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Posted on December 27, 2007July 10, 2018

Employer FMLA Frustrations May Rise With First Extension

Employer frustrations with a federal employee leave law may be exacerbated as it expands for the first time since its enactment in 1993.


The expansion is included in a defense authorization bill that President Bush is declining to sign until Congress changes the wording of a provision related to the Iraq war. The FMLA expansion would enable spouses, children, parents or next of kin to wounded military service personnel to take 26 weeks of unpaid leave to care for their loved one.


That’s more than double the 12 weeks of time off for the birth or adoption of a child or the sickness of a close relative provided currently under the Family and Medical Leave Act.


The expansion idea drew bipartisan congressional support because it targets a politically popular constituency—military families—and emanated from a national commission chaired by former Sen. Bob Dole and former Health and Human Services secretary Donna Shalala.


Companies won’t have a problem with the straightforward mandate related to relatives of wounded soldiers, but other provisions are murky, according to attorney Margaret Hart Edwards of Littler Mendelson’s San Francisco office.


For instance, language in the bill allows 12 weeks of unpaid leave for “any qualifying exigency” that arises from a spouse, son, daughter or parent being on active duty or called to active duty.


The appropriate circumstances would have to be determined by Department of Labor regulations. Whether companies can require that an employee certify a relative’s active duty status also is subject to the regulatory process.


Until rules are promulgated, the situation will be ambiguous. “That puts a big burden on employers,” Edwards says. “The opportunities for abuse are substantial.”


Relatively few people would qualify for leave to care for an injured service member.


Department of Defense statistics show that 28,661 soldiers have been wounded in Iraq and 1,840 in Afghanistan. But those who are affected by a relative being called up for duty could total hundreds of thousands.


Employers voiced concerns about such FMLA growth at a congressional hearing this fall. Business advocates didn’t oppose extending FMLA for military families but they urged Congress to reform the law first.


A Department of Labor survey about FMLA earlier this year generated 15,000 comments, many from employers complaining about unscheduled intermittent leave and the definition of a serious health condition.


Resistance from corporate America made passage of the extension provision difficult, adding a further frustration for families who already face sometimes horrific recovery journeys, according to an advocate for broader leave laws.


“This was significant and historic,” says Kate Kahan, director of work and family programs at the National Partnership for Women and Families. “On the other hand, it’s only an extra three months of leave. This is just a small step in the right direction.”


After claiming a majority in Congress, Democratic leaders have introduced a number of FMLA expansion bills, including some for paid leave.


“We’re optimistic that all of them are going to be moving in a more significant way (in 2008),” Kahan says.


Edwards says that FMLA expansion is “inevitable” because “that is what American workers want.” She cautioned lawmakers to ensure that new rules are easy for employers to implement.


—Mark Schoeff Jr.

Posted on December 27, 2007August 3, 2023

EEOC Issues Rule On Retiree Health Benefits

In a move that the Equal Employment Opportunity Commission says is designed to preserve retiree health benefits, the commission has issued a final rule that lets employers reduce benefits for retirees once they become eligible for Medicare. 


The rule, published Wednesday, December 26, in the Federal Register, allows employers that provide retiree health benefits to continue to coordinate those benefits with Medicare or comparable state health benefits without violating the Age Discrimination in Employment Act.


“Implementation of this rule is welcome news for America’s retirees, whether young or old,” commission chair Naomi C. Earp said in a statement. “By this action, the EEOC seeks to preserve and protect employer-provided retiree health benefits, which are increasingly less available and less generous.” (Read the EEOC’s Q&A on the new rule here.)


Kathryn Bakich, senior vice president and national director of health care compliance at consulting firm The Segal Company, applauded the new rule.


“The EEOC regulation will help employers be creative in addressing the need for retiree health care without worrying about calculating costs,” Bakich said in a statement. “It provides a realistic approach to situations where pre-Medicare and post-Medicare retirees have different needs.”


But the new rule got a chilly reception from advocacy group AARP. “This policy is a civil rights and economic fiasco,” AARP legislative policy director David Certner said in a statement. “It is a wrong-headed move to legalize discrimination, allowing employers to back off their health care commitments based on nothing more than age.”


