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Shrm poll health_care2_actionsbarriers
1.
SHRM Poll: Organizations’
Response to Health Care Reform—Challenges and Actions September 17, 2010
2.
Health Care Reform
Series: Poll 2 Introduction Landmark legislation that brought about major reforms in health care coverage in the United States was enacted in March 2010. The law affects employers and HR professionals in a variety of ways. SHRM will be conducting a series of polls on health care reform and its implications for employers and employees. This presentation covers the findings from the second poll in this series, which was conducted in July 2010. Organizations’ Response to Health Care Reform – Challenges and Actions | ©SHRM 2010 2
3.
Key Findings •
How well do organizations understand the specific aspects of the health care reform law? 50% of organizations have taken some type of action in response to the passing of the health care reform bill. Due to a lack of clarity on the specifics of the law, another 50% have not taken action or are unsure if action has been taken. Sixty-four percent of HR professionals are having difficulty understanding the gray areas and details of the law, 52% are not comfortable with what they know about the law and 54% see lack of understanding as the main implementation barrier. Clearly, HR professionals are waiting on additional information to make informed decisions. • Where are organizations turning to learn about the health care reform law? Nearly 75% of organizations report using an insurance broker to inform them on the new law. Organizations that have not yet taken action are likely relying on information from their insurance broker on how to proceed. • What are the implementation barriers of the health care reform law? Lack of overall understanding of the details of the law, implementation costs and employee out-of-pocket costs were reported as the main barriers to implementing the new law. • What actions are organizations taking in response to the new health care reform law? The top five actions are: 1) working with legal and/or benefits counsel to understand the implications of the law for the organization, 2) sending HR staff to training to learn the details of the law, 3) partnering with current health care benefits providers to design the 2011 health care plan, 4) developing health care cost analysis for organizational leadership, and 5) analyzing the short-term financial impact of the law and the feasibility of offering health care. Organizations’ Response to Health Care Reform – Challenges and Actions | ©SHRM 2010 3
4.
Since April 1,
2010, has your organization taken any action in response to the passing the new health care reform law? 50% 50% 40% 39% 30% 20% 11% 10% 0% Yes No Not sure • 39% of respondents report having taken no action, and these findings are consistent with the data in the next three slides. Specifically, 64% of HR professionals are having difficulty understanding the gray areas and details of the law (see Slide 6); 52% are not comfortable with what they know about the law (see Slide 8); and 54% see lack of understanding as the main implementation barrier (see Slide 9). Clearly, HR professionals are waiting on additional information to make informed decisions. • Respondents who report having taken no action and those who are not sure if action has been taken are likely relying on their insurance broker to take action, as nearly three-quarters of HR professionals report using an insurance broker to inform them on the new law (see Slide 10). Note: n = 1095 Organizations’ Response to Health Care Reform – Challenges and Actions | ©SHRM 2010 4
5.
Since April 1,
2010, has your organization taken any action in response to the passing of the new health care reform law? Comparison by Organization’s Sector and Medical Benefit Funding • Publicly owned for-profits (62%) were more likely than privately owned for-profits (47%) to report that they have taken action in response to the passing of the new health care reform law. • Organizations whose primary medical benefit is currently self -insured (61%) were more likely than organizations with insured (44%) primary medical benefit to report that they have taken action in response to the passing of the new health care reform law. Organizations’ Response to Health Care Reform – Challenges and Actions | ©SHRM 2010 5
6.
In your opinion
as an HR professional, what would you say is the biggest problem for HR caused by the new health care reform law? The grey areas of the new health care reform law 33% Understanding the details of the new law 31% Keeping up with the various regulations and relating them to the appropriate provisions 13% Determining impact on future total compensation strategy 11% Keeping track of when various parts of the law take effect 7% The short compliance deadlines 2% Keeping employees informed about the implications of the new law 2% I don’t see anything problematic about the new law for HR 1% Keeping the C-suite informed about the implications of the new law 0% 0% 10% 20% 30% 40% • 64% of HR professionals are having difficulty understanding the gray areas and details of the law. Note: n = 774. Organizations’ Response to Health Care Reform – Challenges and Actions | ©SHRM 2010 6
7.
