Author: Rita Pyrillis

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Is Bullying the New Sexual Harassment?

Ed Frauenheim is on assignment.

The recent brouhaha over the abusive behavior of the Rutgers University basketball coach toward his players has brought the issue of workplace bullying back into the spotlight.

While most employees have never had basketballs or homophobic slurs hurled at them, a growing number of workers have been the target of a tyrant, leading some experts to conclude that bullying is the new sexual harassment, according to a recent article by the Associated Press.

Toxic workplaces have been around as long as toxic people have been tolerated, but workplace incivility is on the rise, says social psychologist Gary Namie, director of the Workplace Bullying Institute, surpassing incidents of sexual harassment and racial discrimination. And in a tight job market, harassed employees may be reluctant to quit or to complain, leaving their abusers to do as they please.

Bullies come in a variety of flavors—the screamer, the queen bee, the backstabber—and neither gender has a lock on rude behavior, although 62 percent of bullies are men, according to the institute. And a bully’s most frequent target, whether they are male or female, is a woman. And we’re not talking shrinking violets. Many female targets are confident, competent and successful—in other words, a threat to someone who suffers from insecurity and low self-esteem, as most bullies do.

A few years ago I met a bright and ambitious young woman who was the target of such a person. She was a rising star at her company until an older co-worker nearly derailed her career. He undermined her at every turn, yelling at her in meetings, cutting her off in mid-sentence, and gossiping about her to co-workers. She documented every incident and presented her findings to the owner of the firm who sympathized, but did nothing.

The woman quit within a few months and was snapped up by a competitor.

Office ogres exact not only an emotional cost but a monetary one. They can poison productivity, stifle creativity, and force good employees out the door. And in some cases, they can trigger a costly lawsuit. A boss who refuses to rein them in sends a message that bad behavior is acceptable and another toxic workplace is born.

But there is a movement afoot to hold employers accountable and allow workers to pursue lost wages, benefits and medical expenses. It’s called the Healthy Workplace Bill and more than a dozen states, including Illinois and New York, are considering its passage. Many European countries like Sweden, Norway and Serbia—yes, Serbia—have such anti-bullying laws in place.

However, it shouldn’t take a law or a lawsuit to get supervisors and managers to do right by their workers.

As Naime writes on the Workplace Bullying Institute blog, leaders “have to subordinate their buddy relationships (and this is gender neutral, the same goes for women executives) to the good of the company and favor the vast majority of the workers. Call it populist. Call it taking care of the majority upon whom productivity relies. Call it common sense. Call it maturing.”

Or you may be calling your lawyer as more employees turn to the courts for protection from the bully in your midst.

Rita Pyrillis is Workforce’s senior writer. Comment below or email her at rpyrillis@workforce.com. Follow Pyrillis on Twitter at @RitaPyrillis.

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High-Deductible Health Plans Gaining Employer Support

When high-deductible health plans first appeared on employers’ radar around 2006, they were met with skepticism by employees and employers alike. What a difference time and a health care reform law makes.

Today, not only are employers embracing these less-expensive plans, but also many are considering dropping their traditional health benefits for these consumer-driven health plans, or CDHPs. There are number of reasons for this, experts say, including the need to manage spiraling health care costs and to offset fees associated with health care reform, like the 2018 excise tax on high-cost plans, also known as the “Cadillac Tax.”

And employees seem to be onboard, too, with 30 percent enrolled in a CDHP, up from 8 percent in 2006, according to a just-released employer survey by Towers Watson & Co. and the National Business Group on Health.

Among large employers 66 percent offer a CDHP with another 13 percent expecting to add one in 2014, the survey shows. And the number of employers offering these plans as their only option has doubled since 2010 from 7.6 percent to 15 percent in 2013.

That is a “significant number,” according to Brenna Haviland Shebel, director of the Institute on Health Care Costs and Solutions at the National Business Group on Health.

“A lot of employers are looking aggressively at full replacement, even those who were not considering it before. What I’ve heard from some employers is that employees know that benefits are changing so the thinking is, ‘Let’s strike while the iron is hot.’ “

Indeed, the proof is in the statistics, says Maureen Fay, Aon Hewitt senior vice president and head of the CDHP working group. The Lincolnshire, Illinois-based consultancy released its own survey last year showing that these plans have surpassed HMOs as the second-most-common plan design offered by U.S. employers.

“The statistics show growing employer interest,” Fay says. “And that’s driven by reform, which is driving additional costs and fees being imposed on employers and insurers. And that’s leading employers to look for new solutions. Most employers in the past would tweak their plans from year to year, shifting contributions here and there, but they were finding that they couldn’t keep pace with health care trends. A different model is required.”

At Cigna Corp., the number of companies offering CDHPs surged after passage of the Patient Protection and Affordable Care Act in 2010, according to Joseph Mondy, a spokesman for the Bloomfield, Connecticut-based insurer. Employer participation grew by 26 percent during 2013, he says.

“As people become more familiar with CDHPs you’ll see migration,” Mondy says. “Why? Because they work. CDHPs will cost you less as an employee and as an employer, but you’ll see improvements in health outcomes. We have seven years of data to support that.”

Mondy is referring to the seventh annual Cigna Choice Fund Experience Study, which compares claims data of Cigna customers who are enrolled in a CDHP, a traditional Preferred Provider Organization or an HMO.

Whether employees are embracing the plans is unclear. CDHPs are complex and often confusing for many employees, experts say. In addition to higher out-of-pocket costs, these plans also require more employee involvement in health care spending decisions.

“If employees are coming from a PPO where there’s not a lot to think about, it’s a big change,” Fay says. “Now they’re responsible for paying bills, keeping proper documentation for reimbursement, and dealing with additional tax-filing requirements. It becomes more onerous for the employee.”

Typically, employees contribute to a health savings account, or HSA, to pay for their medical costs, which is a tax-advantaged savings account similar to a health reimbursement accounts. Unlike HRAs, health savings accounts must be paired with a consumer-driven health plan.