The new rule comes after years of legal wrangling. A 2000 appeals court ruling, in Erie County Retirees Association v. County of Erie, held that the Age Discrimination in Employment Act requires that the health-insurance benefits received by Medicare-eligible retirees be the same, or cost the employer the same, as the health insurance benefits received by younger retirees.


After that court decision, unions and employers said that complying would force firms to reduce or eliminate the retiree health benefits they currently provided, according to the EEOC. Until the 2000 interpretation, the commission said, employers believed that the law let them coordinate any retiree health benefits they provided with Medicare without having to ensure that the benefits received by Medicare-eligible retirees were the same as those received by younger retirees


The EEOC voted to approve the new regulation in 2004, but AARP sued the commission in 2005 to prevent its implementation. After several years of litigation, the commission said, the Third Circuit Court of Appeals found that the rule was “a reasonable, necessary and proper exercise of [EEOC’s] authority.” That appeals court decision was issued in June, and AARP has appealed the decision to the Supreme Court.


In a statement, EEOC legal counsel Reed Russell said: “Our rule makes clear that it is lawful for employers to continue to provide retirees with the health benefits they currently receive. Contrary to what some interest groups have erroneously asserted, the rule will not require any cuts to retiree benefits.”


—Ed Frauenheim


Posted on December 26, 2007July 10, 2018

Indiana Launching Plan for the Uninsured

The Bush administration has approved an innovative Indiana program that will extend state-subsidized health insurance coverage with consumer-driven features to low-income uninsured residents.



The plan, which is funded in part by an increase in the state’s cigarette tax, is set to begin on January 1, 2008. It will be available to residents whose income do not exceed 200 percent of the federal poverty level, which would be $20,420 for an individual and $41,300 for a family of four. Additionally, residents must be uninsured at least six months and not be eligible for employer-provided health insurance.



Under the Healthy Indiana Plan, which received Bush administration approval last week as a so-called Medicaid demonstration project, the state will pay for $500 a year in preventive services, which include annual physicals, smoking cessation programs, prostate exams, mammograms and diabetes testing.



Enrollees will have an annual deductible of $1,100. To cover that deductible, the state and enrollees will contribute a total of $1,100 to a Power Account, which is similar to health reimbursement arrangements used by many private-sector employers. Employers also can contribute to employees’ Power Accounts.



Like an HRA, accumulated contributions in a Power Account will roll over from year to year, offsetting an enrollee’s future contributions.



Beneficiaries’ contributions to Power Accounts will be linked to their income and range from 2 percent to 5 percent of gross annual income. For example, in the case of a single adult whose annual income is $10,210, the state would contribute $896 to the Power Account, while the individual would contribute $204.



Filed by Jerry Geisel of Business Insurance, a sister publication of Workforce Management. To comment, e-mail editors@workforce.com.

Posted on December 26, 2007July 10, 2018

FedEx Suffers Independent Contractor Setback

In another setback to FedEx on the independent contractor front, The U.S. Internal Revenue Service has tentatively concluded that owner-operators who were working in the firm’s ground delivery business in 2002 should be reclassified as employees.


FedEx may have to pay $319 million plus interest in tax and penalties, the company said in a public filing Friday, December 21. The IRS is auditing the company on similar worker classification issues during the period from 2004 through 2006.


But FedEx is confident it will prevail. “We believe that we have strong defenses to the IRS’s tentative assessment and will vigorously defend our position, as we continue to believe that FedEx Ground’s owner-operators are independent contractors,” FedEx said in its filing.


The IRS move will likely not only affect FedEx, but influence a broader debate about the way firms farm out work to independent contractors.


Companies can create a more flexible workforce through the use of contractors, in addition to being able to avoid paying employment taxes. But worker advocates argue that such arrangements often amount to shams that let companies shirk both taxes and their responsibilities to workers who actually are employees under the law.


For years, FedEx and its FedEx Ground unit have been at the forefront of this debate. FedEx Ground argues that it contracts with independent operators to work its routes. The drivers own their own trucks, but FedEx has a series of requirements governing their work, such as the display of company colors and logos on trucks.


