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Author: Charlotte Huff

Posted on May 5, 2010August 9, 2018

Laparoscopic Surgeries The Better Surgical Cut

In their pursuit of cost-effective medical treatment, officials at a Colorado Springs school district wanted to move beyond prescription drug and chronic disease management programs. So they trained their sights on surgery, specifically laparoscopic procedures that involve smaller surgical incisions.


Studies have shown several related benefits, including shorter recovery time and reduced risk of infection, says Ken Detweiler, the former director of risk-related activities for the district, Colorado Springs School District 11. Plus, the price difference can be substantial, ranging from $1,700 to $7,800 per procedure, depending on the surgery involved.


Detweiler, then the director and now a school district consultant, decided to act on that information, launching a program to encourage the district’s 6,000 medical plan enrollees to consider laparoscopy—also known as minimally invasive surgery—for five common surgeries.


Working in conjunction with the district’s insurance administrator, school district officials talked up the medical benefits and offered employees a lower co-pay, beginning in mid-2007. A preauthorization step also was added, to scrutinize medical necessity when a more traditional open incision was recommended.


“I think a lot of employers would say, ‘Why would you deal at this level?’ ” Detweiler says. “It almost sounds like I’m getting in the middle of the patient and the doctor. And that was not the case at all.


“The surprising thing to me was, the secret to making this happen was the employees,” he says. Teachers don’t want to be out of the classroom, he says. And once they understand the shorter recuperation time, “Word-of-mouth gets out.”


In an analysis prior to the initiative, the district determined that its employees’ use of laparoscopy already had saved nearly $1 million over a two-year period. That savings translates to at least $6 per member per month for the district, which is self-funded. Detweiler presented the data in February to a San Antonio forum hosted by the National Business Coalition on Health and the Integrated Benefits Institute.

Once the educational effort kicked in, the laparoscopy rate increased significantly for some procedures, including hysterectomy and colectomy (in which a portion of the colon is removed). Within 18 months, the percentage of employees getting their hysterectomies through a small incision increased from 28 percent to 81 percent. For colectomy, the rate increased from 33 percent to 100 percent.


Education versus coercion?
Detweiler cites a couple of other Colorado employers that are taking a similar route by providing incentives or education related to minimally invasive surgery. Another frequently cited adherent is Hannaford Supermarkets, which launched a minimally invasive surgery program, including lower co-pays, in 2008.


Such surgery-focused efforts are still relatively rare, but the Colorado initiative is a “signal of things to come,” says Andrew Webber, president of the National Business Coalition on Health.


 Employers first started providing incentives in regard to preventive services and chronic conditions, he says.


“Now, I think we will move in progression into more acute care and clinically based intervention strategies,” he says. “I think the basic theme here is we should be rewarding the higher-value services.”


The first three procedures selected by the Colorado school district—colectomy, gallbladder and hysterectomy—were chosen in part due to their potential cost savings and reduced time away from work. In mid-2008, bariatric surgery and appendectomy were added.

Laparoscopy Adoption Rates

The Colorado Springs school district compared laparoscopy rates before and after its educational effort. The after data was collected for calendar year 2008. Bariatric surgeries and appendectomies were added July of that year, and the remaining three procedures in July 2007.

Procedure

Before

After

Colectomy

33%

100%

Hysterectomy

28

  81

Gall bladder

93

100

Bariatric

93

100

Appendectomy

63

  50

Source: Ken Detweiler, Colorado Springs School District 11

Working with its insurance administrator, the school district provided education via newsletters and e-mails. Employees also pay a lower co-pay for laparoscopy than they do for a procedure using the larger incision: $200 less for outpatient surgery and $400 less if hospitalization is needed. They also were given a list of local surgeons who perform laparoscopy.


It’s the source of that educational literature that makes Michael Gusmano, a research scholar at The Hastings Center, a bioethics research institute, a bit uncomfortable. While such employer-driven efforts might be well-intentioned, it’s a “bit of a problematic scenario,” as he describes it.


“I wouldn’t want my employer, who has a direct financial incentive for having me take the cheaper [medical] option, to be the one charged with providing me with all of the relevant information,” he says. “There is a legitimacy and a trust issue here, I think.”


Employee driven
Previously, employees weren’t necessarily aware of their surgical options. Instead, they simply used the surgeon to whom they had been referred, Detweiler says. After all, he points out, laparoscopic techniques date back some 20 years, but that doesn’t mean the patients always knew about them.


“The question is, why would I have a 28 percent adoption rate on hysterectomies,” if not for the fact that employees hadn’t previously realized they had an option to traditional surgery?

By calendar year 2008, 100 percent of the school district’s gallbladder and bariatric surgeries involved the use of small incisions. Of the five surgeries in the program, only appendectomy fell below 81 percent usage of laparoscopy, in part because the surgery tends to be an emergency procedure with less opportunity to pre-select the surgeon, Detweiler says. If the laparoscopy rate had exceeded 85 percent for all five procedures, the school district would have saved $127,000 across the two years studied, ending in fiscal year 2007, he says.


The American College of Surgeons hasn’t taken a position on such employer initiatives, according to a spokeswoman. But a surgeon whom the college suggested to comment, but who was not speaking for the college, said that employers should keep in mind that not all surgeons are equally skilled or trained.


“Not all surgeons are good at everything,” says Dr. Daniel B. Jones, chief of minimally invasive surgery at Beth Israel Deaconess Medical Center in Boston. One way for employers to check surgeons’ training, he says, is to ask if they hold a certification in the fundamentals of laparoscopic surgery or have completed laparoscopic training following their general surgery fellowship.


Detweiler says the school district doesn’t review the surgeons’ training or the number of procedures they perform. But the district does make sure that employees aren’t penalized if medical necessity requires a larger incision, he says, responding to a concern raised by The Hastings Center’s Gusmano.