In your opinion
as an HR professional, what would you say is the biggest problem for HR caused by the new health care reform law? Comparison by Organization’s Operations Location and Medical Benefit Funding • The grey areas of the new health care reform law (by medical benefit funding): Self-insured organizations (37%) were more likely than insured organizations (28%) to report the grey areas of the new health care reform law as a problem for HR. • Understanding the details of the new law (by medical benefit funding): Insured organizations (36%) were more likely than self-insured organizations (28%) to report understanding the details of the new health care reform law as a problem for HR. • Determining impact on future total compensation strategy (by operations location): Organizations with multinational operations (15%) were more likely than U.S.-based (10%) organizations to report determining impact on future total compensation strategy as a problem for HR . Organizations’ Response to Health Care Reform – Challenges and Actions | ©SHRM 2010 7
8.
What is your
level of agreement with the following statement: "I am comfortable with what I know about the new health care reform law." 50% 45% 41% 40% 30% 20% 11% 10% 3% 0% Strongly disagree Disagree Agree Strongly agree • 52% of HR professionals are not comfortable with what they know about the law. Note: n = 774 Organizations’ Response to Health Care Reform – Challenges and Actions | ©SHRM 2010 8
9.
In general, what
do you think is the main implementation barrier of the new health care reform law for your organization? Lack of overall understanding of details of the new law and its impact on my organization 54% Cost of implementing 37% Employee out-of-pocket cost 16% Not applicable, there is no implementation barrier for my organization 15% Lack of support by senior management 5% Lack of support by employees 3% Lack of support by unions 1% Other 6% 0% 10% 20% 30% 40% 50% 60% Note: n = 759. Percentages do not total 100% as multiple responses were allowed. Respondents were allowed to select their top two options. Organizations’ Response to Health Care Reform – Challenges and Actions | ©SHRM 2010 9
10.
What are the
resources your organization is currently using in regard to the new health care reform law? Insurance broker 73% SHRM’s resources on the new health care reform law 54% Legal counsel (internal or external) 42% Consultants 30% Internal experts 17% Other 12% 0% 10% 20% 30% 40% 50% 60% 70% 80% Note: n = 759. Percentages do not total 100% as multiple responses were allowed. Respondents were allowed to select their top two options. Organizations’ Response to Health Care Reform – Challenges and Actions | ©SHRM 2010 10
11.
What are the
resources your organization is currently using in regard to the new health care reform law? Comparison by Organization Staff Size • Insurance broker (by staff size): Smaller organizations (those with fewer than 2,500 employees) were more likely than organizations with 2,500 to 24,999 employees to report that they are currently using insurance broker as one of their resources in regard to the new law. Smaller Organizations Larger Organizations Differences Based on Organization Staff Size •50 to 99 employees (97%) •2,500 to 24,999 employees Smaller organizations > larger •100 to 499 employees (85%) (55%) organizations •500 to 2,499 employees (75%) • SHRM’s resources on the new health care reform law (by staff size): Smaller organizations were more likely than organizations with 2,500 to 24,999 employees to report that they are currently using SHRM’s resources as one of their resources in regard to the new law. Smaller Organizations Larger Organizations Differences Based on Organization Staff Size •100 to 499 employees (68%) •2,500 to 24,999 employees Smaller organizations > larger (40%) organizations • Legal counsel (internal or external) (by staff size): Larger organizations (those with 500 or more employees) were more likely than smaller organizations (100 to499 employees) to report that they are currently using legal counsel as one of their resources in regard to the new law. Smaller Organizations Larger Organizations Differences Based on Organization Staff Size •100 to 499 employees (28%) •500 to 2,499 employees (49%) Larger organizations > smaller •2,500 to 24,999 employees organizations (57%) •25,000 or more employees (57%) Organizations’ Response to Health Care Reform – Challenges and Actions | ©SHRM 2010 11
12.