Despite their complexity, enrollment is steadily increasing, surveys show. But Shebel of the National Business Group on Health points out that those numbers are growing in part because more employers are replacing their traditional health benefits with account-based plans. Others are designating CDHPs as the default option for workers who fail to choose a health plan during open enrollment, she says.

But enrollment in account-based health plans will continue to grow as employers get better at helping employees understand how these plans work, she says.

“At first employers weren’t sure how to communicate these plans, but the more employees use them, the more they are telling their co-workers that these plans aren’t so bad. Word is really getting out that these plans aren’t as scary as they seemed at first.”

Rita Pyrillis is Workforce’s senior writer. Comment below or email editors@workforce.com. Follow Pyrillis on Twitter at @RitaPyrillis.

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Elder Care — You Can’t Buy, Pray or Prescribe Your Way Out of It

elder care

Ed Frauenheim is on assignment.

I had been looking forward to lunch with my friend Kate for some time. During the past few years we’ve bonded over the travails of raising teenagers, the challenges of balancing work and home and the exhausting job of caring for elderly parents. We laugh a lot when we’re together too, but those topics always seem to creep into our conversations—the last one with increasing frequency.

We’ve tried to get together several times in the last year but as any working mom knows, coordinating schedules with friends often means planning so far in advance several holidays can go by before you actually see each other. But this time the planets had aligned and our lunch date was set. I was looking forward to it.

The day before she sent me an email that began with: “Well, things with my parents have gone to hell in a hand basket and I’m heading to Tennessee for a week.” Her mom is struggling with dementia and her father is in failing physical health. Watching their decline has been devastating for Kate and her family.

So it goes with the life of a caregiver. There are good days and there are bad days and there are days when all hell breaks loose. One minute you’re on the phone with your mom planning a trip to the mall and the next minute you’re in the emergency room praying that she didn’t have a stroke or break her hip or catch pneumonia. A million things can go wrong when our bodies start to fail us.

It’s a wild and unpredictable ride and eventually, most of us will climb aboard. Or as Greg Johnson, director of family care giving at New York-based EmblemHealth, Inc. says, “you can’t buy, pray or prescribe your way out of it.” When a parent needs help few of us have much choice other than stepping up and doing the best we can.

And that’s exactly what 65 million people are doing every day — caring for an elderly relative, often while holding down a full-time job. Any many of them are also raising children — the sandwich generation as they are called. I am one of them. I have two amazing teenagers and one loving 86-year-old mother, and all three are at a stage in their lives where they need me more than ever.

Trying to meet their needs while working full time often leaves me feeling drained and in need of some care myself. Luckily, I have understanding editors who allow me to work from home when I need to, but not everyone is so lucky. Just ask the telecommuters at Yahoo!

With people living longer the number of caregivers in the workplace is rising rapidly and that costs companies up to $34 billion a year due to absenteeism and lost productivity. That doesn’t include health care costs, which are higher for caregivers who are more likely to suffer from heart disease, depression and other health issues than noncaregivers. At the same time the number of companies offering elder care programs and services has declined.

That means more employees are using lunch breaks to drive dad to the doctor or sort out medical bills. Employees at companies without elder care referral services or flextime or other supports must navigate the confusing world of Medicare and Medicaid and nursing homes and in-home care alone and during any spare moment, including vacation time. Not surprisingly, burnout and fatigue are higher for caregivers than for other workers.

But there is much that employers can do to help those workers, like offering flextime and resource-and-referral services. Some companies, like Johnson & Johnson in New Jersey, are taking it a few steps further, offering free geriatric care services to its employees. Caregivers work with a case manager who checks in regularly and will even visit nursing homes and other facilities with the family.

While many employers can’t afford such extensive supports, just offering flexible schedules and a little understanding can go a long way in helping workers stay healthy and in boosting retention and loyalty.

The issue of elder care will gain more attention as more workers become family caregivers—a role typically dominated by women. And as more women move into executive positions the problem of caring for mom or dad will become just as pressing as finding good child care.

Johnson of EmblemHealth calls caregivers “the backbone of the world.” But the weight of supporting kids and parents can be crushing. By providing elder care support employers can do a lot to lighten their load.

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How Companies Can Support Cancer Survivors in the Workplace—and Manage Costs

Esther Yarbrough had recently started a new job as the executive director of a membership organization when she got the news—breast cancer.

She was stunned. Just three months earlier in 2011 her predecessor had died of pancreatic cancer leaving the group’s members and staff feeling adrift. She had stepped in to take charge. The last thing that Yarbrough wanted to do was panic her colleagues or raise doubts about her ability to do the job.

“It was very important to me to keep things going,” says Yarbrough, 60, who was diagnosed in 2011. She heads an association of independent physicians in Georgia. “I wasn’t sure how our association members would react.”

She responded like the take-charge executive that she is, doing research on treatment options, getting a second opinion, scheduling a lumpectomy at a cancer center in Illinois, and, for the most part, keeping the news to herself. She had surgery to remove a small tumor on a Tuesday and was back on the job on Wednesday working from her hospital bed. She told her two staff members but never said a word to the association’s board of directors or its members.

Thanks to cutting-edge medical technology and early detection, she didn’t have to.

Yarbrough received a new treatment that allows breast cancer patients to receive radiation therapy in a single dose during surgery, sparing them weeks-long rounds of radiation and all of the side effects that come with it. And because her cancer was discovered early, she did not need chemotherapy. Few people knew that she was ill.

“No one had a clue,” she says.

Yarbrough is one of a growing number of survivors who have had to balance cancer and career—returning to work after receiving what was once viewed as a death sentence. There are nearly 14 million cancer survivors today compared with just under 10 million in 2001, and those numbers are steadily rising, according to the National Cancer Institute.

Advancements in early detection and treatment mean that cancer survivors are being diagnosed younger and living longer. Nearly half are between 19 and 64 years old, which means there are more cancer survivors in the workplace than ever before. That poses new challenges to employers as they struggle to control health care costs and help their workers lead healthier lives.

“Cancer has grown in importance to employers as the frequency of diagnosis increased,” says Helen Darling, president of the National Business Group on Health, an association of more than 300 large U.S. employers. In response, the Washington, D.C.-based business group has developed a series of online tool kits to help employers design medical and pharmacy benefit plans and other programs that support cancer patients and their families. The tool kits will be published in An Employer’s Guide to Cancer Treatment and Prevention later this year.