If the preauthorization coordinator makes that decision, or the surgeon changes approach mid-surgery, the employee doesn’t pay the higher co-pay. “I’m not out to make a couple of hundred bucks on co-pays,” Detweiler says. “I’m more interested in getting them back to where they want to be. Back to work, return to their normal lifestyle.”


Launching the initiative was inexpensive, amounting to a few meetings and some educational materials. The primary investment was the cost of the reduced co-pay for laparoscopy patients, Detweiler says. Thus, for each dollar spent, the savings ranged from $5.7 for a colectomy to $26 for gallbladder surgery.


That analysis, he adds, doesn’t include other costs, such as reduced physical therapy and pain medication with the smaller incision. Neither does it factor in lost educational time and the cost of a substitute, which rings up an additional $90 per day.


Workforce Management Online, May 2010 — Register Now!

Posted on April 20, 2010August 9, 2018

New Law Requires a Rework of Health Risk Assessments

For Concentra, a Dallas-based health care company, the impact of the new genetics nondiscrimination law primarily has boiled down to a single question. Last year, Concentra leaders trimmed that question, about family history, from the 39-question health risk assessment it uses with its 6,000 employees and recommends to other employers.


Typically, risk assessments run 30 to 45 questions long, with no more than one or two delving into family history, says Jim Greenwood, CEO of Concentra, which operates more than 550 medical centers and work-site clinics.


“You are still collecting a wealth of information on an individual and their lifestyle,” he says. “The key point is that employers want their people to be aware of any health risks that they have regardless of the genesis of that health risk, whether that’s behavior or genetics.”


Prior to the implementation of the Genetic Information Nondiscrimination Act, which went into effect for many health plans this year, some employers and related interest groups expressed concern that the new law would erode their ability to motivate employees to improve their own health.


The law prohibits the collection of any individual’s genetic information—including family history—for any purposes related to insurance underwriting. According to the interim final rules that implement the act, it also stipulates against using any incentives to encourage the completion of a health risk assessment or participation in a wellness program. “Incentives” is a broad category that includes discounts, rebates or other premium payment changes.


Some groups, including the American Benefits Council, are pushing for the finalized wording to be more conducive to wellness efforts. To date, though, the ripple effect has been limited, with many employers simply removing family history questions in advance of the law’s implementation, according to several workforce experts interviewed.


“I think employers have already made their decision—they’ve decided that they are going to scrub [the family history questions],” says J.D. Piro, principal and leader of the health care law consulting group at Hewitt Associates.


But employers should remain vigilant about shielding employee health information, particularly in light of the new law’s protections in regard to genetics-related employment discrimination, says Stephen Paskoff, an attorney and president of ELI, an Atlanta-based training company. A terminated employee could allege that he was fired in part because the boss knew of an underlying genetic risk, such as a family history of Huntington’s disease.


Employees know that employers are watching every dollar they spend, thus elevating their index of suspicion about employer actions, Paskoff says. “I think proving that causal link [to genetic discrimination] will be an issue probably,” he says. “But it adds an issue of complexity that I can tell you that I think most people are not aware of right now.”


Wellness hurdles?
Meanwhile, wellness incentives are more popular than ever, thanks to rising health care costs. By 2010, 53 percent of large employers were providing financial incentives to those who enrolled in wellness programs, such as weight loss or smoking cessation, according to a survey released in March by Towers Watson and the National Business Group on Health. An additional 23 percent planned to do so by 2011. The survey results were based on 507 employers with 1,000-plus employees.


In a comment letter sent to federal officials in December 2009, the American Benefits Council and the HR Policy Association raised concerns about the wording of the interim final rules for the implementation of GINA, saying they force group health plans to choose between providing incentives or asking for details about family history.


Incentives typically encourage employees to complete the assessments, says Kathryn Wilber, senior counsel for health policy at the American Benefits Council. “You kind of have to sacrifice your [employee] participation, since incentives do work well, or you lose some meaningful information in terms of health risk assessment,” she says.


The Genetic Information Nondiscrimination Act will influence employer-driven wellness initiatives, although to what degree is still unclear, says Daniel Vorhaus, a North Carolina attorney and editor of the online Genomics Law Report. “There are fewer degrees of freedom in terms of what they can ask about and how they can structure the incentives around wellness programs compared with pre-GINA,” he says.


“Does that mean wellness programs can’t be effective? No,” he says. “Does that mean in some instances they may be less effective? Maybe.”


Maintaining the wall
To protect themselves, employers now need to maintain a firm separation between those handling workers’ health information and those making hiring and firing decisions, says ELI’s Paskoff. For GINA to be triggered, he says, a claimant would have to prove some level of knowledge about a genetic condition by the person who fired or failed to hire.


GINA does contain what’s frequently dubbed a “water-cooler exemption,” adds Connie Walters, ELI’s general counsel. “Managers don’t have to be frightened about asking the question of ‘How are you feeling today?’ But stay away from more detailed questions, she advises. If an employee mentions they have a sick family member, she says: “Don’t ask, ‘What exactly is wrong?’ You don’t want to push.”


Current uncertainties will ease over time, as society becomes more comfortable with not only the law, but also the inherent limits of genetic information itself, Vorhaus says. After all, genes typically indicate some underlying risk, rather than providing a set template for future health complications, he says. Neither, he says, is “every use of genetic information harmful and a misuse, and that includes by employers.”


At Concentra, the one question deleted from the risk assessment focused on health problems in the employee’s immediate family. It specifically asked about a half-dozen medical diagnoses, including colon and breast cancer, diabetes and heart attacks before age 55 in men (65 in women).


But employers are moving away from relying on questionnaires alone, Greenwood says. Risk assessments ultimately are only as reliable as what the employees know or are willing to report, he says. The better route is to pair the assessments with biometric screenings, such as weight and blood pressure readings. This approach provides a better window into health risks, some of which the employees themselves may not realize that they have.


