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As Healthcare Evolves, Professionals and Patients Must Too

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Young Intelligent Female Doctor Talking To Elderly PatientHave you stopped to look at the ever-changing world of healthcare in recent years?

If not, you’ve missed a number of happenings, some of which may very well have impacted you whether you acknowledged them or not.

While many people have heralded Obamacare as being the answer to their healthcare nightmares, others sport a different opinion.

No matter which side of the coin you fall on, it is important to do your best to stay abreast of the changes taking place.

For those who do not stay in touch, it can prove to be a financial and healthcare nightmare for that matter.

Changes in the Making

Given there is an evolving role of transitional leadership in healthcare, both professionals and patients must adapt.

For example, nurses are being asked in many instances to do more than ever before.

From working longer hours to being in on what maybe once were not considered traditional nursing roles, the women and men working in the nursing field have to adapt. Without adapting to the on-going changes in the healthcare field, they can easily get left behind.

As mentioned earlier, the implementation several years ago of Obamacare has changed the landscape not only for thousands and thousands of patients, but also many in the medical profession, notably doctors.

With more and more doctors not wanting to deal with the insurance fallout from Obamacare, the answer for some has been to leave their practices and work elsewhere in the medical field.

Less doctors in practices and for that matter hospitals means nurses are being asked to step up and take on more defined roles.

Demand for Nurses Continues Nationwide

Peruse the newspaper or online want ads on any given week and you will almost always see advertisements for nursing help.

While there are a number of reasons for the demand in nurses, two of them are the critical care that more and more of them are being asked to deliver, along with the fact that Americans are living longer. As the population ages, more of them end up at medical practices and in hospitals for healthcare.

Given that nurses oftentimes serve as a bridge between patient and doctor, it is critical that they have a good relationship with both.

Stop for a moment and think about the last time you were in a medical practice or hospital. What amount of time was spent with the doctor versus the amount of time you had conversations and/or assistance from a nurse? Safe to say, you probably had more time and interaction with your nurse or nurses.

While doctors still take the lead role at both their practices and when caring for patients in a hospital setting, nurses will continue to evolve into more of a leadership role now and in the years to come. This will especially be true if there continues to be shrinkage in the number of doctors practicing nationwide.

For those already in nursing or thinking about such a career, it is important to remember these factors:

  • Job opportunities – There are no apparent signs of a lessening of demand for nurses across the country. If you have the dedication and skills for this field, there should almost always be job opportunities available;
  • Increased leadership roles – As more patients come to both medical clinics and hospitals seeking care, nurses will continue to be an important piece of the healthcare puzzle. Along with the necessary medical skills, good communication skills are essential. Given the demands on doctors and/or their absence at times when patients call or stop by a medical facility, nurses must be able to deal with a variety of medical situations. Having the skills and patience to deal with myriad of personalities is nothing short of critical;
  • Continued education – Being open to continuing one’s nursing education (both online and in-person) is all but a necessity. As medicine continues to evolve, nurses will be asked to do the same. By learning more on-the-job skills, along with additional information in the classroom, nurses will be even better positioned to increase their roles and salaries.

As more changes undoubtedly come in the healthcare industry, those nurses willing to embrace and grow with the changes will more than likely prove successful.

Photo credit: BigStockPhoto.com

About the Author: Dave Thomas covers business and medical topics on the web.

Making a Healthy Choice When It Comes to Insurance Plans

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ahealthcheckSmall business owners wrestling with the decision of whether to offer group health coverage to their employees have several more months before Obamacare’s small business insurance marketplace is fully operational.

Under the provisions of the Affordable Care Act, businesses with 50 or fewer full-time equivalent employees, or FTEs, are not obligated to provide such coverage for their workers.

However, many companies, both large and small, find they can better attract — and keep — top-quality employees if they offer health coverage as a benefit.

SHOP Postponed

The multiple problems following last fall’s launch of open enrollment for individual health coverage prompted the federal government to postpone for a year the opening of SHOP, known officially as the Small Business Health Options Program.

In the meantime, small businesses that want to move ahead with group health coverage can continue to purchase health plans that meet Obamacare standards from insurance brokers.

Also, businesses in states that have their own Obamacare exchanges can buy coverage in those marketplaces.

Guidelines for Eligibility

If you’re among the small business owners who are opting to wait until SHOP is fully operational, here’s what you need to know about the qualifications necessary for participation in the marketplace:

  • You must have a principal business address within the state where you’re seeking to buy coverage or have an eligible employee with a primary worksite within the state where you’re buying coverage;
  • You must have at least one common-law employee on your payroll other than the business owner, sole proprietor, or their spouses. A common-law employee is defined as anyone who performs services for you wherein you can control what will be done and how it will be done;
  • Your business must have 50 or fewer FTEs, including part-time employees, in order to be eligible to purchase health plans within the small business marketplace. Two part-time employees are equal to one FTE. A couple of years down the road, SHOP eligibility will be expanded to include businesses with 100 or fewer FTEs.

Pay o to 100% of Premium

Interestingly, small businesses that purchase health insurance plans through SHOP are not required to pay any of the premiums for such coverage, according to a Forbes analysis of small business options under Obamacare.

Employers can pay anywhere from 0 to 100 percent of the plan’s premium, and employees must pay the rest. This rule applies only to health insurance plans purchased through SHOP, which is the federal marketplace for small businesses, and is not necessarily applicable to coverage purchased through state-operated exchanges.

For example, employers purchasing coverage through California’s state-operated exchange must pay at least 50 percent of the premiums for such coverage.

No matter whether you plan to pay 100 percent, 50 percent, or none of the premiums for health coverage offered to your employees, there’s a significant tax benefit to buying through SHOP.

Premiums for all such plans are paid with pre-tax dollars. This means that whoever pays the premium — employer, employees, or both — gets a nice tax break.

Control the Coverage

Choosing a health insurance plan from SHOP allows the small business owner to control the coverage that is offered to employees and, as we’ve already seen, to decide how much, if any, to pay toward employee premiums.

If your small business has 25 or fewer FTEs and you decide to pay 50 percent or more of the premiums for health plans purchased from SHOP, you may be eligible for a small business tax credit for the premiums paid.

In order to be eligible for this tax credit, your employees must average less than $50,000 per year in annual wages. Forbes reports that many employers that are eligible for this tax credit are forgoing it because the calculations involved are “slightly cumbersome.”

4 Levels of Coverage

As a small business owner, you can select the level of coverage that will be available to your employees.

As for individual health plans, the four main levels of coverage are Bronze, Silver, Gold, and Platinum.

According to HealthCare.gov, these categories have nothing to do with quality of care but rather describe “the way your employees and the plan can expect to share costs for health care.” In other words, bronze plan coverage would require a higher copay for health services than would be charged under the other metal categories.

HealthCare.gov points out, however, that all plans available through SHOP must provide a set of essential health benefits.

Such benefits include ambulatory patient services, emergency services, hospitalization, maternity and newborn care, mental health and substance use disorder services, prescription drugs, rehabilitative services, laboratory services, preventive and wellness services, and pediatric services.

When evaluating health insurance plans in SHOP, you can compare side by side what services are available under the four levels of coverage.

As noted above, all must provide for the essential health benefits, but higher level plans are likely to have additional benefits.

And, of course, higher level plans cover more of the costs of services and thus have lower copays, if any.

Photo credit: Image courtesy of Vichaya Kiatying-Angsulee / FreeDigitalPhotos.net

About the Author: Don Amerman is a freelance author who writes extensively about a wide array of business and personal finance topics.