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The role of Artificial Intelligence in healthcare

While it’s true that the healthcare industry is witnessing a record-breaking year in digital health investments, the AHA simultaneously projects healthcare’s financial losses at more than $300 billion in 2020. Due to the pandemic, healthcare institutions are increasingly turning to digital and artificial intelligence (AI) solutions that streamline behind-the-scenes functions and alleviate administrative and operational spending. Many hospitals are seeing immediate results from such investments in departments and functions that involve error-prone, repetitive, time-intensive tasks. And one function fraught with such tasks is claims processing and reimbursement. It involves a myriad of stakeholders and steps, such as validation, justification, authenticity, and payment. Each step of the process is just as crucial as the last, making efficient and accurate communication critical for success. It is no surprise that the reimbursement and claims processing work stream primarily consists of high-volume and repetitive tasks, such as collecting and inputting patient and provider data. When a mistake in the process is made, such as incorrect billing or erroneous patient documentation, the process is further delayed. Payers, providers, and patients alike are faced with extra back-and-forth communication to reconfirm details for the medical claim. This issue transcends the billing cycle and can directly impact payers, as well. Continually delayed claims can make hospitals leery of accepting certain plans or even entire carriers. A lower number of accepted plans results in benefit brokers only being able to offer a small range of options to their clients. Ultimately, this leads to employers providing health plans for their employees only having a limited number of options to choose from. As more and more hospitals understand the magnitude of these issues, they are implementing AI solutions to help streamline the claims processing and reimbursement process. AI automates these critical but repetitive tasks to reduce mistakes, enhance workflows, and let hospital staff focus on tasks that require a human touch. AI is also being used to minimize the hefty costs associated with insurance claim denials. With AI, providers are able to identify and mitigate erroneous claims before the insurance company denies payment for them. Not only does this streamline the process, but it also saves hospital staff the time it would take to work through the denial and resubmit the claim. With faster payments and greater accuracy, hospitals are more willing to accept a wider number of plans, which means benefits brokers can offer a broader range of options to their clients. Hospitals are continuing to reimagine the claims process, with AI in mind. In fact, recent research indicates that 61% of hospital leaders are looking to implement AI/RPA within the next two years. Hospitals will continue leveraging AI solutions to streamline backend functions to reduce operational costs, alleviate administrative spending, and allow employees to focus on more important tasks. Just what the doctor ordered Also, when searching for the best surgeon, consumers may get a major assist from AI, a new study says. The report in the Journal of Medical Internet Research (JMIR) compared healthcare decision-making based on a range of choices: consumer ratings; quality stars; reputation rankings; volumes and outcomes; and precision machine learning-based rankings. That last category looked at a type of AI that uses data to determine whether a hospital is a good fit for a potential patient. The study found that the machine-learning approach to picking a surgeon delivered better outcomes than choosing surgeons by other methods. The AI approach allows a more personalized choice—the algorithm matches the patient to the hospital that has the best outcomes for patients with similar profiles. Benefits in administration AI offers employers and brokers an opportunity to maximize the impact and efficiency of their offerings and human resource programs. In 2021, and in the wake of COVID-19, the role of AI will grow as companies continue to transition to long-term remote work, tackle COVID-19-related expenses, educate employees on their health benefits, and introduce benefits platforms to address individual needs better. In 2021, we’ll likely see AI play a more significant role in helping employees avoid burnout through tools that encourage real-time engagement, provide individualized recommendations on how people can do their best work, and robot coaches. For HR teams, AI-powered solutions will quickly flag employee roadblocks and prioritize those most at risk. Greater use of remote teams also means more integration of HR and day-to-day collaboration tools. HR data analytics’ power is in how it can proactively assist in more accurately predicting annual benefits costs—a tool that will become crucially important for families, employers, and health plan providers as they plan for this year. This emerging, critical decision-making data will play a key role for brokers, employers, and health plan providers as they navigate both expected and unexpected changes. With COVID-19-related fraud also on the rise, health plan providers and employers who use HR data analytic tools to spot and flag outliers could save themselves hundreds of thousands of dollars. In 2021, health plan providers and employers expect employees to prioritize flexibility and personalization in their healthcare coverage to meet their unique needs and challenges. With budgets top of mind in 2021, employers and employees will continue to use these financial tools to save money and lower medical plan premiums. Brokers, health plan providers, and employers will continue to leverage AI to educate employees on their medical costs and personalize their benefits based on their current and projected future needs. Insight-driven benefits administration relies on automated platforms to collect, aggregate, streamline, and analyze data from multiple systems to produce actionable steps to drive value. These platforms will only become more essential as companies continue to adapt to the changes seen in 2020. As priorities continue to shift in 2021, the demand for employee data to evaluate workplace wellness programs, retention, and benefits will grow. But seamless interaction with personalized benefits program offerings will likely provide the most significant avenue for growth of modern benefits platforms. Modern benefits platforms will become an even more essential tool to health plan providers and brokers in the coming year as they allow them to reach the end consumer more effectively. AI will continue to drive evolution in the benefits space. While many things changed in 2020, data is still the most dependable way to understand what is happening now and predict the future. As everyone adjusts to the changes on the horizon, we will continue to rely on the data and insights AI provides to support the healthy growth of the benefits ecosystem. At a glance: * Healthcare industry’s financial losses projected at more than $300 billion in 2020 * 61% of hospital leaders are looking to implement AI/RPA within the next two years * AI automates repetitive tasks to reduce mistakes, enhance workflows * AI is being used to minimize the hefty costs associated with insurance claim denials * AI uses data to determine whether a hospital is a good fit for a potential patient * HR data analytic tools can be used to save hundreds of thousands of dollars * Benefits administration relies on automated platforms to collect and analyze data