FedEx has been hit with multiple lawsuits challenging its treatment of FedEx Ground owner-operators. In its recent public filing, FedEx said the California Supreme Court has refused to review an appellate court decision upholding a trial court ruling that found a number of California contractors should be reimbursed as employees for some expenses.


FedEx said it doesn’t expect to incur a material loss in the California case. But it does face having to pay hundreds of millions to the IRS.


“The IRS has tentatively concluded, subject to further discussion with us, that FedEx Ground’s pick-up-and-delivery owner-operators should be reclassified as employees for federal employment tax purposes,” FedEx said in its filing. “The IRS has indicated that it anticipates assessing tax and penalties of $319 million plus interest for 2002.”


FedEx said that given the preliminary status of the matter, it cannot determine the amount of potential loss. But, it said, “We do not believe that any loss is probable.”


—Ed Frauenheim

Posted on December 24, 2007July 10, 2018

States Face Huge Funding Gap for Non-Pension Benefits

States owe public employees at least $2.73 trillion in pension, health care and other retirement benefits. And while they’ve set aside 85 percent of long-term pension costs, states have saved just 3 percent of funds needed for health care and other non-pension benefits, according to a new study by the Pew Charitable Trusts’ Center on the States.



The Pew study is a peek at the amount of non-pension benefits states owe employees, which—until a new ruling by the Governmental Accounting Standards Board—states have not had to disclose. Those numbers are expected to become public between December 2008 and March 2009.



“Now we know the magnitude of this bill—and paying it will require an enormous investment of taxpayer dollars,” says Susan Urahn, managing director of the Pew Center on the States.



Just six states—Arizona, North Dakota, Ohio, Oregon, Utah and Wisconsin—appeared to be able to fully fund their non-pension obligations for the next 30 years as of the end of fiscal 2006.



None of the five largest states—California, Texas, New York, Florida and Illinois—had put aside money for non-pension benefits as of fiscal year 2006. According to the Pew study, New York faces the largest liability, at $50 billion, followed by California at $48 billion, and Connecticut and New Jersey at $22 billion each.



Filed by Megan Johnston of Financial Week, a sister publication of Workforce Management. To comment, e-mail editors@workforce.com.

Posted on December 20, 2007July 10, 2018

Former HR Chief at AIG, Others Charged in Alleged Headhunting Scam

Federal authorities have charged a former human resources vice president of American International Group Inc. and three accomplices with defrauding the insurer of $1.1 million with phony bills for employee search services.


FBI agents and local police arrested John J. Falcetta, a former vice president with AIG’s life insurance division, on Tuesday, December 18, in Nantucket, Massachusetts. He was scheduled to be arraigned Wednesday in federal court in Boston.


Arrested separately were Gary J. Santone and Thomas Pombonyo, while a fourth defendant, Justin Broadbent, was still being sought Wednesday.
 
According to a federal criminal complaint, Falcetta moved from Philadelphia to New York to take his job with AIG in September 2005. His duties included managing contracts with employee search firms, and he had the authority to add firms to AIG’s approved list of vendors and to pay vendor bills up to $50,000.


Over the next two years, until AIG terminated him in August, Falcetta approved payments to bogus headhunter firms set up by Santone, Pombonyo and Broadbent, authorities allege. Those payments included $320,525 to G. Santone Associates, run by Santone; $674,886 to two firms, Enterprise Business Group and Global Search Affiliates Inc., run by Pombonyo; and $120,000 to Broadbent Advisory Group, run by Broadbent, the complaint says.


The four companies then kicked back $462,476 to Human Capital Management Partners, an entity Falcetta had created, authorities charge.


None of the search firms actually performed any work for AIG, and at least some of them appear to exist only on paper, the complaint suggests. The address Broadbent Advisory gave on its invoices, for example, is a residence belonging to Broadbent’s mother, and its fax number is registered to a Dunkin’ Donuts store in Philadelphia, the complaint says. The fax number on Santone & Associates’ bills belonged to a Philadelphia jewelry store.


Filed by Douglas McLeod of Business Insurance, a sister publication of Workforce Management. To comment, e-mail editors@workforce.com.