That includes Concentra’s own employees. “We want them to know their own numbers,” Greenwood says. Although Concentra did drop the family history question, it still provides incentives. Employees who complete the health risk assessment and biometric screenings benefit by getting a lower premium on their health insurance.


Workforce Management Online, April 2010 — Register Now!

Posted on November 23, 2009June 27, 2018

Taking a Tailored Approach to Dental Benefits

Dental coverage, traditionally a one-size-fits-all benefit, is becoming more complex. For interested employers, though, the more nuanced options may provide better prevention and related cost savings than does the cookie-cutter approach.


The plan designs, which range from new covered services to better coverage of existing treatments, have emerged from an evolving body of research called evidence-based dentistry. As the field develops, one of its central tenets is risk stratification.


Rather than offer the same dental services to everyone, the plans more closely align coverage not only with the individual’s cavity and gum history but even with other non-dental conditions, such as diabetes or heart disease. By providing broader coverage upfront, the goal is to forestall or prevent more costly dental work later, according to the providers and dental consultants interviewed.


Frequently, though, employers haven’t caught up with the new world of dental coverage, says Doyle Williams, DDS, chief dental officer at Delta Dental of Massachusetts. “I give about 150 lectures a year to employers,” he says. “To watch their eyes pop open tells me that they don’t know this, they don’t get it. They have no idea that dentistry can be tailored—that there is a risk status. That some people are at higher risk.”


Tailoring coverage
The specifics of tailored coverage vary depending on the plan involved, as well as what the employer has negotiated. Along with providing more stratified coverage options, insurance providers also are striving to better educate employees about their own dental risk and the related benefits available to them.


Employees with a cavity track record, for example, might get more than two covered cleanings annually. Other plans might pay for deep cleanings of diseased gums (also known as scaling and root planing), rather than asking the employee to pick up part of the tab. Depending on the employee’s risk, other products might be offered, including fluoride varnish or a special prescription mouth rinse.


Investing in Prevention
As evidence-based dentistry evolves, some plans and employers are expanding prevention, in some instances footing the bill for some products or procedures. A few examples:
 
Fluoride varnish: This sticky concentrated fluoride, which is applied by the dentist, adheres longer than fluoride rinses.
 
Deep gum cleaning: Also called scaling and root planing, these cleanings reduce bacteria that have collected in gum pockets. Prescription products: They include an antimicrobial mouth rinse and a fluoride toothpaste to help protect vulnerable gums and teeth.
 
Prescription products: They include an antimicrobial mouth rinse and a fluoride toothpaste to help protect vulnerable gums and teeth.
 


In recent years, the Massachusetts Public Employees Fund has expanded preventive coverage for the approximately 76,000 enrollees, including dependents, who are covered by the fund’s dental and vision plans. The fund, which is self-insured, uses Delta Dental of Massachusetts to administer its dental coverage but has designed its own network of affiliated dentists and related benefits.


In recent years, the fund has started paying for a prescription antimicrobial mouth rinse after deep gum cleaning treatments. It also covers 100 percent of the cost of fluoride varnish—a sticky coat of fluoride applied to the tooth’s surface—for both children and adults who are considered to be at moderate to high risk of tooth decay.


Susan Fournier, the fund’s executive director, can’t point to any precise cost-savings data. But she remains hopeful, based on some early indications of improved dental health. “It just makes sense that if you can move them [enrollees] out of that higher risk status and get them into a low risk status, it will be less expensive,” she says. “But we also know it will take a lot [of care] upfront.”


Weighing risk
By 2008, 176 million Americans—slightly more than half the U.S. population—carried some type of dental insurance, a 1.3 percent increase from the prior year, according to a survey published this summer by the National Association of Dental Plans and the Delta Dental Plan Association.


Employers are becoming more aware of dental care’s value, says Evelyn Ireland, executive director of the National Association of Dental Plans, a trade group. In 2008, 62 percent of employers surveyed described dental as essential to their benefits package, compared with 53 percent three years earlier. That’s a nearly 10-point jump, Ireland points out. “The message about the connection between dental benefits and overall health is really getting through.”


Still, providing coverage doesn’t guarantee that employees will use the benefits, whether the underlying reason is dental-chair nerves or simply an overbooked schedule. Just three-fourths of those with dental insurance (and half of those without) have gotten at least one checkup in the prior year, according to a 2007 consumer survey conducted by National Association of Dental Plans. “There’s a real hard core of patients who will not seek dental care no matter what,” says Marv Zatz, DDS, a senior dental consultant at Towers Perrin.


In truth, though, not all patients face the same dental risk. Risk can be altered by the patients’ history of cavities and gum disease, whether they smoke or drink, and even vulnerability to conditions like dry mouth. Cigna is among those insurers that offer online risk assessments, such as this cavity risk tool.


Emerging research also indicates that untreated gum disease may be associated with other medical conditions, including heart disease and diabetes. As a result, some plans have made it easier for those at-risk groups to get scaling and root planing, when needed, by covering it at 100 percent, Ireland says.


Cigna offers that option for at-risk individuals who are enrolled in both their medical and dental plans. “I’ll be very frank: The studies that are out there show a strong association,” says Miles Hall, DDS, chief clinical director for Cigna Dental. “At this point, they do not necessarily show a causal relationship. But it’s significant enough that we took a step to be proactive about it.”


But to capitalize on the latest research, employers need to regularly re-evaluate their dental coverage, says Vincent Graziano, a Boston-based vice president and dental expert at Segal Co., a human resources consulting firm. “I see a lot of dental plans that are out of date,” he says. Plans left on autopilot, he says, run the risk of incorporating deductibles and co-pays that discourage employees from preventive steps that could save money later.

Educating employees
It’s not just employers that can give dental benefits short shift. A MetLife survey found that employees spend just 25 minutes on average on dental coverage during initial enrollment. During re-enrollment, that average drops to just five minutes, according to the 2009 online survey of 500 employees.