25 Mar 2021
The Millennials: A new generation of employees

Now that millennials make up the largest portion of the American workforce, chances are good that almost every company has at least one member of this generation within its staff. According to Pew Research, 56 million millennials are earning a living, and the post-millennial generation – those born after 1996, known as Gen Z – are now entering the workforce, with 9 million currently at working age. What does this mean for the typical HR professional? Now that older generations are retiring and younger professionals are entering the workforce, HR teams must make sure that they have crafted the right benefits package to support these employees. What’s more, it’s imperative that HR administrators are clear when it comes to enrollment, benefits administration and overall management. This critical generational juncture provides an ideal opportunity for HR teams to re-evaluate their existing benefits package, and to add or subtract items to align offerings with workforce needs. This important review won’t just help support the existing staff, but can serve to attract young professional employment candidates as well. An essential factor to keep in mind here, however, is that those within different age brackets will have a variety of needs. Just as workers that are part of the Baby Boomer generation or Generation X had specific focuses and benefits needs, requirements will differ when it comes to millennials and Gen Z. HR professionals will need to develop new engagement models to take into account the generational differences between baby boomers and millennials. Managers accustomed to using certain practices to engage boomers will have to change their ways – and practices – if they hope to engage and retain the newest heavily scrutinized employee cohort, the millennials. As Emily Bailey of OneDigital told HR Dive, these differences extend, particularly, to the ways in which employees engage with and consume details related to employee benefits. “It really does cause us to take a step back and better assess how we’re putting information out there,” Bailey said. “[Younger generations] may not put as much value on certain benefits that the boomers and other generations that have been in the workforce for a while do.” Top considerations: Appealing to Millennials and Gen Z In this way, as HR teams work to review and improve benefits resources for young professionals, there are a few key essentials to keep in mind: A goal-oriented generation: As Stephanie Penner, senior partner at consultancy firm Mercer, told the Society for Human Resource Management, young workers tend to be more goal-focused, and appreciate opportunities for personal and professional growth. In this way, training programs, certification workshops and other career development programs will be advantageous. Financial support: Many young professionals are dealing with significant student loan debt – in fact, SHRM reports that 80 percent of employees would value a student loan repayment assistance program, but only 4 percent of businesses offer this benefit . Any efforts companies can make to help support new graduates and their financial situation – including financial planning guidance, or automatic deductions for loan repayment – will be a considerable boon for attracting and retaining young professionals. Decision-makers can consider partnering with an organization like GotZoom to provide this benefit. Digital consumers: A key thing to keep in mind regarding Millennials and Gen Z workers is that much of their life has revolved around the use of computers and advanced technology. In this way, young professionals expect to be able to utilize these resources at work. Providing an online employee portal for benefits enrollment and administrative management can help workers engage with benefits information and make use of the resources a company offers. To find out more on how an online, accessible benefits portal can support your HR team and workforce, connect with the experts at Secova today.