Posted on December 20, 2007July 10, 2018

Controversial DOL Official DeRocco to Leave Post

Assistant Secretary of Labor Emily Stover DeRocco, who oversaw high-profile programs but also came under fire on matters including the closing of a public online job board, will leave her post in January.


DeRocco has served as U.S. assistant secretary of labor for employment and training for more than six years. During this time, her projects included improving community colleges, supporting talent development plans in regional economies and creating partnerships for the High Growth Job Training Initiative. The initiative is a program to prepare workers for jobs in high-growth, high-demand and economically vital industries, such as health care and advanced manufacturing.


“America’s workers and employers have had a steadfast friend in Emily Stover DeRocco, who always has understood that it is essential to prepare our workforce for the rewarding opportunities that lay ahead,” U.S. Secretary of Labor Elaine Chao said in a statement Thursday, December 20. “Emily transformed a $10 billion social services agency into an economic development driver actively working to enhance workers’ talents and prosperity.”


But there are questions about how well DeRocco managed her substantial budget at the Employment and Training Administration. In a report published in November, the Labor Department’s Office of Inspector General found that ETA did not adequately justify decisions to give out non-competitive awards for the High Growth Job Training Initiative. The Office of Inspector General examined 39 non-competitive awards and concluded that “ETA could not demonstrate that it followed proper procurement procedures” in 35 of them. Those 35 awards totaled $57 million.


The report says DeRocco “strongly disagreed” with findings related to the procurement practices used for noncompetitive grants.


The November inspector general report isn’t the only time DeRocco has landed in hot water. A 2005 inspector general report about the award of National Emergency Grant funds found that ETA was inconsistent in applying federal procurement rules and regulations with which the department was responsible for ensuring compliance.


DeRocco also was criticized for ETA’s move earlier this year to shutter America’s Job Bank, a public online job board. The Labor Department cited outdated technology and claimed that America’s Job Bank duplicated what was already available in the private sector. But the department declined to make public any comprehensive study weighing the pros and cons of America’s Job Bank and justifying the decision to close it, even though a good deal of evidence argued for the site’s preservation.


DeRocco represented the U.S. in numerous international forums, and was named to and led boards and commissions in areas ranging from the future of the aerospace industry to the aging of the American workforce, the Labor Department said in a press release Thursday.


Prior to her appointment at the U.S. Department of Labor, she served 11 years as executive director and COO of the National Association of State Workforce Agencies, a group of state administrators.


“The impacts of globalization and technology have made this period in our history one in which development of a more highly educated and skilled American worker is critical to the nation’s competitiveness in the world economy,” DeRocco said in a statement.


“It has been a privilege and an honor to serve the American people under President Bush’s and Secretary Chao’s leadership,” she added.


—Ed Frauenheim

Posted on December 20, 2007July 10, 2018

Bad Breakup

Here’s a hypothetical business problem to ponder: What do you do when your top executive, someone who has only been on the job a short time yet has quickly revamped and revitalized the organization, has a momentary moral lapse and gets involved romantically with a subordinate?

    In America’s 21st century business environment, there’s an easy, knee-jerk answer—you get rid of the executive involved, even if he (or she) is doing a great job. That’s what happened to American Red Cross president Mark Everson, who resigned late last month after admitting that he had engaged in a personal relationship with a subordinate.


    For many, this is a cut-and-dried issue. After all, this is not France. How can an executive, particularly the top executive, continue to command the respect of the workforce after such a huge moral misstep? Wasn’t the Red Cross board right to call Everson on the carpet and force him out?


    You might say yes, but surprisingly, a lot of America’s business press is seeing it a bit differently.


    As The Wall Street Journal pointed out, “While CEOs sometimes have relationships with subordinates, until recently it was rare for such behavior to lead to a public dismissal.” And The New York Times talked to Regina Rafferty, a consultant to Red Cross donors, who was critical of the board’s quick action. “I’m sure there were sanctions,” she told the Times, “that could have been taken short of firing the man, which wasted the 18 months they spent searching for him, any money spent on that search, and his six months’ worth of learning.”