“We have much better detection methods so people are diagnosed earlier and are under treatment for a longer period of time. It’s important that employers help manage and support employees that have been diagnosed through a comprehensive benefit plan and other programs that support family members.”

Cancer is no longer the taboo topic that it was in the 1950s and ’60s when few talked about the disease, including doctors who frequently withheld the diagnosis from their patients. Given the low survival rates, many feared destroying their patients’ hopes of recovery. It wasn’t until well-known figures like first lady Betty Ford and President Ronald Reagan began talking publicly about their bouts with cancer in the 1970s and 1980s that the stigma began to fade.

Today, with celebrities like Good Morning America co-anchor Robin Roberts and TV actress Christina Applegate sharing their cancer stories with the world, the disease has emerged from the shadows. And the workplace is where many survivors share the news.

“A lot of people find out about their diagnosis at work, so a lot of people don’t get to decide when or if to tell,” says Kate Sweeney, executive director of Cancer and Careers, a program of the Cosmetic Executive Women Foundation that provides online resources for employees with cancer. “If they do share the news, more and more employees are telling people in the workforce. There is less of a stigma than there was even 10 years ago when we launched our organization. People realize that a cancer diagnosis isn’t a death sentence.”

Sweeney says that those who decide to keep the news a secret are driven by the fear that their careers will suffer. “They don’t want to be labeled as someone who can’t be productive. They worry that they’ll be passed over for promotions.” And sometimes well-meaning employers might withhold certain opportunities for fear of overwhelming an employee who is battling cancer, she says.

For Jonny Imerman, who was diagnosed with testicular cancer in his mid-20s, the thought of keeping his diagnosis from his co-workers never occurred to him.

“What is the fear? I realize that those who are executives or CEOs don’t want to be perceived as weak or as losing a battle, but I don’t agree personally,” says Imerman, 38. “Cancer is part of life.” He was working in commercial real estate in Detroit when he was diagnosed in 2001. A year later he quit his job, moved to Chicago and founded Imerman Angels, a one-on-one support group for cancer survivors.

“Today, younger people are more open about these things,” he says. “They get a diagnosis and they go straight to Facebook and say, ‘OMG, I have thyroid cancer.’ “

Employers are realizing that they must focus on cancer care as they look for ways to manage health care costs. They can’t afford not to.

Cancer costs employers an estimated $264 billion a year in medical care and lost productivity, according to 2012 figures from the American Cancer Society. While cancer patients represent just 1.6 percent of the privately insured population, they account for 10 percent of employers’ medical claim costs and a large share of long-term and short-term disability claims, according to the National Business Group on Health.

And with 80 percent of working-age cancer patients returning to their jobs, employers must develop “a comprehensive approach to fighting cancer through general medical benefits, behavioral health programs and pharmacy recommendations,” including employee assistance programs, says Ron Finch, vice president of the business group. “As employers, we need to learn about disability coverage, family leave, EAPs to help the patient, the family or co-workers as they experience cancer,” he says.

At Ameren Missouri, a public utility company based in St. Louis, cancer is becoming a topic of growing importance, according to Mark Lindgren, chief human resources officer.

“About two to three years ago we started to launch targeted programs around cancer and cancer prevention, and began looking at our benefit plans with a cancer lens,” he says. That meant making sure that the company’s health plans focused on cancer prevention and that wellness programs included cancer-specific initiatives like free screenings.

In addition to health and wellness benefits, Ameren also has generous short-term and long-term disability programs, Lindgren says, and allows employees to donate their vacation days to a sick co-worker if needed.

“We had a gentleman a year ago who had throat cancer, and I was amazed at how much workplace support he got,” he says. “Employers today recognize that people want to be supported because that helps alleviate much of the stress when they are in that situation.”

Helping employees navigate treatment and providing them with information and resources is critical in ensuring that they return to work as productive and engaged employees, says Tenbroeck Smith, a behavioral researcher at the American Cancer Society.

“Why does a survivor care if he or she has a job?” he asks. “Financial compensation, health insurance for sure, but also for social support and a sense of purpose and well-being.”

Without supportive co-workers, Todd Lovern, 50, says he can’t imagine how he would have made it through a devastating diagnosis. In 2010, the 50-year-old field-service engineer with GE Healthcare in Seattle was diagnosed with stage 4 colon cancer.

The father of four was training to run a marathon in the late summer of that year when he began noticing some strange symptoms like frequent urination and bowel movements and weight loss. At first he attributed the symptoms to his coffee habit and rigorous training regimen—he was running 40 to 50 miles a week.

His doctor suggested a colonoscopy. Lovern wasn’t too worried at first. He was 48, and 90 percent of colon cancers are found in men over 50. But he was in the 10 percent, and the prognosis wasn’t good. The cancer had spread to his liver.

“I was in shock for about three to four hours before it sunk in that I had quite a battle ahead of me,” he says. “I called my manager and explained to him that I was diagnosed and that I’d probably need some time off. His reaction was amazing. He was obviously upset. He was shaken by the news, but he was very caring.”

In fact, Lovern says that everyone from his general manager to the company’s HR representatives to his co-workers “took a leadership role” in making sure that he and his family had all the support and information they needed.

“My boss and HR told me that I had six months of short-term disability but not to worry about it because, ‘We’ve got your back,’ ” he says. “That was awesome to hear. It took some of the financial worry out of it. My wife works part time and makes a fourth of what I make. I thought we might have to move out of our house. But HR said you’re good for a year at 100 percent of my pay if I needed it. They were very generous.”

Lovern underwent aggressive chemotherapy and several grueling surgeries and procedures, but today he is cancer free. While he credits GE’s comprehensive benefit plan with helping him get back on his feet, he says that the emotional support of his colleagues got him through some of his darkest times.

“Two days after I told my boss the news, I got a FedEx box from our general manager,” says Lovern, his voice thick with emotion. “It was full of cards from my co-workers, people I don’t even work directly with. She would travel around the country and every week for months she made sure that I had a FedEx box filled with cards. Some days I really needed those cards to get through the week.”