It may be that they spent so little time because they weren’t offered much plan detail. Only one-third felt they had sufficient information about their coverage or to select a plan. And comprehension did drive satisfaction, the MetLife analysis found. Those employees who reported an excellent understanding of their benefits reported a threefold higher overall satisfaction level; 53 percent were very satisfied, while 17 percent said they had a fair to poor understanding of their dental plan benefits. Early this year, MetLife launched an online dental resource to help employers better communicate dental benefits.


While it’s not uncommon for medical plans to cover 80 percent of an expensive procedure or surgery, dental insurance may only cover half the cost of such care. To guard against sticker shock, some dental plans offer online calculators so employees can estimate the out-of-pocket cost of that looming root canal. Employees also can use online tools to calculate the relative tax benefits of flexible spending accounts.


Employees who don’t bank enough in advance may set themselves up for bigger—and more painful—bills later, says Alan Vogel, DMD, national dental director for MetLife. For example, an employee might invest in a root canal, but postpone the crown that protects the tooth involved from fracturing. “I think a lot of people think that dental care can be delayed ad infinitum,” Vogel says. “Sometimes that delay can be problematic.”


The cost-savings question
As insurers take steps to redesign their plans, they can outpace the dentists themselves, as Fournier of the Massachusetts Public Employees Fund discovered. The fund, for example, covers fluoride varnish for enrollees who are at moderate to high risk. But there are no universally accepted criteria for determining risk, she says. And not all dentists are accustomed to making the assessment.


Even so, Fourier is intrigued by the progress made by some fund enrollees, who use a designated oral health center that provides additional preventive coverage. “We’ve seen over the years, as we get into the data, that there is definitely a reduction in the risk status of those patients,” she says.


And that reduction can translate to dollars and cents. The annual claims cost for a low-risk dental patient is $175, according to fund data provided by Fournier. The cost for a high-risk patient—someone who has undergone at least three procedures in as many years—runs about four times higher, roughly $800 annually.

Posted on October 1, 2009June 27, 2018

Preparing for a Hiring Frenzy—Protecting Your IT Talent

What can your company do to protect and support valued IT employees before recruiters come courting? Experts offer a mix of strategies:


Salary does indeed matter: Companies with IT talent—particularly those whose employees have health care expertise—should watch hiring trends closely in case they need to thaw any recession-related wage freezes, says John Stevenson, a Dallas-based information technology executive consultant. “Having a frozen wage base could harm them quickly,” he says.


Beyond pay: Re-examine your fringe benefits. While pay in the health care field may not necessarily be as high as in other industries, those jobs may offer better health insurance and longer-term career stability.


Be proactive: If you’ve laid off talented IT employees, start reconnecting with them to discuss upcoming opportunities, says Walt Zywiak, a principal researcher in Computer Sciences Corp.’s Healthcare Group. Health care leaders also should work hard to retain any employees with systems implementation skills, even if it’s on a consulting basis, he says.


Keep the work challenging: Bored employees may be enticed away by an emerging IT field, says Marty Witrak, who chairs the workforce subgroup of the National Rural HIT Coalition. “I would make the jobs in my own industry as exciting as possible, because I think they are going to be very exciting in health care.”

Posted on May 20, 2009June 27, 2018

Special Report on Training & Development Powering Up a Hispanic Workforce

Officials at Florida Power & Light Co. preferred not to dally until national demographic trends eroded the core of their nuclear expertise: their employees. The median age of a nuclear energy worker had reached 48, according to data from the Nuclear Energy Institute, a Washington-based industry lobbying group. Up to 35 percent of existing employees nationally will qualify for retirement within the next five years.


Florida Power & Light had traditionally hired through several routes for its nuclear plant in South Florida, including recruiting former military personnel, says James Auld, industry and community training coordinator for the 11,000-employee company. Since those employees usually relocated from elsewhere, they were prone to later jump ship, fleeing Florida’s hothouse climate or moving back closer to family.


So officials began to brainstorm several years ago about ways to better cultivate local talent. That meant reaching out to the predominantly Hispanic community living near the nuclear plant, which is about 25 miles south of Miami. The result: a partnership with nearby Miami Dade College that has already produced its first class of graduates, with more in the pipeline, and a growing waiting list.


Teaming up with a nearby community college is only one of various strategies that corporate employers in Florida and elsewhere are implementing to better train and support Hispanic employees, a demographic group that’s poised to constitute a significant portion of the labor force’s backbone.


Within the next decade, one out of every four new U.S. workers will have legally emigrated from Latin America, according to a recent analysis of federal data. Training programs, though, shouldn’t be limited to English classes for entry-level employees, multicultural experts say. Initiatives also should incorporate math skills, computer basics and, as Hispanic employees are promoted into supervisory roles, additional training and mentorship efforts.


By 2016, 16.4 percent of U.S. workers will identify themselves as Hispanic, compared with 9.5 percent in 1996, according to the Bureau of Labor Statistics. Companies ignore these trends—even amid the current economic downturn—at their own peril, says Mariita Arosemena Conley, who leads Hispanic Source, a Chicago-based firm specializing in Hispanic cultural awareness and diversity training.


After the recession lifts, “the landscape is going to be different,” she says. “You will have baby boomers retiring. And that younger workforce—you can see it now at job fairs. You go to a job fair today and it’s a sea of brown faces.”


Training at the ground floor
Although no racial or ethnic group has been immune to the recession, job losses have hit Hispanic workers particularly hard, according to a Pew Hispanic Center analysis of Census Bureau data. By the fourth quarter of 2008, the unemployment rate had reached 9.5 percent among U.S.-born Hispanics and was 8 percent among foreign-born Hispanics, compared with 6.6 percent for the workforce overall. That rising unemployment rate coincided with the downturn in construction that began two years ago, says Rakesh Kochhar, the Pew center’s associate director for research. “Since then, it’s only picked up steam,” he says.