    Two experts on workplace romance, Stephanie Losee and Helaine Olen, authors of Office Mate: The Employee Handbook for Finding—and Managing—Romance on the Job, also questioned the seemingly precipitous decision by the Red Cross board.


    As they point out in an online column on the Huffington Post, “The American Red Cross has been a troubled organization in recent years, and more turmoil at the top is the last thing this worthy charity needs. … Ironically Everson, who had only been on the job for six months, had won raves for the agency’s handling of this fall’s California wildfires.”

    “If Everson was fired expressly for committing adultery with a co-worker in spite of his objective success in his position, we’ll be rather disappointed with the Red Cross,” Losee and Olen added. “People do stupid things at the behest of their hearts. We don’t need headline-making firings to serve as a modern-day version of The Scarlet A,” with a nod to Nathaniel Hawthorne’s novel.


    I can’t believe I’m writing this, but I tend to agree with the I authors that perhaps the Red Cross board was too hasty in pushing Mark Everson out the door.


    Yes, he showed terrible judgment here, but all reports say that this was a consensual relationship between two adults who were married to others. There’s no threat of a lawsuit (according to the Times), nor are there accusations of harassment or favoritism.


    More important, Everson, a former commissioner of the Internal Revenue Service, seemed to bring stability to the Red Cross, an organization that had been through five chief executives in six years and was severely criticized for its response to Hurricane Katrina. He “appeared to have brought a level of stability to the Red Cross that it had not experienced in more than a decade,” the Times wrote. “Even as he eliminated senior vice presidents and set what some thought were overly ambitious fund-raising goals, employees said, he was respectful of staff members and an ardent defender of the organization.”


    Leaders like that are hard to find. But more and more, it seems that we prefer easy solutions to complex problems. Zero-tolerance policies are just one example of how our society seems to prefer one-size-fits-all decision-making that is preferable to actually thinking through an issue and weighing the consequences of an action.


    Relationships in the workplace are never easy, and they get geometrically more difficult when there is sex involved. Everson made a bad decision, but was it one that was so terrible that it should have cost him his job? I’m all for decisiveness and strong leadership, but this seems like a hasty decision made on the fly that the Red Cross board may ultimately come to regret.

Workforce Management, December 10, 2007, p. 58 — Subscribe Now!

Posted on December 20, 2007July 10, 2018

Tales of Backshoring

A torrent of jobs are offshored every year. And every year, a trickle of jobs return home—or are “backshored”—after companies experience disappointment and frustration with remote, foreign workforces.


    Accurate counts of both flows are elusive. Perhaps one dollar’s worth of work gets backshored for every $10 offshored, according to some experts. Others say the numbers could be much higher. Companies don’t reveal numbers of offshored or backshored jobs. Although efforts have been made to count offshored jobs, backshoring reports are anecdotal.


    Backshoring does happen, though, and five factors drive most of it: cultural misunderstandings, unexpected management needs, high turnover in the offshore workforce, low skill levels and work that’s too complex. The offshoring experiences of two companies show what happened when they encountered these factors. Although both companies are small businesses, enterprises of any size can relate to their experiences. The challenges they faced are textbook examples of why work gets backshored.


    When offshoring fails, bringing the work back home to the parent company, or at least a domestic outsourcer, seems like a logical solution. But especially for large companies, it takes just as much planning and forethought to make backshoring succeed as it does to make offshoring succeed. For backshoring to turn out well, a transition plan is crucial.


Guessing the numbers
   The offshoring of blue-collar jobs is an accepted way of doing business. Sending white-collar, highly skilled jobs abroad is a much more recent phenomenon. “I was fascinated by the rise of the Indian software industry,” says Ron Hira, assistant professor of public policy at the Rochester Institute of Technology and author of Outsourcing America. “I saw their competitiveness emerge in 2002 and 2003, and it exploded in 2004.”


    Hira also observes that no one has a good estimate of the number of offshored high-tech services jobs. “The government doesn’t collect proper data on services,” he says. “In 2003, the U.S. government said the country imported $400 million in services from India. [In the same year,] the Indian government said it exported $8.4 billion worth of services to the U.S. The numbers should be the same.”


