In her post last week Joni Watson described how anticipated reimbursement changes brought about by the Affordable Care Act (ACA) contribute to lower admissions rates, and therefore less profit for some hospitals. At the end of her post, Watson asks if members of TheONC community have experienced effects from the changing financial reimbursement of the ACA. For me, the answer is, "Yes, significantly."
Besides reimbursement changes, ACA calls for the formation of Accountable Care Organizations (ACOs): joint ventures coordinated by hospitals and providers in communities in which they stop competing and create seamless coordinated services for patients, thereby reducing the cost of care.
In this vein, the hospital I work for has undertaken collaboration with another hospital to provide outpatient oncology care for patients. As a result, after working for the same healthcare system for nearly 20 years, I have become an employee of the other hospital. Though my job is basically the same, I unexpectedly find myself working for a new healthcare system.
In many ways this change is actually beneficial. However, it has also created turmoil for my coworkers and me.
There is the potential expectation that we occasionally float to locations other than our home unit, involving commutes for some of us. Vacation plans beyond the new hire date are uncertain; we've been asked not to request vacations until after the end of the year. New benefits packages require reading, new retirement options must be considered, and there is a different pay scale than what we were accustomed to. I want to reiterate, none of this is a bad thing, but when a job change is unexpected it creates disruption. Here are some coping skills I learned, in case it happens to you:
- Get your vacation plans approved by your manager as soon as you are aware of the job change. Merging two staffs means some people won't get the time slots they desire.
- Polish your resumť. Find the addresses of the schools you attended, remember the names of your past managers, and assemble reference contacts. Even if you are automatically offered a job with the new employer, you will have to fill out a job application.
- Make dental, vision, and medical appointments, and renew prescriptions for yourself before the new hire date, in case your new insurance makes it necessary to seek new providers.
- If you can't rollover your sick leave or vacation time, consider using as much of it as you can before the job change. It may be taxed at a lower rate that way.
- Remain calm, and avoid the rumor mill. Find out who is authorized to answer your questions, and get as many answers in writing as possible.
- Be patient. ACOs are new for everyone. Administrators and human resources personnel are also learning facts as the project develops. They are not necessarily purposely vague. They really may not know the answers to your questions yet.
Are any members of TheONC in a similar situation? How are you managing?