But some Hispanic employees may actually be in greater demand in the years to come, says Louis Nevaer, an economist who helped author the 2007 book HR and the New Hispanic Workforce. In some industries outside construction and restaurant work, companies are disproportionately laying off older workers, he says. As a result, managers will find themselves leading a noticeably different workforce in the years ahead, one with less institutional memory and younger workers who are more likely to be Hispanic, he says.


To date, though, a lack of education has limited advancement for some Hispanics. Among all major racial and ethnic groups, Hispanics are least likely to hold even a high school degree. The resulting gaps in basic skills can fuel turnover, which is costly for employers and employees alike, says Jeannine La Prad, president of the Corporation for a Skilled Workforce. The nonprofit research organization, which is based in Ann Arbor, Michigan, highlighted the Florida Power & Light initiative and a handful of others in analyzing the role of corporate partnerships in advancing immigrant Hispanic workers who had low skills.


In her work, La Prad has noticed a recurring pattern: The newly hired employees “were engaged initially in the work, but did not have some of the skills that were needed to successfully perform their jobs,” she says. “The businesses became frustrated and the people became frustrated. And we were seeing both people leaving and companies letting people go.”


Programs that combine education and work can help bridge that skills gap and can also address the need among some Hispanics to start working at a relatively young age, La Prad says.


At Miami Dade College, the two-year associate’s degree in electric power technology quickly launches students into paying work. After focusing the first year on a core curriculum, the students work over the summer at Florida Power & Light before returning to Miami Dade to specialize in a particular area of the nuclear industry. As many as 20 of the graduates who meet the academic qualifications, along with demonstrating on-the-job proficiency, will be hired at a starting salary typically of $45,000 to $50,000 annually, Auld says.


In the first class, 11 of the 12 graduates were Hispanic, according to a Florida Power & Light spokeswoman. Roughly two-thirds of the 26 to 30 students expected to graduate this spring also are Hispanic. It’s not uncommon for graduates to be first-generation college students, Auld says, recalling that the first ceremony occurred “with big tears and smiles—it was quite an event.”


In the years ahead, the partnership will save the power company in recruiting costs, Auld says, although Florida Power & Light officials declined to provide specifics. Plus, the collaboration will reduce the need for on-the-job training. Meanwhile, power company officials essentially get to run a two-year job interview, he says. “By the time they’ve graduated from this program, we’ve identified those with the aptitude to be successful.” It’s a win not only for the company, but for the community and college as well, Auld says.


Beyond teaching English
Language training often forms a cornerstone of training for entry-level Hispanic employees, particularly those who are first-generation U.S. residents. Increasingly, though, companies are realizing that basic language instruction should not be confined to Spanish speakers, says Bob Garcia, a human resources and training consultant at Gagen MacDonald, a Chicago-based employee engagement firm. “I’m seeing companies saying, ‘We need to provide English as a second language, but we also need Spanish language for frontline supervisors,’ ” he says.


Garcia, who is bilingual and specializes in multicultural education, also believes that cultural training should run along a two-way track. He successfully made that case earlier this year to a large manufacturing company that has approximately 4,000 employees. Along with training entry-level Hispanic employees about the importance of timeliness, avoiding absenteeism and other job expectations, the company also provided non-Hispanic employees and supervisors with some background on Hispanic customs and traditions, Garcia says.


For example, it’s important that managers understand the significance of the quinceañera, the coming-of-age celebration of a daughter’s 15th birthday. “It’s always an honor for a manager or a supervisor to be invited to that,” Garcia says. Thus, such an invitation should not be lightly turned down, and if managers can’t attend, they should later ask about the festivities, he says. “For me, this all comes down to respecting tradition and respecting someone else’s culture, no matter what it is.”


As Hispanic employees move into supervisory roles, the need for other types of training may emerge, although the necessity is more subtle and less likely to be addressed, Garcia says. “It’s definitely a missing component,” he says. For first-time managers, the learning curve can become significantly steeper when an extended network of friends and family work together at the same company or possibly on the same factory floor, Garcia says. As an example, Garcia casts himself as an employee in a close-knit work group who is offered a $3-an-hour raise to assume a supervisory role and takes the job.


“The thing is, I just know how to work hard,” he says. “I don’t know how to manage people. And now I’m managing my best friend, my son and two of my nephews.”


Cultural conflicts also can develop within work sites. Hispanic culture is not monolithic, and problems can crop up if the supervisor is originally from a different country than the crew being supervised, Nevaer says. In that respect, training and promoting talented employees from within not only can help improve long-term retention, but also can potentially bypass such cultural rifts, he says.


In some circumstances, relatively little training is required to produce a visible payoff, says Kim Kooy, a human resources coordinator at The Decc Co., an industrial coating company in Grand Rapids, Michigan. One of Decc’s team leaders, she says, had “marginal English” before recently taking an ESL class.


“Afterwards, she started e-mailing notes to us and using the intercom more in English,” she says. “I think she knew more than she let on that she knew—she just didn’t have the confidence to use it.”


Employers that shortchange training and support of talented Hispanic employees risk watching them migrate into more supportive industries in the years ahead, La Prad says. And that’s not good strategic planning, she says. Auld agrees. “I think common sense dictates that once this economy turns around, and those 401(k)s start heading in the right direction, we’ll see folks retiring again,” he says.


Auld’s not losing any sleep about that, though. As of this writing, the waiting list for Miami Dade’s next class in electrical power technology, limited to about 40 students, ran more than 200 names long.


Workforce Management, May 18, 2009, p. 25-29 — Subscribe Now!