    Opinions diverge on the size of the backshoring phenomenon. Erran Carmel, associate professor and chair of the information technology department of American University’s Kogod School of Business, estimates that one dollar’s worth of work comes back to the U.S. for every $10 that is offshored. He doesn’t, however, think backshoring is going to go away.


    “Offshoring is an innovation,” he says. “Organizations experiment. They reassess, stumble, make mistakes. [Backshoring] is a natural phenomenon of this large economic change we’re going through.”


    Rafiq Dossani, a senior research scholar at Stanford University and the author of India Arriving, agrees that the offshoring trend continues to be strong. But he also believes that more backshoring may occur than anyone realizes.


    In travel for his research, Dossani says, “I’ve visited more than 200 companies in the last five years. Seventy percent of them have brought work back.” The primary reason was the offshored company’s failure to understand the U.S. company’s corporate culture.


Reasons for backshoring
   Carmel cites as an example Indian software engineers working for Big Three automakers. The engineers typically never had a car or even a driver’s license. “They don’t know much about the car culture in the U.S.,” Carmel says. “This has a subtle impact on their understanding of the business impacts their work has.”


    Companies that look just at low pay rates are surprised when offshore workers need a lot of hand-holding. “From a workforce management perspective, you’re asking a lot of managers who are tasked with managing an offshore workforce,” says Martin Kinney, professor in human and community development at the University of California, Davis. “Your workforce must go there to see the environment and monitor turnover in India. You can’t ever get rid of your workforce management responsibilities.”


    Turnover has become a huge offshoring issue. “Today, call center attrition rates are around 40 percent to 50 percent, and information technology rates are around 15 percent to 20 percent,” Dossani says. Those with the greatest talents and skills will go first, since they are the most heavily recruited by the competition.


    Pay rates may be cheap in developing nations, but it’s for a reason—the skills sets among workers there might not be as well developed as in the U.S. “Lots of outsourcing is still about cost arbitrage, not about skills,” says Joseph Greco, director of the Center for the Study of Emerging markets at California State University, Fullerton. Consequently, if a company tries to offshore highly complex work, “it can’t find the skills, and it can’t train the people because they don’t have the background,” he says.


    Sometimes the work is just too high-tech for people with minimal skills and knowledge. “The more cutting edge the technology, the harder it is to offshore,” Dossani says. Well-defined tasks are better for offshoring.


Rapid prototyping, slow failure
   Decision Design encountered all five backshoring factors when it experimented with offshoring from 2000 through early 2003. With offices in Bannockburn, Illinois, and Pleasanton, California, the 20-person company specializes in software development for the corporate and government market. It has a number of Fortune 500 clients.


    The company’s development approach is known as rapid prototyping, in which software is quickly designed, built and tested. Problems are rapidly identified and fixed, and the next round of design, build and testing proceeds. Succeeding stages often overlap. It’s an approach that requires flexibility, quick response to change and a keen understanding of the client’s needs.


    With the Y2K software bug making it hard that year to find good programmers at reasonable costs, company president Monty Davis decided to try offshoring.


    “One of our goals is to keep our costs well below the rate structures of big companies like Accenture or Deloitte,” Davis says. “We need to keep salaries low, but get good people.” To do that, he hired a U.S.-born Indian-American who wanted to build partnerships with his cousin in Delhi, India.


    Through Davis’ Indian-American liaison, Decision Design contracted with Max Ateev, a billion-dollar Indian software development company. Davis went with a large company because he thought it would do better work and pose less risk than a small company. Six developers, a project manager and a quality assurance specialist were to be dedicated to Decision Design. Davis sent his Indian-American contact to work with the team and explain Decision Design’s corporate culture and rapid prototyping methods.


    “They’d be like our employees, except they’d only cost $20, and the time zone would work to our advantage,” Davis says.


    Instead, the Indian software engineers produced “buggy” products, didn’t foresee problems and took too long. “Our liaison went over there once or twice a quarter to try to work with them on the methodology. This team could not adapt,” Davis says. He also suspected, though could never prove, that his “dedicated” team was in fact often working on other projects. When the work from India came in, Decision Design had to redo it. “It’s always at the end of the project you find this out,” he says. “It adds cost and stress.”