What are the
resources your organization is currently using in regard to the new health care reform law? Comparison by Organization Staff Size (continued) • Consultants (by staff size): Larger organizations (those with 500 to 24,999 employees) were more likely than organizations with 100 to 499 employees to report that they are currently using consultants as one of their resources in regard to the new law. Smaller Organizations Larger Organizations Differences Based on Organization Staff Size •100 to 499 employees (18%) •500 to 2,499 employees (34%) Larger organizations > smaller •2,500 to 24,999 employees organizations (57%) • Internal experts (by staff size): Larger organizations (those with 2,500 to 24,999 employees) were more likely than smaller organizations (500 to 2,499 employees) to report that they are currently using internal experts as one of their resources in regard to the new law. Smaller Organizations Larger Organizations Differences Based on Organization Staff Size •500 to 2,499 employees (18%) •2,500 to 24,999 employees Larger organizations > smaller (32%) organizations Organizations’ Response to Health Care Reform – Challenges and Actions | ©SHRM 2010 12
13.
What are the
resources your organization is currently using in regard to the new health care reform law? Comparison by Selected Organizational Demographics Differences Based on Differences Differences Differences Organization Sector Based on Based on Based on Union Organization’s Medical Benefit Status Operations Funding Location U.S.-based only Privately owned for-profits organizations (76%) (80%) & nonprofits (81%) > Insured (83%) > self- Non-unionized (75%) Insurance broker > multinational publicly owned for-profits insured (66%) > Unionized (65%) operations (66%) (60%) & government (59%) Privately owned for-profits U.S.-based only (59%) & government (66%) organizations (56%) Insured (59%) > self- SHRM’s resources on the new health care reform law > publicly owned for-profits > multinational insured (51%) (43%) operations (43%) Multinational Publicly owned for-profits operations (50%) > Self-insured (52%) > Unionized (51%) > Legal counsel (internal or external) (56%) > privately owned U.S.-based only insured (29%) non-unionized (40%) for-profits (37%) organizations (39%) Publicly owned for-profits Multinational (44%) > privately owned operations (42%) > Self-insured (43%) > Unionized (41%) > Consultants for-profits (25%) & U.S.-based only insured (15%) non-unionized (28%) nonprofits (27%) organizations (27%) Multinational Publicly owned for-profits operations (22%) > Self-insured (20%) > Internal experts (28%) > privately owned U.S.-based only insured (14%) for-profits (15%) organizations (16%) Note: Blank cell indicates that there were no significant differences in this category. Organizations’ Response to Health Care Reform – Challenges and Actions | ©SHRM 2010 13
14.
What actions has
your organization taken in response to the passage of the new health care reform bill? Already Planning Currently NOT Doing/Done to Do Doing and Have NO Plans to Do Working with legal and/or benefits counsel to help the organization understand the 80% 15% 5% implications of the new law Sending HR staff in organization to classes (i.e., attending seminars, participating in 78% 14% 8% webcasts on this topic) to learn details of the new law and its impact on organization Partnering with current health benefits provider to design 2011 health care plan that will 75% 24% 1% include areas affected by the new law Developing health care cost analysis for organization’s leaders 59% 35% 7% Analyzing short-term financial impact of the new law and the feasibility of offering 57% 33% 10% health care Developing a new health care strategy plan for our organization 48% 39% 13% Developing an employee communication strategy related to the new law 45% 46% 9% Developing employee communication on the impact of the new law on the 41% 54% 6% organization’s health care plan and the employees Analyzing long-term financial impact of the new law and the feasibility of offering health 38% 54% 9% care Communicating impact of the new law to employees 37% 57% 7% Communicating impact of the new law to retirees 12% 40% 48% • HR professionals appear to be focused first on understanding the law and its implications for the organization and employees before communicating with employees/retirees. Note: n = 395-427. Percentages do not total 100% due to rounding. Only respondents whose organizations have taken action(s) in response to the passing of the new health care reform law were included in this analysis. “Not sure/not applicable” responses were excluded from this analysis. Organizations’ Response to Health Care Reform – Challenges and Actions | ©SHRM 2010 14
15.