Posted on February 23, 2009June 27, 2018

Communicating Benefits During Layoffs Can Be Tricky

In 2008, Andy Landis noticed that his routine retirement education seminars no longer ran quite so routinely. Increasingly, employees at forest products company Weyerhaeuser wanted to know the benefits impact if their retirement date was selected for them—by a sudden layoff.


Meanwhile, managers started asking Landis, a Weyerhaeuser life and retirement planning manager, to conduct sessions with small groups of employees vulnerable to job loss—say, when their current project ended—so they could better understand their benefits options.


Providing these types of details proactively seems to help in an uncertain job climate, according to Landis. “What we’ve been told by managers is the anxiety level goes way down,” he says.


Employees also may be more receptive while the layoff is still only a possibility, Landis says. “Their ears may be more tuned in to hearing what the facts are.”


With tens of thousands of U.S. layoffs occurring each month, corporate leaders are trying to negotiate a delicate balance: How do they ensure that jettisoned employees pay attention to sometimes time-sensitive and complex decisions at an emotion-laden time? Even during a routine workday, understanding the various acronyms and terms involved can be daunting: COBRA, lump sum, 401(k) rollover and so on.


“When you’re stressed, you do not function very well—it’s as simple as that,” says Judith Bardwick, a psychologist and author of One Foot Out the Door: How to Combat the Psychological Recession That’s Alienating Employees and Hurting American Business.


After employees hear the word “layoff,” they may appear relatively unfazed, Bardwick says. “But they are not normal. They cannot focus. They cannot problem-solve. They cannot analyze.”


Handling the initial shock
Many of today’s employers are striving to be forthright about their company’s financial forecast, according to a December 2008 survey by global consulting firm Watson Wyatt Worldwide. Eight out of 10 employers reported communicating details about their company’s solvency and performance in the previous two months, according to the results, based on responses from 92 employers.


Perhaps few companies understand the challenges posed by industry upheaval better than Weyerhaeuser. The company’s employee count has shrunk from 54,000 in 2004 to about 19,000 at the end of 2008 as the company sold off business lines and closed some facilities. In mid-2008, Weyerhaeuser leaders notified employees that roughly 1,500 people would be laid off by the end of 2009, including about 1,000 from company headquarters in Federal Way, Washington, according to spokeswoman Shannon Hughes.


Each laid-off employee faces numerous related benefits decisions, Landis says. “Some have deadlines on them. Some of them don’t. Some of them are irreversible,” he says.


Educating employees in advance—albeit an intriguing idea—can be risky, says Kathryn Yates, global director of communication consulting at Watson Wyatt. In the December 2008 survey, just 38 percent of companies reported communicating with employees about job security.


If layoffs appear imminent, a company may lose its most marketable employees first, Yates says. “You want to keep people focused on work and yet you want be straightforward with them. Where is the sweet spot for your company and for your employees?”


Once layoffs become public knowledge, human resources leaders can take several steps to keep communication lines open, Yates says. Be sure to prepare the most important benefits information in writing, since the employee will likely absorb few specifics during that first conversation. For example, frequently asked questions could be broken into several broader categories, including retirement, severance payouts and health options under COBRA (Consolidated Omnibus Budget Reconciliation Act).


Follow-up questions, of course, are inevitable. To better field those, Yates recommends establishing a centralized hot line. That line can be answered by a cadre of people who will not only have the necessary information handy, but will have been trained not to guess at specifics or become inadvertently drawn into “Why me?” or other types of awkward or emotional conversations, Yates says.


That personal touch
Corporate leaders should think twice, though, about relying too much on written materials, particularly in the first days after a layoff, says psychologist Bardwick. “In periods of high emotion, communicating people-to-people is best,” she says.


Instead, Bardwick recommends that human resources leaders organize a benefits session for laid-off employees, scheduling it several days after the announcement, “so people have time to get past the shock.” The session could be held off site and combined perhaps with outplacement or other job training services, she says. Another sensitive gesture: Ask the employee to invite a friend or family member along to help take notes and provide support.


In an effort to retain that personal connection with laid-off employees, Weyerhaeuser officials handle all severance-related questions internally, using the same 1-800 human resources number provided for active employees, says Greg Thiessen, director of manager and employee services. With an average tenure of nearly 14 years, Weyerhaeuser employees often have accrued both significant corporate benefits and emotional connections to the company, he says. “We’re part human resources expert, part counselor, part someone to vent at.”


In the last six months of 2008, the hot line’s call volume was 400 to 500 a day, compared with 250 to 280 previously, Thiessen says. Those calls are driven by a variety of factors, including the transition of employees to other companies, along with layoffs, he says.


Weyerhaeuser does not limit the time devoted to each call, as can occur when such services are outsourced, according to Thiessen. The effort is worth every penny, he says.

“We know that we’re letting good people go in these economic conditions,” Thiessen says, noting that employees who believe they have been treated well amid dispiriting circumstances might fill out a Weyerhaeuser job application again once the economy rebounds.

Posted on February 5, 2009June 29, 2023

Training Adapts to the Downturn

The newspaper’s financial section reads more like the obituaries some mornings, but the sales associates at HelmsBriscoe must forge on. Every day the roughly 1,000 associates at the meeting-site selection company must convince corporate and association leaders that they still need to book today for a meeting that might be a year or more away.


It’s a tough sell as executives curtail such events either because of immediate cost concerns or longer-term perception worries, says Nell Nicholas, a HelmsBriscoe regional director who serves the New England area. To update their sales pitch, the associates in the New England office—called associates because they work exclusively on commission—reached out last fall for some training assistance.


Those sessions have helped the associates reframe their approach, Nicholas says. Now they highlight the ways that HelmsBriscoe can assist with economy-related headaches, such as abrupt meeting cancellations or unused blocks of rooms. (The Scottsdale, Arizona-based company books $2 million a day globally in hotel space and other sleep-related revenue.) They also play up their ability to ease the workload of overtaxed human resources staffers and event planners, says Nicholas. “There’s a lot more multitasking going on in this economic environment,” she says. “Outsourcing is a great way to go. Companies are receptive.”