But some survivors like Gail Nelson, a health care industry executive, find that old stereotypes can linger, especially when it comes to women in male-dominated industries.

Nelson, a senior vice president at MedSpeed, a medical courier and transportation company in Elmhurst, Illinois, was first diagnosed with breast cancer in 2003 when she worked for a different company. She says that her boss was very supportive, but Nelson chose not to share the news with her staff.

“When you’re diagnosed with cancer, you worry about the perception people will have,” she says. “I was afraid that I’d be pushed aside in terms of promotions and career opportunities. I had been climbing the ladder a long time without a hiccup and as a woman you have to climb twice as hard, twice as fast. You don’t want cancer to derail your progress.”

Her treatment was successful and her career flourished, but four years later the cancer returned. By then she was at a different firm. She decided to tell her colleagues, but she didn’t get the response she had hoped for.

“The first time I went to a local team meeting, they were asking, ‘How are you going to keep up with everything?’ ” she says. “I was so shocked that they were questioning me, saying, ‘You must be sick.’ They just didn’t get it. They thought that this would derail me.”

Nelson took time off while she underwent treatment. Three months after she returned, her position, along with another, was eliminated.

She found out later that some team members had expressed their concerns over her ability to do her job to company leaders. “I’ll never know for sure if that’s why my position was eliminated, but I’ll always wonder about it.”

While discrimination against cancer survivors has not disappeared completely, companies have come a long way since the days when sharing a cancer diagnosis sometimes meant the end of a career, says Barbara Hoffman, a law professor and founding chair of the National Coalition of Cancer Survivorship. “Back in the 1960s and ’70s, cancer was still a private thing—there was a shame factor associated with it.”

Before the Americans with Disabilities Act was passed in 1990, discrimination against cancer survivors was common.

“We’ve moved away from the taboo of having cancer toward almost a pride about being a survivor,” Hoffman says. “I think we’re getting to the place where employers look at cancer survivors and see an individual rather than a label.”

Rita Pyrillis is Workforce’s senior writer. Comment below or email editors@workforce.com. Follow Pyrillis on Twitter at @RitaPyrillis.

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Interview With Ford’s Felicia Fields: Shifting Out of Reverse

Ford Motor Co.’s turnaround since hiring CEO Alan Mulally in 2006 is now considered legendary. When the former Boeing Co. executive arrived, the company was grappling with plummeting profits and a highly competitive culture that, some say, stood in the way of its success. Under Mulally’s leadership, the company returned to profitability and embraced a new corporate philosophy called “One Ford.” Felicia Fields, 48, group vice president of human resources and corporate services, oversaw that cultural transformation and recently shared her insights with Workforce senior writer Rita Pyrillis.

Workforce: Ford has had a reputation for its competitive, some say cut-throat, culture. How has that culture changed over the years?

Felicia Fields: I read your first question, and I’ve been here for 26 years, but I must say ‘cut throat’ didn’t resonate for me. I would say it was more individually focused vs. team-focused. ‘One Ford’ changed everything because it put everybody on the same plan with the same goals and really got everybody focused on delivering against the same plan. There were a lot of good people here, but they weren’t always working with same objectives, and that didn’t create the kind of performance you’d want. Not everyone was rowing in the same direction.

Workforce: What is the ‘One Ford’ philosophy?

Felicia Fields: It is a set of goals that we work toward, but the behaviors are just as important as the actual objectives. For example, the goals include ‘Fostering technical excellence,’ that’s the ‘F’ in Ford. The ‘O’ is ‘Own working together.’ The ‘R’ is ‘Role model Ford values’ and the ‘D’ is ‘Deliver results.’ Inside each of those goals are expected behaviors, and we live those behaviors. It has transformed our culture, and you can see and feel the difference.

Workforce: Corporate mottos and mission statements sound nice but don’t often spark a cultural transformation. How did ‘One Ford’ evolve, and what role did human resources play in that transformation?

Felicia Fields: It’s not just a clever saying. It’s everything we do, and it’s how people are taught to lead. HR had a big role in a lot of the coaching around that. The first year Alan was here he talked a lot about one team and one goal. He brought these behaviors from Boeing. Alan brought a lot of that can-do positive attitude, with a focus on respecting and listening to people and having a passion for the business and the customer.

We spent about a year collectively working with Alan, really crystallizing that philosophy and getting it down to a format, and that became the ‘One Ford’ card that we give to all employees. That was launched in January 2008. We revised all of our people management processes, our performance management, our leadership-development programs, our 360 feedback, everything. It’s how people were taught to lead, how people were recognized for good performance, and in talking about succession planning, we began looking at who exhibits those behaviors. We embedded ‘One Ford’ into all our people processes.

Workforce: What has been the impact on morale?

Felicia Fields: If you look at the 2006 employee opinion survey at that time it was about 63 percent favorable and, as of last week, it was 75 percent. The external benchmark is 70 percent. We also have an index that measures employee satisfaction. It’s been a steady climb year after year.

Workforce: Can you give me some real-life examples of how morale has improved?

Felicia Fields: One of the signature processes Alan brought to Ford is the BPR [business plan review] process. Every week for 2½ hours we meet and we cover every skill team in our company. We go around the world in a very transparent way and look at the health of the business.

We give each team a red, yellow, or green based on the status of where they stand against our business plan. We usually have about 10 to 15 [employee] guests who are there in the room with us or online because this is a global meeting. Employee after employee are allowed a chance to express any observations they have, and it’s wonderful reinforcement for the leadership team to continue this transparent and inclusive behavior because we hear from person after person what an incredible process it is, how transparent it is, how motivational it is to see that we’re dealing with the realities of our business very openly.

People who have been at the company for many, many years just talk about the contrast they’ve seen in the leadership team. … It’s very real. People can sense the difference, and it’s far more fun. One of our behaviors is enjoy the journey and that’s a big part of it. It’s a much better place to work.

Workforce: Like other automakers, Ford has had tumultuous relations with the United Auto Workers, but that relationship seems to have improved in recent years. Where do the company and UAW stand today?