    Davis pulled the work around the end of 2002, but gave offshoring one more try. The company rented office space and equipment and directly hired three Indian employees for $10 an hour. “It didn’t work,” Davis says. “It got cheaper, but they still weren’t able to do the work. We had done this for more than two years. It wasn’t cheap and it wasn’t good.” Davis brought all development back in-house in the spring of 2003, absorbing the small quantity of work the Indian workers had been doing with Decision Design’s existing employees.


    Davis offshored in part to show customers the company was doing the “modern thing.” Now he thinks that not offshoring is a business advantage. “It really simplified management,” he says. “We didn’t have to worry about an offshore workforce.”


From dream to nightmare
   Los Angeles-based Arvani Group is a boutique management consulting firm that helps international mobile and wireless companies expand into emerging markets. The company’s clients include Casio, PalmSource/Access, the research and development labs of Japanese telecom/wireless giant DoCoMo, and others. The core company is just three people, but through contractor agreements, it can quickly scale up to 50 people when necessary—and scale back down just as fast.


    “As a small company, we are always looking for ways to use the latest methods to optimize our productivity,” says Azita Arvani, president of the firm. In February and March of 2007, the company decided to make the most of its productivity by sending some basic research offshore. “From the start, we emphasized that we absolutely require the highest-quality research, reliability and responsiveness,” Arvani said. “We were also hoping the time zone would work to our advantage. You know the dream: We provide a request, they take care of it while we sleep and it is ready the next morning.”


    Arvani contracted with an Indian company and provided ample sources for the research. “We wanted the Indians to get data about potential European and American partners for our clients,” she says. “We needed research done overnight on about a dozen companies, and we wanted the data structured for easy reading.”


    The research reports came back a week late. Worse, they contained the same information that Arvani had sent, except in a new format. After another week passed with no results, Arvani pulled the job and assigned it to U.S.-based contractors she’d used for such tasks in the past.


    “The Indians really never understood the urgency of the task, and the quality wasn’t good,” Arvani says. “Whenever I complained, they’d say, ‘We’ll fix it,’ but we’d still be talking about it a week later. It took too long.”


    Arvani was disappointed and frustrated not only by the late work and low quality, but especially by the management demands. “I didn’t have time to baby-sit and didn’t see why I should have to,” she says. “Total costs were much higher because the management costs were so much higher. All the extra effort and anxiety wasn’t worth it.”


Transition plans required
   Arvani was fortunate in that she had a contingency plan—her U.S.-based contractors—in case things went wrong with her offshore experiment. Many companies don’t adequately plan for offshoring—or backshoring.


    “We do see outsourced work coming back, and it isn’t always a success,” says Stan LePeak, managing director of research with Houston-based EquaTerra, a global management consulting firm specializing in outsourcing and business process change. “In some cases, organizations forgot why they outsourced. Frequently, they weren’t doing the work as well as they thought [before they outsourced it] and they didn’t get better by not doing it for a while.”


    If backshoring is to succeed, LePeak says a transition plan is necessary, especially if the work is strategic, touches the customer or hasn’t been done by the company for a while. “Human resources needs to ensure that the organization has sufficient people with the necessary skills to do the work,” he says. “Set expectations, establish a time frame, identify the benefits of backshoring and identify who to call for help in case of problems and other such transitional issues.”


    Even if offshored work is brought back to a domestic outsourcing company, a transition plan is needed. “Companies shouldn’t assume that migrating work back isn’t happening a lot—or that it is painless,” LePeak says.

Posted on December 20, 2007July 10, 2018

Looking Through Health Care Transparency

We’ve come a long way in terms of providing more and better health care information to employees. As health care deductibles and co-payments have risen for the U.S. workforce, so have efforts to promote more enlightened health care choices and consumerist options—from incentive programs to health savings and reimbursement accounts and a growing range of resources for more cost-efficient health. At the same time, pressure has mounted on health care providers to make their cost data more transparent in the marketplace.