What actions has
your organization taken in response to the passing of the new health care reform law since April 1, 2010? Comparison of Actions Organizations Have Taken by Organization Staff Size • Partnering with current health benefits provider to design 2011 health care plan that will include areas affected by the new health care reform law (by staff size): Larger organizations (those with 2,500 to 24,999 employees) were more likely than organizations with fewer than 500 employees to report that they are partnering with their current health benefits provider to design 2011 health care plan that will include areas affected by the new law. Smaller Organizations Larger Organizations Differences Based on Organization Staff Size •100 to 499 employees (58%) •2,500 to 24,999 employees Larger organizations > smaller (84%) organizations • Developing health care cost analysis for organization’s leaders (by staff size): Larger organizations (those with 2,500 to 24,999 employees) were more likely than organizations with fewer than 500 employees to report that they are developing health care cost analysis for organization’s leaders. Smaller Organizations Larger Organizations Differences Based on Organization Staff Size •100 to 499 employees (42%) •2,500 to 24,999 employees Larger organizations > smaller (76%) organizations • Analyzing short-term financial impact of the new law and the feasibility of offering health care (by staff size): Larger organizations (those with 2,500 to 24,999 employees) were more likely than smaller organizations (fewer than 2,5000 employees) to report they are currently analyzing short-term financial impact of the new law and the feasibility of offering health care. Smaller Organizations Larger Organizations Differences Based on Organization Staff Size •100 to 499 employees (37%) •2,500 to 24,999 employees Larger organizations > smaller •500 to 2,499 employees (59%) (80%) organizations Organizations’ Response to Health Care Reform – Challenges and Actions | ©SHRM 2010 15
16.
What actions has
your organization taken in response to the passing of the new health care reform law since April 1, 2010? Comparison of Actions Organizations Have Taken by Organization Staff Size (continued) • Developing a new health care strategy plan for our organization (by staff size): Larger organizations (those with 2,500 to 24,999 employees) were more likely than organizations with fewer than 500 employees to report that they are developing a new health care strategy plan for their organization. Smaller Organizations Larger Organizations Differences Based on Organization Staff Size •100 to 499 employees (35%) •2,500 to 24,999 employees Larger organizations > smaller (62%) organizations • Developing an employee communication strategy related to the new law (by staff size): Larger organizations (those with 2,500 to 24,999 employees) were more likely than organizations with fewer than 2,500 employees to report that they are developing an employee communication strategy related to the new law. Smaller Organizations Larger Organizations Differences Based on Organization Staff Size •100 to 499 employees (36%) •2,500 to 24,999 employees Larger organizations > smaller •500 to 2,499 employees (38%) (61%) organizations • Developing employee communication on the impact of the new law on organization’s health care plan and the employees (by staff size): Larger organizations (those with 2,500 to 24,999 employees) were more likely than smaller organizations (500 to 2,499 employees) to report they are currently developing employee communication on the impact of the new law on organization’s health care plan and the employees. Smaller Organizations Larger Organizations Differences Based on Organization Staff Size •500 to 2,499 employees (35%) •2,500 to 24,999 employees Larger organizations > smaller (58%) organizations Organizations’ Response to Health Care Reform – Challenges and Actions | ©SHRM 2010 16
17.
What actions has
your organization taken in response to the passing of the new health care reform law since April 1, 2010? Comparison of Actions Organizations Have Taken by Organization Staff Size (continued) • Analyzing long-term financial impact of the new law and feasibility of offering health care (by staff size): Larger organizations (those with 2,500 to 24,999 employees) were more likely than smaller organizations (500 to 2,499 employees) to report they are currently analyzing long-term financial impact of the new law and their ability to offer health care. Smaller Organizations Larger Organizations Differences Based on Organization Staff Size •500 to 2,499 employees (32%) •2,500 to 24,999 employees Larger organizations > smaller (61%) organizations • Communicating impact of the new law to employees (by staff size): Larger organizations (those with 2,500 to 24,999 employees) were more likely than smaller organizations (500 to 2,499 employees ) to indicate that they are communicating impact of the new law to employees. Smaller Organizations Larger Organizations Differences Based on Organization Staff Size •500 to 2,499 employees (30%) •2,500 to 24,999 employees Larger organizations > smaller (53%) organizations Organizations’ Response to Health Care Reform – Challenges and Actions | ©SHRM 2010 17
18.