Felicia Fields: Certainly among our major competitors, Ford has long enjoyed, since I’ve been here to be honest, a good relationship with the UAW. I think that by and large it’s been a constructive relationship and a pretty transparent one. We’ve moved to incredible levels of transparency and that probably started with Ron Gettlefinger (former UAW president) and really explaining the business challenges and what we had to do to keep jobs in America so I think it’s a good relationship that got better. It allowed us to get into some inventive agreements before others did and frankly I think it still continues to be one of our strengths. The way we partner with them (UAW) and respect their involvement and leadership and their thinking on how to stay competitive and how to do everything we can to create jobs here in the U.S. And that’s really speaking from a US perspective. We obviously have lots of relationships with unions globally and those are very different and some are more challenging than others.

Workforce: There seem to be fewer women in leadership roles in the auto industry today than in 2005, the year that some say was the peak of women’s influence in automotive leadership. What is Ford doing to promote women and minorities into executive positions?

Felicia Fields: We were lucky that we had Anne Stevens who was in a COO role in North America [she left in 2006]; Louise Goeser [retired in 2008] who was CEO in Mexico. There’s always been a heavier amount of women in HR and finance-type roles, and our desire is to continue to stock that pipeline, but we also want to get more women in operating roles and in general management.

Workforce: There’s been much speculation recently over retirement plans for Mr. Mulally, who is 67 and his potential successor. What are his plans and what is Ford’s succession-planning philosophy?

Felicia Fields: Just know that we are continually working on great internal candidates to be ready for his succession when that happens. And he’s committed to stay at least until the end of 2014. We have a strong succession-planning process. … I hope that if you see the transitions we make, they are very smooth and orderly and they make sense. I do give HR some credit for that.

Rita Pyrillis is Workforce’s senior writer. Comment below or email editors@workforce.com.

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2012 Game Changer: Julie Hoff

Pharmacy benefit manager Express Scripts Holding Co.’s acquisition of Medco Health Solutions Inc. stirred up controversy among lawmakers and consumer groups and marked a difficult time for the company, but for Julie Hoff it was the opportunity of a lifetime.

The $29 billion deal finalized earlier this year that brought together Express Scripts and Medco was a complicated merger of distinct cultures and 33,000 employees from across the country. It doubled the size of Express Scripts, which is now the largest PBM in the country.

Hoff, 36, was responsible for developing and executing human resources strategy during the acquisition.

“It’s so massive in size and complexity that it could become overwhelming,” says Hoff, who started at Express Scripts in 2003 as an entry-level HR generalist and now is senior director of HR strategy, planning and communications. “There is so much pressure. We were navigating things that we haven’t dealt with before. Once you come together as a new team, you have to start building new relationships. I’m working with a team of people who don’t know me. At the same time, you have pretty aggressive goals to meet. Sometimes I’m not their favorite person.”

Hoff says the experience was a “career changer,” but it wasn’t the first time she stepped out of her comfort zone to tackle a unique challenge. In 2010 she accepted a position in sales as a senior director, account management, at Express Scripts after completing her MBA. Senior management thought it would be a good opportunity for her to learn the PBM business.

“I had 90 account managers, and I didn’t have that kind of experience,” she says. “The integration was difficult, but making a cross-functional move was also tough.”

She says it was worth the challenge. “You’re a better HR person if you know the business well.”

Rita Pyrillis is Workforce’s senior writer. Comment below or email editors@workforce.com.

Workforce Management, December 2012, p. 26 — Subscribe Now!

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Alliant Techsystems Inc.: Optimas Award Winner for Innovation

When more than half the jobs at your company require expertise so specialized that in some cases only one or two employees possess it, retaining workers becomes a unique challenge requiring an innovative approach. For weapons-maker Alliant Techsystems Inc., the answer is in the data.

The company, which is also known as ATK, has developed a flight-risk model using human resources data such as an employee’s age, tenure and marital status to predict which workers might leave because of retirement or for other opportunities. The initiative began in January 2010 at ATK’s Radford, Virginia, location, which employs about 1,200 people. In 2012 the program was rolled out to the company’s three divisions: aerospace, defense and sporting, says Cory Edmonds, manager of compensation and workforce analytics for the Minnesota-based firm’s 15,000 employees.

ATK is teaching managers and HR team members how to use the data to address talent management challenges. ATK is a leader in this area and was profiled in the March 2011 issue of Workforce Management. Edmonds says that the publicity generated some interest among the company’s HR professionals, but some managers were skeptical.

“The impression was that this is too theoretical,” he says. “Some got it right away, but others could not see that this had a direct impact on the business. We’re trying to educate managers and make the results more available to the HR community so they can start using it.”

Edmonds says that the system is fully automated and refreshed daily.

The information is also used to create a quarterly flight-risk report alerting managers to the number of employees who might leave during a specific time period. The goal of the project is to reduce costs through more effective talent management.

“You can get information on why people are leaving, but at that point they’re already gone,” Edmonds says. “The next step is predicting employee engagement. It’s about trying to make the correlation between engagement and business outcomes.”

For its pioneering work in using analytics to manage workforce issues, ATK is the 2012 winner of the Optimas Award for Innovation.

Rita Pyrillis is Workforce’s senior writer. Comment below or email editors@workforce.com.

Workforce Management, November 2012, p. 28 — Subscribe Now!

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Benefit Tech Tools Aim to Turn Employees Into Smart Shoppers

Few industry watchers took notice last year when Automatic Data Processing Inc. bought a small North Carolina-based developer of employee benefit decision tools. Yet the September 2011 acquisition of Asparity Decision Solutions appears to be a savvy move for the human resources software and services company as more organizations look for ways to turn employees into smart health care shoppers.

The trend toward health care consumerism—a movement to empower users with information to help them wisely choose plans, providers and treatments—is giving rise to online decision-support tools that help employees find the best benefit plan for their needs. A growing number of companies including PepsiCo Inc. and oil-recovery firm Safety-Kleen Systems Inc. which is an Asparity customer, are offering them. In fact, about 65 percent of employers provide these tools, a 2012 Towers Watson & Co. survey shows.