During economic downturns, training dollars might appear to be a tempting line item to cut or re-evaluate, as companies shed workers. Some companies will likely adjust their thinking in the current recession, tracking return on investment more closely and restricting limited dollars to the most talented of employees, according to training leaders interviewed. In the years after the dot-com bust, a sizable percentage of training moved to technology-based options that didn’t involve travel expenses, according to data from the American Society for Training & Development.


   The retrenchment in this recession appears to be substantial, according to a new report by research firm Bersin & Associates. In 2008, average training expenditures per employee fell 11 percent, from $1,202 per learner in 2007 to $1,075 per learner last year. The U.S. corporate training market shrank from $58.5 billion in 2007 to $56.2 billion in 2008, the greatest decline in more than 10 years, according to the report, which was released in January.


   But radical or indiscriminate cuts can be risky, because economic tumult exposes yawning business challenges and emerging competitive opportunities alike, says Pat Galagan, executive editor for the American Society for Training & Development. “Often in tough times, companies will change direction,” she says. “They will change their business model or decide to put more emphasis on a particular function, such as sales. Those things require more training rather than less.”


Maximizing dollars
Galagan says she is watching for trends in technology-based learning. From 2001 to 2003, the average percentage of hours that companies devoted to e-learning and other technology-based options increased from 11.5 percent to 26.2 percent, according to data compiled in ASTD’s annual “State of the Industry” report. “We could see another big jump,” she says.


Based on early feedback, Laird Post of management consulting firm Booz & Co. predicts that corporate leaders will be more selective in how they cut staff development. “In past downturns it’s been very typical to stop all training for an indefinite period of time because it’s simpler and easier to do it that way,” he says.


This time around, it appears that corporate leaders are more inclined to use “a scalpel,” picking and choosing based on long-term strategic goals, says Post, leader of the human capital management practice at Booz. “Your workforce is your only true competitive advantage,” he says.


Training programs that are most vulnerable to being jettisoned are those that hadn’t taken steps to show their value before the economy stalled, say Post and other training leaders. It’s also more important than ever to assess relative cost-effectiveness of various programs, says Nadine Keller, founder of Precision Sales Coaching and Training, who worked with the HelmsBriscoe associates. Rather than running yet another training session on the art of the sale, she says, perhaps those employees would benefit more from a crash course in time management—efficiencies that could better boost sales over the long haul.


If their training budgets are tight, human resources leaders also should consider which employees are worth developing, Keller says. On the sales side, for example, companies have already figured out in recent months which employees were simply “order takers” rather than innovative sales professionals. “I think good markets mask poor skills,” she says. “In this environment, I think you need to get rid of the underperformers and you’ve got to invest from the top down.”


Leveraging talent
As Southwest Airlines negotiated economic and security uncertainties following the September 11 terrorist attacks, the company didn’t ratchet back on training, says Elizabeth Bryant, senior director of talent development. But the airline’s leaders knew their employees needed to develop maximum adaptability amid a rapidly evolving airline industry, she says.


Employees were not only adopting new security roles, but technologies such as online ticket reservations meant they interacted less frequently with the flying public. As a result, a single encounter could make or break a customer relationship. Meanwhile, volatile fuel prices and weather changes aggravated other daily stresses. “The kind of challenges we are facing, and have faced over the last several years, necessitate our leaders to be more flexible and agile in response to the changing marketplace,” Bryant says. “Change is absolutely a theme for us—the only constant is change.”


To assist frontline supervisors with adaptive thinking, Southwest officials have incorporated a game-based system into the airline’s extensive training program. Working together in teams, Southwest employees use the Paradigm Learning game, called Zodiak, to create and build a mythical company. Then facilitators work with the teams on applying what they’ve learned to similar challenges and surprise scenarios at Southwest, Bryant says.


“If we can expose them to as many experiences as we can today, that’s going to prepare them for tomorrow,” she says. “For example, what if fuel prices go up to $170 [a barrel] tomorrow? What does that mean for us?”


Leaders at Paychex, a payroll and benefits outsourcing company, also pride themselves on not dialing back their training focus, despite the short-term economic forecast. The company, which employs about 13,000 people, averaged 92 hours of training per employee in fiscal year 2008.


Economic downturns can create their own opportunities, says Will Kuchta, vice president of organizational development. In the current scenario, for example, laid-off employees are launching their own small businesses, Kuchta points out. That provides a fertile emerging market, given Paychex’s focus on small businesses; its average client employs fewer than 20 people.


And, he adds: “Considering that we believe that our training and the knowledge of our employees improves our product, the more that other companies cut back, they actually weaken their product against ours.”


Similarly, Nicholas believes that her associates’ recent training will help them better reposition themselves. Associations that book annual meetings have been particularly receptive to the new sales pitch, as they are vulnerable to being stuck with a block of rooms and other headaches if the economy reduces how many members can travel to a particular event, she says.


Meanwhile, any clients who have temporarily cut back aren’t going anywhere, Nicholas says. “They will come back to me when the meeting is back on,” she says. “I haven’t lost the client. When the economy comes back, we will be much better for it.”

Posted on February 5, 2009June 27, 2018

Honing Sales Savvy to Compete in a Recession

When Chris Cassata started working in 2004 at the Glass Doctor franchise in Daytona Beach, Florida, the work was flooding in—literally. Several hurricanes had crisscrossed the state that year and glass-related repairs kept Cassata hopping.


These days Cassata feels like he’s swimming upstream, as the sales representative strives to peddle auto, residential and other types of glass in the economically depressed state. “It’s rough out there,” he says.


So in November 2008, he signed up for a three-day session at Glass Doctor’s brand-new training facility to sharpen his sales edge. The 3,600-square-foot facility in Waco, Texas, which held its grand opening amid last fall’s economic crisis, is part of the company’s long-term strategy to compete more on higher quality and better service than the lowest prices.


