilities, face deeper cuts on average than do
nonprofit and government-owned homes, a Kaiser Health
News analysis of the data found.
In Arkansas, Louisiana and Mississippi, 85 percent of
homes will lose money, the analysis found. More than
half in Alaska, Hawaii and Washington state will get
bonuses.
Overall, 10,976 nursing homes will be penalized, 3,983
will get bonuses and the remainder will not experience
any change in payment, the KHN analysis found.
Medicare is reducing payments to 12 of the 15 nursing
homes run by Otterbein SeniorLife, an Ohio faithbased
nonprofit. Pamela Richmond, Otterbein’s chief
strategy officer, says most of its readmissions occurred
with patients after they went home, not while they
were in the nursing facilities. Otterbein anticipates
losing $99,000 over the year.
“We’re superdisappointed,” Richmond says about the
penalties. She says Otterbein has started to follow up
with former patients or with the home health agencies
that send nurses and aides to patients’ houses to care
for them. If there are signs of trouble, Otterbein will try
to arrange care or bring patients back to the nursing
home if necessary.
“This really puts the emphasis on us to go out and
coordinate better care after they leave,” Richmond
says.
Congress created the Skilled Nursing Facility Value-
Based Purchasing Program incentives in the 2014
Protecting Access to Medicare Act. In assigning
bonuses and penalties, Medicare judged each facility’s
performances in two ways: how its hospitalization rates
in calendar year 2017 compared with other facilities
and how much those rates
changed from calendar...
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2. Taking Care of the Caregivers: Next year will see employers
being more comprehensive with benefits that address
the needs of employees who serve as caregivers. Today’s
multigenerational workforce includes employees who care
for parents, adult children and even grandchildren on a
variety of levels -- emotionally, financially and with general
caregiving support. In fact, nearly one in four employees is
providing financial support for parents or in-laws; and among
employees with adult children, 42 percent are providing
financial support to them, according to the PwC study. Elder
care support, childcare, adoption assistance, financial wellness
benefits -- all are increasingly important to the caregivers.
3. Facilitating Savings: The statistics are staggering --
employees are still struggling paycheck-to-paycheck; many
don’t have $1,000 or more in savings to use for emergencies;
and the typical worker has saved $0 for retirement. It’s time
for the industry to help employees start to take control of
their financial future by encouraging savings. Look for more
financial services benefits in 2019 that offer automated
savings plans as a voluntary benefit.
4. Encouraging Utilization of Financial Wellness Benefits:
Financial wellness has been the buzz for a couple of years now
and employers have added a variety of financial wellness and
education voluntary benefits. But only one-third of employees
utilize the financial wellness benefits their employer offers,
according to the 2018 Workplace Benefits Report from Bank
of America Merrill Lynch. It’s a simple fact that when financial
wellness benefits aren’t used, they don’t work. Employers and
the industry alike will be searching for ways to make these
benefits more engaging, personalized and effective in order to
help their employees improve their financial wellness.
5. Communicating Year-Round: With so many benefit
offerings available today, it can be mind-boggling to
employees to be aware of them all and to understand them.
Year-round benefits communications in a multitude of
communication methods that appeal to each generation and
on platforms and devices they pay attention to is mandatory.
2019 will see employers and the industry re-dedicate itself to
benefits communications, understanding and engagement.
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