With annual health care insurance premiums costing about $15,000 for a family of four, according to a 2012 survey by the Kaiser Family Foundation, it is likely the priciest purchase an employee can make in a given year, aside from buying a house, says Tim Clifford, vice president of benefits services for ADP, which is based in Roseland, New Jersey. “Yet we dive right in and say I’ll buy the one I bought last year,” he says.

Not surprisingly, employees can find the benefit-enrollment process overwhelming. More companies are asking workers to pay a greater share of the costs and presenting them with new plan choices, such as high-deductible health plans, which can be complicated and confusing.

“You’re asked to do more at work and suddenly you’re being asked to take more responsibility in this area, and people are shutting down,” says Joann Hall Swenson, health engagement consultant at Lincolnshire, Illinois-based Aon Hewitt. “It’s complicated and we haven’t had to think about that in the past, and now suddenly employers want us to be good consumers. Keeping it short and simple is really critical.”

Most employees are on autopilot when it comes to benefit-plan selection, shows a recent survey by insurance company Aflac. An overwhelming number—89 percent—say that they elect the same benefit options every year. And that lack of engagement can cost $750 a year—the amount that more than half of the 2,000 workers surveyed estimate they waste each year by choosing the wrong benefit plan. On top of that, only 16 percent of workers were confident about their benefits choices in 2012 compared with 24 percent in 2011, the survey shows.

Clifford says that providing decision-making support, like Asparity’s suite of online tools, is critical in helping employees make the right choices. The program ranks and compares health plans according to individual needs and preferences.

Federal employees have been using Asparity since 1998 to help them choose from among 20 medical-plan options, including dental and vision care. The Durham, North Carolina-based company began offering these tools to private-sector employees in the early 2000s, company officials say.

The tools guide employees through the decision-making process starting with a survey of how many times in the year a user expects to incur charges for various services including routine office visits, outpatient surgery and X-rays. From there users pick the health-plan features that are most important to them and the program ranks the plans according to price and provides a detailed comparison with estimated out-of-pocket costs. It allows users to make tradeoffs between one feature and another, such as no copayments versus a certain coverage level for chiropractic care.

“Without a decision-support tool, employees will go into a system and choose Plan A or B, but it’s very hard to compare the plans and see all the difference in costs in all these choices,” Clifford says. “You need to know based on [your] … situation healthwise which one of these plans will have higher or lower out-of-pocket costs. These tools have cost calculators so you can input your anticipated health history and the tool will stack up the different plans as well as show you the contribution rate.”

The goal of these tools and of health care consumerism in general is to overcome the biggest challenge to controlling health care costs—changing employee behavior.

“Employers been tinkering with wellness programs for years and experimenting with different ways to control costs, but at the end of the day changing behaviors is at the root of how health care costs are driven and that’s what we are trying to get at,” Clifford says.

Rita Pyrillis is Workforce’s senior writer. Comment below or email editors@workforce.com.

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Employers Should Ignore the Rhetoric and Focus on the Reality of Health Care Reform, Experts Say

Few recent political issues have absorbed as much of the national spotlight as health care reform, which took center stage at the Democratic National Convention and has become a rallying cry among Republicans who vow to kill it if their candidate wins the November presidential election. But employers need to ignore the rhetoric and focus on the realities of complying with the law, known as the Patient Protection and Affordable Care Act, experts say.

They must be “smart political consumers and educate themselves to know the difference between political power grabs and reality,” says attorney Tami Simon, a legislative expert at Buck Consultants in Washington. “Democracy is messy. What’s fascinating for us in the benefits industry is that the curtain has been pulled back because we care about what’s going on. We are all watching the sausage being made much more closely.”

She says that for many observers, like her mother, a baby boomer who grew up watching the civil rights movement unfold, few issues since the Vietnam War have captured the national interest like health care reform. “Health care is essential to every human being. What I do for a living is on the front page every day. It’s a fascinating time in history right now.”

With the presidency and 33 Senate seats up for grabs in 2012, how the battle over health care reform will play out is anyone’s guess, but employers are watching the tussle closer than most.

While Democrats are busy touting the benefits of the 2010 law, Republican presidential nominee Mitt Romney has said that repealing it will be his first order of business if he is elected in November. The Republican Party also promises to overhaul Medicare and Medicaid and introduce broad tax code changes that could cut incentives for employer-based benefit programs if Romney and his vice presidential running mate, Rep. Paul Ryan, R-Wisconsin, are elected.

“It would really take Romney winning for repeal to happen,” says Steven Wojcik, vice president of public policy for the National Business Group on Health, a trade group based in Washington. “Employers are watching closely over the next two months who will win the White House and in Congress, especially the Senate. It’s possible that if the Democrats take control of the Senate and Romney wins, there could be a repeal of some of the law. But they [Republicans] would need both the White House and the Senate for a total repeal.”

In any case, employers are going forward with their compliance efforts, despite a lack of regulatory guidance on various provisions of the law, Wojcik says.

“Regardless of the outcome of the election, the main issue for employers still remains,” he says. “Whether it’s Obama or Romney, they will have to tackle health care cost control. I wish the candidates would focus on that issue and blow away the rhetoric.”

Since it was passed in 2010, the Affordable Care Act has survived 31 Republican attempts to repeal it in the House Rules Committee—the most recent in July—and a U.S. Supreme Court challenge of its constitutionality. The political bandying has been distracting for employers, says Neil Trautwein, vice president of employee benefits at the National Retail Federation, an international trade association based in Washington.

“It’s been a tough haul between passage, implementation, the debates in Congress, the Supreme Court and now with an election coming,” he says. “There’s been a tendency to wait for Congress, wait for the Supreme Court or wait for the elections. This isn’t the kind of reform we wanted. We still support efforts to overturn the law, but our focus now is on helping our members survive it.”

Rita Pyrillis is Workforce’s senior writer. Comment below or email editors@workforce.com.

Workforce Management, October 2012, p. 3 — Subscribe Now!