What actions has
your organization taken in response to the passing of the new health care reform law since April 1, 2010? Comparison of Actions Organizations Have Taken by Selected Organizational Demographics Differences Differences Differences Differences Based on Based on Based on Based on Union Organization Organization’s Medical Benefit Status Sector Operations Funding Location Working with legal and/or benefits counsel to help Self-insured (83%) > organization understand the implications of the new law insured (73%) Sending HR staff in our organization to classes (i.e., Privately owned for- attending seminars, participating in webcasts on this topic) to profits (86%) > learn details of the new law and its impact on the publicly owned for- organization profits (70%) Partnering with current health benefits provider to design Self-insured (81%) > 2011 health care plan that will include areas affected by the insured (64%) new health care reform law Developing health care cost analysis for organization’s Self-insured (71%) > Unionized (73%) > leaders insured (44%) non-unionized (58%) Publicly owned for- Multinational Analyzing short-term financial impact of the new law and the profits (73%) > operations (73%) > Self-insured (69%) > Unionized (72%) > feasibility of offering health care privately owned for- U.S.-based only insured (43%) non-unionized (57%) profits (55%) organizations (55%) Developing a new health care strategy plan for our Self-insured (57%) > organization insured (34%) Note: Blank cell indicates that there were no significant differences in this category. Organizations’ Response to Health Care Reform – Challenges and Actions | ©SHRM 2010 18
19.
What actions has
your organization taken in response to the passing of the new health care reform law since April 1, 2010? Comparison of Actions Organizations Have Taken by Selected Organizational Demographics (continued) Differences Differences Differences Differences based on based on based on medical based on union organization organization’s benefit funding status sector operations location Developing an employee communication strategy related to Self insured (51%) > the new law insured (34%) Multinational Developing employee communication on the impact of the operations (53%) > Self insured (50%) > new law on organization’s health care plan and the U.S. based only insured (25%) employees organizations (37%) Publicly owned for- Analyzing long-term financial impact of the new law and the profits (55%) > Self insured (45%) > feasibility to offer health care privately owned for- insured (28%) profits (35%) Multinational operations (49%) > Self insured (41%) > Communicating impact of the new law to employees U.S. based only insured (29%) organizations (32%) Note: Blank cell indicates that there were no significant differences in this category. Organizations’ Response to Health Care Reform – Challenges and Actions | ©SHRM 2010 19
20.
Since the enactment
of the new health care reform law, has there been an increase or a decrease in contact from your organization’s plan participants (e.g., employees, spouses, retirees) with your HR/benefits staff or third-party administrator (TPA)? 1% From active employee participants 80% 19% 1% From non-employee plan participants (e.g., spouse) 91% 8% 1% From retirees 90% 10% 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% Decrease About the same Increase Note: n = 291-715. Percentages do not total 100% due to rounding. “Not sure/not applicable” responses were excluded from this analysis. Organizations’ Response to Health Care Reform – Challenges and Actions | ©SHRM 2010 20
21.
Since the enactment
of the new health care reform law, has there been an increase or a decrease in contact from your organization’s plan participants (e.g., employees, spouses, retirees) with your HR/benefits staff or third-party administrator (TPA)? Comparison by Organization’s Sector and Medical Benefit Funding • Increased contact from active employee participants (by medical benefit funding): Self-insured organizations (25%) were more likely than insured organizations (12%) to report that there has been an increase in contact with HR/benefits staff or TPA from active employee participants. • Increased contact from active employee participants (by sector): Publicly owned for-profits (27%) were more likely than privately owned for-profits (14%) to report that there has been an increase in contact with HR/benefits staff or TPA from active employee participants. Organizations’ Response to Health Care Reform – Challenges and Actions | ©SHRM 2010 21
22.
How is your
organization’s primary medical benefit currently funded? Insured, 44% Self-insured, 56% Note: n = 749 Organizations’ Response to Health Care Reform – Challenges and Actions | ©SHRM 2010 22
23.