“When times are tough, people cut price,” says Kay Jacobsen, a sales trainer and franchise consultant at Glass Doctor, which has about 370 U.S. locations. The company is encouraging the sales force to get off the phone and schedule more in-person appointments with potential clients, she says. “During this time, it’s even more important that we are letting people know what we have to offer and setting ourselves apart.”


The new center’s classes not only delve into the myriad aspects of glass products, but also work on the psychological components of sales, Jacobsen says. “They have to be confident when they go out there.”


Cassata readily admits that he’s more comfortable selling auto glass because of his personal interest in cars. During his time at the training center, he focused on other types, such as residential or commercial flat glass. He also picked up some pointers on potential sales leads, such as marketing to the local police department or scheduling a meeting with the local hospital’s engineer.


But he talks mostly about the role-playing sessions, where he got feedback on his sales style. “When I’m not too comfortable going into a place, I notice I talk too quickly,” he says.


Since that training stint, Cassata now slows down as he makes his case. And he’s practicing other strategies, such as noticing family photos and other office mementos, in the hope that he’ll make a personal connection that later seals the deal in glass.

Posted on October 13, 2008June 27, 2018

A Writing Test Run

Initially, Kush Wadhwa simply requested a writing sample when hiring contractors and employees for Global Security Intelligence, the security technologies consulting firm that he founded.


But the writing samples he received didn’t necessarily fit with the type of work the applicants would be performing. So Wadhwa provided a topic. Then he realized that some applicants devoted an inordinate amount of time to completing the two-page assignment.


These days Wadhwa selects the topic, sending it at a predetermined time. Applicants are given two hours to research and write an analysis, frequently on a subject outside their expertise. “This is about assimilating the information quickly and presenting it in a cohesive, coherent, compelling and concise fashion,” says Wadhwa, the firm’s founder and managing director.


It’s a screening step that relatively few companies take, according to a 2006 survey conducted by the Conference Board and several other groups. Just one in four companies reported that they assessed an applicant’s writing skills before extending a job offer.


Developing and grading a writing test may appear daunting and labor intensive, but it can still be far more cost-effective than placing a writing-challenged employee on the payroll, says David Arnold, general counsel at Wonderlic Inc., a Libertyville, Illinois-based educational testing and consulting firm. “When it comes to training, it takes a significant amount of time and effort to get someone improved in terms of writing skills,” he says.


As a general rule, Arnold says, it’s legally defensible to pre-screen applicants as long as the employer can demonstrate that writing constitutes an intrinsic part of the job description. For that reason, Arnold suggests that employers request a writing sample that fits with the applicant’s prospective job. A customer service manager, for example, might be asked to respond in writing to a customer complaint letter.


Equally important is consistent evaluation of that writing sample, given the various interpretations and subtleties involved with writing, Arnold says. He recommends that corporate leaders establish a standardized grading system ahead of time. Then they should monitor its usage to verify that certain applicants aren’t adversely affected based on race or gender, he says.


Moretrench American, a New Jersey-based construction company, already has writing workshops in place, but the firm’s organizational development coordinator, Jack Paluszek, plans to recommend that applicants write their own job description, once they clear several stages of the interview process. The benefits could be twofold, determining if applicants understand their proposed role and gauging whether they possess the writing acumen to pull it off, says Paluszek. “That’s something that I’m going to push for,” he says.


Wadhwa, meanwhile, estimates that he turns down five applicants for every hire he makes, because their writing can’t withstand the screening scrutiny. These applicants already boast a top-level résumé and technical background, he says. “But we are now convinced that we will not sacrifice this, even for a fantastic candidate, if they cannot write.”

Posted on October 13, 2008June 27, 2018

The Art of the Subject Line

Hit “send” these days and you never quite know where your e-mail will be read.


Your recipient could be sitting behind a desk, but he’s just as likely to be sunbathing on a Mexican beach or weaving through a downtown traffic snarl. Perhaps more important, the reader could be scanning that game-changing e-mail a few lines of type at a time on a personal digital assistant.


As if business writing wasn’t challenging enough, the proliferation of PDAs has added a new layer of writing complexity for readers and writers, says Kiko Korn, a Los Angeles-based writing coach who works primarily with attorneys. It’s still a business communication, she warns her students, regardless of where that message is composed. “If you’re e-mailing your client from a BlackBerry while driving, you still have to make sure your e-mail is appropriate.”


One good first step for PDA writing: Pay attention to subject lines. If space is at a premium, a subject line can get a message noticed and deliver crucial information. When introducing a new subject, take an extra moment to start a new subject heading rather than piggybacking on a previous e-mail thread.


In the e-mail itself, explain concisely why you’re getting in touch and what action you need, Korn says. Given the small screens, there’s no luxury of an introductory paragraph, she says. “I would say those first three sentences are the key.”


What if you’re uncertain how an e-mail will be picked up? When a lengthy document is involved, J.D. Schramm advises his MBA students to attach rather than paste it within an e-mail. That way the sender can properly format the memo or report with the appropriate bullets and various headings without worrying that all of those presentation details will be lost on a tiny PDA screen, says Schramm, director of the CAT (Critical Analytical Thinking) Writing Program at Stanford’s Graduate School of Business. Along with the attachment, you can send a brief e-mail warning the recipient that the document might require some time to peruse, he says.


For some verbose writers, PDA communication may promote writing discipline, Korn says. By learning to synthesize complexities into just a few sentences, an attorney may develop similar skills for more lengthy documents, such as 10-page briefs, she says.


When in doubt, though, listen to your instincts, Korn says. Sometimes nothing beats a quick phone call to a colleague or a client. “Anything you write down never goes away,” she says. “You can’t undo the tone—you can’t undo that misstep.

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