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Health Care: A Real Fixer-Upper

In 1929 when Baylor University Hospital began offering prepaid hospital visits for 50 cents a month to a small group of public school teachers in Dallas—a program that would morph into iconic insurance giant Blue Cross—few could have predicted that decades later most Americans would get their health care coverage through their employers. What soon became known as a “fringe benefit” is now an expected part of any competitive compensation package.

But with health care reform unfolding and no end in sight to soaring medical costs, the future of employer-based health plans is unclear. Dramatic changes are under way, and employers are playing a key role in transforming health care delivery. Some are reluctant innovators and others are eager trailblazers, but most have little choice but to roll up their sleeves and look for solutions to a crisis that is threatening their bottom lines and the country’s economy. With national health care spending at $2.6 trillion annually and growing, employers are seeing a greater portion of their labor costs eaten up by medical expenses. In 2010, health care costs represented 12.8 percent of payroll, up from 8.9 percent in 1999, according to a 2012 Kaiser Family Foundation report. Between 1999 and 2009, the average annual premium for employer-sponsored family health insurance coverage rose from $5,800 to $13,400.

While politicians and pundits debate the Patient Protection and Affordable Care Act, often referred to as the ACA, a growing number of employers are forging their own version of reform one workplace at a time. It’s a movement that some call “DIY,” or “do-it-yourself,” health care reform. “Employers are now in the business of population health management, so, yes, they have a sense of urgency,” says Andy Webber, president and CEO of the National Business Coalition on Health. It’s a two-pronged effort to improve employee health and productivity and to get more value for the money, he says. “This challenge has been ongoing for many years and is independent of the ACA and any other legislation.”

Employers are turning to an array of approaches from disease management programs to on-site clinics, direct primary care, value-based medicine and predictive modeling—and many are seeing dramatic reductions in costs and other improvements. Viking Range Corp. in rural Mississippi, where obesity and diabetes are rampant, saw a decline in health care spending two years after redesigning its wellness program to target those conditions. The company analyzed claims data to make predictions about certain behaviors and health outcomes, a process known as “predictive modeling.”

This approach also helped Pitney Bowes Inc., the Stamford, Connecticut-based manufacturer of mail and document management systems, to develop a benefit plan based on the principles of value-based insurance design. Value-based design aims to reduce or eliminate the cost of essential medical care, such as cancer screenings and blood-pressure drugs. Companies such as Caterpillar Inc., Dell Inc., Dow Chemical Corp. and Gulfstream Aerospace Corp. have followed suit, offering medications for chronic diseases at low or no cost to employees.

“I’ve been in the benefits business for 30 years, and for the first time I see change among all stakeholders at the same time: carriers, hospitals, employers are experimenting with all different approaches,” says benefits consultant Jerry Frye, president of the Benefits Services Group Inc. in Milwaukee. “I see an opportunity to manage costs more so than for a long, long time. Some is due to reform, but most is being driven by employers.”

The philosophy behind many of these employer innovations is to shift the focus from cost savings to quality improvement, from access to affordability, and, according to physician Mark Fendrick, “from one-size-fits-all solutions to clinically nuanced benefit design.” Fendrick is the director of the University of Michigan Center for Value-Based Insurance Design, a think tank that promotes benefit plan innovation. The idea is to make essential health care services, such as immunizations, cancer screenings and drugs to manage chronic conditions, more affordable or free, while increasing out-of-pocket costs for services that provide less value, like MRIs for simple lower back pain or electrocardiograms, or EKGs, for low-risk patients, Fendrick says. In other words, getting more bang for your buck. Value-based insurance design is embraced in a provision of the 2010 health care reform law that eliminates copayments for certain preventive-care services.

Many employers have adopted this approach to include office visits, diagnostic tests and treatments for common chronic conditions such as asthma, diabetes and heart disease. According to a 2012 Towers Watson & Co./Midwest Business Group on Health survey, 34 percent of companies could adopt this approach by 2013, compared with just 15 percent today. While an accurate number of employers using value-based design is hard to determine, Fendrick says, there are 350 employers in the University of Michigan Center for Value-Based Insurance Design registry.

Value-based design may be generating interest of late, but it’s not a new concept. In 1996, the city of Asheville, North Carolina, launched the movement when it began offering free medication and health care counseling to diabetic employees to reduce costs. At the time about 8 percent of the city’s workforce suffered from the disease. By 2003, the city was saving between $1,200 and about $1,900 per patient per year, according to a study in the Journal of the American Pharmaceutical Association.

Pitney Bowes was one of the first private employers to adopt this approach when it began waiving copayments for drugs to treat diabetes and heart disease in 2001. By 2006 medication adherence rates improved from 38 percent to 54 percent, according to a study in the Journal of Managed Care Pharmacy. When compared with other firms of similar size during that period, Pitney Bowes’ health care costs were about 20 percent lower, which translated into about $40 million in avoided costs.

“The focus on health care costs has to shift from how much you’re spending to how well you are spending it,” Fendrick says. “I want to give credit to the employers because this cost-to-value shift is being driven by market-based reformers. The Congress and Obama saw what they were doing and embraced that. The fact that we don’t buy the services that get the most health for the money is the fundamental problem.”

Workplace clinics have been around since the post-war manufacturing boom, but employers are retooling this model to meet the needs of today’s workforce. These clinics dispense far more than bandages and aspirin and are just as likely to be found at a high-tech Silicon Valley startup as they are on a manufacturing floor. Many offer full-service health care with primary-care doctors and specialists such as cardiologists, endocrinologists and dermatologists.

Interest in on-site clinics has surged in recent years, according to Grand Rapids, Michigan-based health care consultant Mike La Penna. One reason is that employers have become increasingly concerned about improving access to health care, not just lowering costs, he says.

“This was a new idea we hadn’t picked up on before,” La Penna says. “Employers are becoming more and more concerned that they are paying for benefit programs, but employees are facing access problems in the community, like not being able to get an appointment for weeks.” And the inability to get in to see the doctor can mean more sick days and lower productivity, which is costly.

Few companies have taken the concept of comprehensive care to the level of QuadGraphics Inc., a Sussex, Wisconsin-based printer and pioneer in the development of workplace clinics.