    But health care will always be more than a commodity to be purchased and consumed on a best-price basis. Instead, it will remain a complicated value proposition in which cost and quality factors must be weighed carefully. And that’s still not very easy for most people to do, despite rising consumer demand for transparency from payers, providers and pharmacy benefit managers. The fact that they are sharing more information on the cost of tests, treatments and drugs only underscores the need to make that information more meaningful to the consumer.


    Fortunately, the forces for meaningful health care transparency have been gathering positive momentum in recent years. An executive order from President Bush directed U.S. government agencies responsible for health care programs to release price and quality-of-care information. And Department of Health and Human Services Secretary Mike Leavitt has asked major employers, state governments and other large health care purchasers to embrace health information technology, share their health plan quality and cost information, and insist that providers adopt quality and cost measurement standards.


    Meanwhile, the federal Center for Medicare and Medicaid Services, the nation’s single largest health purchaser, and the U.S. Department of Health & Human Services have been releasing cost and provider-quality data, which can be accessed online at CMS’ Consumer Initiatives section and HHS’ Hospital Compare site State government initiatives, such as New Hampshire’s mandate that health insurers provide data on health care costs by facility and procedure and then post that data online, are swelling the tide. Indeed, the traditional provider’s argument—that health services quality in relation to cost can’t really be measured—is eroding under the weight of available data. This is enhanced by the efforts of lobbying groups such as the National Business Group on Health, and the emergence of organizations such as the Leapfrog Group, whose membership comprises some of the largest health care purchasers in the nation and which encourages health providers to publicly report on quality outcomes to advance the cause of informed health care consumerism.


    Importantly, the private sector is stepping up to the plate. Mercer’s original 2004 initiative, called Care Focused Purchasing, has led more than 50 large employers to pool their data and develop a scorecard system that rates health care providers on quality and cost efficiency, with a goal of developing a rating system based on treatment standards and consumer experiences. Mercer’s U.S. health care thought leader, Arnold Milstein, M.D., a Leapfrog Group co-founder and the medical director of the Pacific Business Group on Health, the largest employer health care purchasing coalition in the U.S., has called for the use of Medicare and Medicaid data as a public asset to help raise the efficiency bar for all providers.


    If there’s a disconnect, though, it may well be that awareness and usage of the information remain low, largely because it’s still problematic for consumers to marshal all of the cost and quality data that is becoming available. Comparative health information is not a “build it and they will come” endeavor. It requires significant marketing to get out the word on ease of use and value of the information to the public. It also requires data consistency that standardizes quality and efficiency measurement, avoiding confusion by relying only on nationally recognized and vetted measures that can be understood by the average consumer.


    People not only have to be aware information is available, but also must clearly see “what’s in it for me” and for their loved ones. The consumerist trend encourages everyday folks, not just M.D.s and Ph.D.s, to consider all dimensions of health care value more carefully—and, fortunately, more of them are searching out, demanding and finding the best quality and health outcomes at a reasonable cost and with acceptable levels of service.


    Yet as far as health care transparency has come, it still has a long way to go. And if the polls of health information users and consumer plan enrollees hold true, the more information people get, the more they’ll want and demand. Faster, easier to use, more accurate, more reliable and timely, and so on. We may never be done in this regard, and that’s fine. Greater demand will open up the capital required to create truly intuitive solutions. The foundation technology—led by the near-universal accessibility of the Internet—is certainly in place, but at this point, the various points of contact remain scattered. How many health care consumers, for example, know that the Leapfrog Group providesquick online information on hospital quality and patient safety:  by city, state or ZIP code?


    And that will remain the larger challenge: making consumers aware that such information is being codified and is out there for them, that it’s easy to find and important for them to use. An obvious analogy relates to the price of oil. Knowing the cost per barrel at any given time doesn’t really help the consumer, but the emergence of Internet sites listing comparative gasoline prices at local stations has made it easier for us to make better choices at the pump.


    Health care cost and quality information is much more complicated, of course, and so much raw data is entering the pipeline from different sources we must not overlook the ultimate purpose of that data—to serve us, for we are all health care consumers, and to make our choices clearer and our lives better.


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