How is your
organization’s primary medical benefit currently funded? Comparison by Organization’s Staff Size, Sector, Operations Location, Sector and Union Status • By staff size: Larger organizations (those with 500 or more employees) were more likely than organizations with fewer than 500 employees to report that their organization’s primary medical benefit is self-insured. Smaller Organizations Larger Organizations Differences Based on Organization Staff Size •100 to 499 employees (39%) •500 to 2,499 employees (69%) Larger organizations > smaller •2,500 to 24,999 employees organizations (84%) •25,000 or more employees (84%) • By operations location: Organizations with multinational operations (71%) were more likely than U.S.-based (51%) organizations to report that their organization’s primary medical benefit is self-insured. • By sector: Publicly owned for-profits (72%) were more likely than privately owned for-profits (50%) and nonprofits (49%) to report that their organization’s primary medical benefit is self-insured. • By union status: Unionized organizations (64%) were more likely than non-unionized (54%) organizations to report that their organization’s primary medical benefit is self-insured. Organizations’ Response to Health Care Reform – Challenges and Actions | ©SHRM 2010 23
24.
Demographics: Organization Industry
Industry Manufacturing –other 18% Health care, social assistance (e.g., hospitals, clinics) 13% Financial services (e.g., banking) 8% Services –professional, scientific, technical, legal 7% Educational services/education 6% Government/public administration—federal, state/local, tribal 5% 5% Retail/wholesale trade Construction, mining, oil and gas 4% 4% Insurance Note: n = 754. Percentages do not total 100% due to rounding. Organizations’ Response to Health Care Reform – Challenges and Actions | ©SHRM 2010 24
25.
Demographics: Organization Industry
(continued) Industry Other services (e.g., other nonprofit, church/religious organizations) 4% Transportation, warehousing (e.g., distribution) 3% High-tech 3% Services—accommodation, food and drinking places 3% Utilities 2% Real estate, rental, leasing 2% Publishing, broadcasting, other media 2% Manufacturing—auto/auto-related 2% Arts, entertainment, recreation 1% Consulting 1% Telecommunications 1% Association—professional/trade 0% Pharmaceutical 0% Biotech 0% Other 5% Note: n = 754. Percentages do not total 100% due to rounding. Organizations’ Response to Health Care Reform – Challenges and Actions | ©SHRM 2010 25
26.
Demographics: Organization Sector
Privately owned for-profit organization 47% Publicly owned for-profit organization 21% Nonprofit organization 20% Government sector 8% Other 4% 0% 10% 20% 30% 40% 50% 60% Note: n = 756 Organizations’ Response to Health Care Reform – Challenges and Actions | ©SHRM 2010 26
27.
Demographics: Organization Staff
Size 50% 40% 35% 30% 27% 26% 20% 10% 6% 5% 0% 50 to 99 employees 100 to 499 employees 500 to 2499 employees 2500 to 24999 25000 or more employees employees Note: n = 497. Percentages do not total 100% due to rounding. Organizations’ Response to Health Care Reform – Challenges and Actions | ©SHRM 2010 27
28.
Demographics: Other
Does the organization have U.S.-based Is organization a single-unit company or a multi- operations (business units) only or unit company? does it operate multinationally? Single-unit company: A 29% company in which the U.S.-based operations 75% location and the company are one and the same Multinational operations 25% Multi-unit company: A 71% company that has more than Note: n = 750 one location Note: n = 763 • 19% of organizations indicated that Are HR policies and practices determined by employees at their work location were the multi-unit corporate headquarters, by each unionized. work location or both? Note: n = 755 Multi-unit headquarters determines 64% HR policies and practices Each work location determines HR 1% policies and practices A combination of both the work 35% location and the multi-unit headquarters determine HR policies and practices Note: n = 556 Organizations’ Response to Health Care Reform – Challenges and Actions | ©SHRM 2010 28
29.
SHRM Poll: Organizations’
Response to Health Care Reform – Poll 2 Methodology • Response rate = 21% • Sample comprised of 1,095 randomly selected HR professionals with the job title of manager and above, as well as HR professionals in the compensation and benefits functional area. All analyses were based on respondents working at organizations with a staff size of 50 employees or more. • Margin of error is +/- 3% • Survey fielded July 22–August 3, 2010 For more poll findings, visit: www.shrm.org/surveys Follow us on Twitter: http://twitter.com/SHRM_Research Organizations’ Response to Health Care Reform – Challenges and Actions | ©SHRM 2010 29
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