The company runs five health centers—three near Milwaukee that offer primary care, dental and vision care, and specialties such as cardiology, dermatology, obstetrics and gynecology, pediatrics and orthopedic surgery. There is also a pharmacy, laboratory, X-ray, rehabilitation clinic and fitness center. The other clinics, which are in Saratoga Springs, New York, and Martinsburg, West Virginia, have similar offerings, minus dental or vision care.

At the West Allis, Wisconsin, plant, the clinic is a short hallway walk from the production floor where forklifts shuttle giant paper rolls to the printing presses. On a recent visit, the large waiting room is quiet except for a woman and her toddler there to see the pediatrician. “Summer is always slow,” says QuadMed’s chief medical officer, Raymond Zastrow. QuadMed is a subsidiary of QuadGraphics that was formed in 1990 to run the company’s health centers.

The clinics’ focus is on preventive care and chronic disease management and avoiding costly hospitalizations, expensive brand-name drugs and unnecessary medical tests. “We consider an ER visit or a hospital visit as a failure of our system,” Zastrow says.

While the company spends more on primary care per patient than the average employer, it pays less for hospitalizations, according to Zastrow. The company offers a point-of-service health plan that covers specialty and emergency care not available at the clinics. This has slowed the rate of health care cost increases. Since 1999, costs at QuadGraphics have risen at an average annual rate of 6 percent compared with 8.3 percent at other Midwest companies, according to a 2010 Mercer study. In 2008, the company’s health care costs per employee were $2,500 lower than those of other regional employers. About 85 percent of the company’s 9,000 employees get their medical care at one of the in-house facilities.

QuadMed’s success in lowering costs and improving health outcomes has led other companies to seek their help in developing similar clinics. The company has established clinics for local employers Briggs & Stratton Corp., MillerCoors and Northwestern Mutual.

A newer development, and one that is likely to get more attention in the next two years, is direct primary care. Starting in 2014 direct primary-care providers will start competing for employers on the insurance exchanges established by the health care reform law.

It’s a twist on “concierge medicine” where wealthy patients pay a doctor a steep annual fee or retainer for unlimited access to medical attention. Direct primary care is the populist version with a more affordable monthly membership fee, usually less than $100. Typically, an employer picks up part of the cost. Doctors have lighter patient loads, and that means they are more accessible, including nights and weekends and through email and telephone consultations.

Direct primary-care providers receive a salary, unlike most physicians who are paid per service, which allows for more time with patients. Appointments typically last up to an hour. There are no insurance claim forms to fill out or deductibles to meet. Everything is covered by the monthly fee.

While direct primary care is not an insurance product, when paired with a “wrap around” insurance policy to cover specialized and emergency care, direct primary-care clinics will be allowed to compete on the exchanges. Such a product has yet to be developed, according to providers who envision a policy customized for direct primary-care practices that would cover services not offered by the practice.

Proponents, like Dave Chase, CEO of Avado, a health care technology startup, compare the direct primary-care model to auto insurance.

“Do you pull out your auto insurance card when you go to Jiffy Lube? Of course not,” he says. “So why do you do it for health care? You shouldn’t use insurance for the predictable day-to-day stuff, like changing your tire or getting a flu shot. Insurance is for the unexpected, catastrophic events.”

The concept is new enough that many in the insurance industry haven’t heard of direct primary care. A spokesman for America’s Health Insurance Plans, a health insurance industry trade association, says he has no information on the trend. “I haven’t seen the data.”

But in Washington state, the birthplace of direct primary care—the first clinic opened there in 2007—some insurers are wary of the concept, says Erika Bliss, a physician who is president and CEO of Qliance in Seattle. Qliance was the first direct primary-care network to set up shop in the state.

“We’ve said from the beginning that we’re not anti-insurance, but primary care is a routine and predictable event,” she says. “So, why not divide it up and let us handle the routine care and let insurance cover what they need to? We reduce risk for insurance companies, and that’s appealing.”

She says that Qliance has been meeting with insurance companies to develop a wrap-around policy and that interest is growing among insurers and employers.

Starting this fall, Qliance, which has five clinics in Washington state, will have some competition when Monterey, California-based MedLion Direct Primary Care sets up shop in the Tri-Cities area of Washington. It’s the company’s first foray outside of California where it has five clinics, including one in Fresno that caters to a large population of migrant farm workers. It also plans to open clinics in Miami, Las Vegas and Portland, Oregon, among other locations, within the year, according to Samir Qamar, a physician who is the company’s president and CEO.

MedLion is pushing hard to sign up employers in Washington. Robert Anderson, a benefits consultant in Kennewick, Washington says that interest is high but some employers are skeptical. Anderson is working with MedLion to sell to regional companies. They “see that they can save a lot of money with a DPC structure, but no one believes anyone can do it for the monthly fee or that by not billing insurance we can save them a lot of money and time. They also want to know the employees can actually get in to use the clinic and that there won’t be this bottleneck with employees having to go somewhere else.”

Anderson points out that a doctor typically has a patient base of about 2,500, but at MedLion each doctor handles about 1,000 to 1,500 patients allowing for greater access. “Everyone is taken aback at first because we’re taking the medical-care model and setting it on its ear,” Anderson says. “It’s a hard concept for everybody. Things are changing dramatically, and it’s going to take time for everyone to figure it out.”

The coming changes to health care delivery will likely be challenging for all stakeholders. What the system will look like in the future is anyone’s guess, but Larry Becker, director of plan administration for Xerox Corp. expects tremendous innovation ahead. Becker is a frequent speaker on the role of employers in shaping health care delivery.

“We will learn a great deal from data derived from electronic medical records and that will drive much of the changes to come,” he says. “With data and the applications of some very smart people will come innovations that we can’t even imagine today. Look at Apple. People weren’t looking for an iPhone or a tablet but [Steve] Jobs said that this is what their latent needs are and look what happened. The same will come with health care.”

Rita Pyrillis is Workforce’s senior writer. Comment below or email editors@workforce.com.

Workforce Management, September 2012, pgs. 22-27 — Subscribe Now!