How ACA Compliance Projects Are Affecting Staffing Management for Businesses and Healthcare Providers

ACA Compliance

Healthcare reform in the United States continues to redefine how benefits are offered and delivered. Additional trends are shaping the hiring environment, especially for payers and providers under the Patient Protection and Affordable Care Act (ACA).

Healthcare providers need to ensure they’re meeting ACA compliance standards on their healthcare information management systems — both electronic health records (EHR) and practice management systems.

For some providers, this doesn’t mean just upgrading existing systems, but digitizing processes that were previously paper-based. They also must provide appropriate training to help staff transition to working with the new systems.

Many providers implementing healthcare systems, and managing the change around the process, are enlisting the help of outside consultants who have healthcare management and business systems expertise. Some healthcare providers are also looking for continued support from these experts beyond initial implementation projects and into the optimization phase.

ACA compliance demands on other businesses

Major ACA deadlines have already passed for many organizations. Now, these businesses are focused on maintenance, support and analysis related to maintaining ACA compliance.

Other organizations with temporary exemptions, such as employers with 50 to 100 employees, are still in the implementation stage. They are working to reach full compliance with ACA before 2016.

One thing many organizations at various stages of the ACA compliance journey have in common is that they’ve had to adjust their staffing management strategy to support ACA projects. This includes assigning tasks to in-house personnel, or hiring outside consultants when specialized expertise is required or the business does not have enough staff to handle these projects.

Here’s a quick look at how ACA compliance projects are affecting project staffing management for these businesses:

ACA audits

Organizations need to conduct self-examinations to find potential breaches before regulators do. Some questions businesses need to answer include “How many full-time equivalent (FTE) employees does the company have under ACA definitions?” and “Are executive health plans out of compliance with nondiscrimination rules?”

To save time and reduce the burden on internal resources, some organizations are hiring external auditors to review their ACA compliance processes.

Engaging these expert resources to help verify ACA compliance can help prevent avoidable missteps that could lead to fines. Penalties for noncompliance are stiff, including fines of up to $3,000 per staff member for employers in certain circumstances.

Reporting systems

Employers also face the challenge of knowing exactly how to offer and administer insurance benefits, especially in larger firms.

Businesses will eventually be able to complete a single report for the entire organization, if they offer coverage to more than 98 percent of their FTE employees. However, during the first year of ACA compliance, most organizations will need to note the coverage on each individual W-2 when filing their return.

These demands may require managers to dedicate additional staff to monitoring changes in reporting systems and assisting with benefits or W-2 initiatives. They may also need to engage outside resources to provide extra assistance when workload spikes. Additionally, management will need to communicate changes in reporting systems and related demands to employees.

Ongoing monitoring and analysis

Meeting ACA compliance requirements is a significant challenge for any organization that must adapt to the healthcare mandate. And for many businesses and healthcare providers, the work will likely be ongoing for some years to come. Like other types of regulatory compliance measures, ACA is bound to evolve.

In addition, just as organizations are trying to do with their compliance efforts related to measures like the Sarbanes-Oxley Act, they will need to revisit their ACA compliance processes to find ways to improve efficiencies and control costs.

What challenges has your organization faced in meeting ACA compliance requirements? Share your experiences in the comments.

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