25 Mar 2021
College grads: Are you prepared for professional employment?

"Congratulations!" is a word you've probably been hearing a lot lately. And it's not unwarranted – after all, you worked extremely hard through classes and assignments to earn your degree. You deserve a little recognition! But, the hard work isn't over yet – in fact, it's just begun! Those loans are going to be due soon, and now's the time to seek out a position that will allow you to put all the skills you learned during your college courses to the test. Professional employment: It's much different than college Work life will bring stark changes in comparison to what you've been used to during your college days. Not only will new responsibilities emerge, but you'll also be expected to act and carry yourself in a more mature and professional manner. Here are a few factors to be aware of as you head into professional employment: It may take you a little while to get going – and that's okay. According to a survey conducted by author and Harvard Business Review contributor Jeffrey J Selingo, 33 percent of all recent grads "press pause" after college, and spend most of their twenties working toward starting their professional career. Thirty-two percent spend half of their twenties getting going, and only 35 percent jump right into a career after graduation. Time management and scheduling matters. As Live Career noted, if you treat a job like that dreaded 8 AM course you took in your freshman year and continually show up late , you'll be unemployed sooner than you think. Personal accountability is important. Whereas in college, where a wrong answer or misstep would earn you a bad grade or a slap on the wrist, professional employment calls for more responsibility. Clients and co-workers rely on you to further your company's mission and complete important tasks on time. Flex your skills, but remain humble and be ready to learn. College has taught you a lot regarding the career field you're aiming for, but there will be much more to learn and experience on the job. Recent graduates: Are you ready to enter the professional job market? Interviewing and onboarding As a recent college graduate, chances are good that you'll go on plenty of interviews before landing a position. Don't be discouraged – this is all good practice, even if you don't receive a call back. It's important to be prepared and professional in the interview process. This includes creating a resume, cover letter and other important documents and being ready to talk of your experiences, skills and accomplishments. And once you've successfully achieved employment, you'll go through the onboarding process. While it's not the same for every job, your employer's HR team will walk you through your new responsibilities, the overall company and the business's culture. A few words of advice here: Pay attention and ask questions. As College Recruiter noted, some orientation and onboarding may seem dry, but the information is important. Don't glaze over, and be sure to ask questions on whatever you're unsure of or need clarification on. Get to know your HR team. This won't be the only time you interact with the HR team, so use this time to get to know your representatives and the types of benefits and services they direct within the company. Secova is a leading benefits administration service provider, and is popular with HR managers. Congratulations and good luck on the road to professional employment!

25 Mar 2021
ACA reporting and deadlines: Top mistakes and how to avoid them

When it was first introduced, the Affordable Care Act offered advantages for employees and employers alike. However, it also created added complications for businesses that continue today and into the future. HR stakeholders, in particular, must make sure that their organization and its staff are observing requirements for ACA reporting, and are doing so in a way that matches stated deadlines. Despite understanding the importance of ACA, many businesses are still making mistakes with their ACA reporting and other associated HR and benefits processes. These mistakes can be time-consuming and costly – a report from Accounting Today found that between 2017 and 2018, the IRS had issued more than 30,000 notices  to organizations that failed to comply with ACA standards. The penalty assessments included in these notices add up to a staggering $4.4 billion  for noncompliance. It's best for HR teams to work proactively to avoid them. Here, we've rounded up some of the top missteps companies make with ACA, as well as best practices for making sure that these issues don't impact your organization. Not filing according to ACA requirements One problem with ACA emerges when stakeholders don't observe ACA requirements for report filing, and therefore don't properly complete these tasks. It's important that HR leaders determine whether or not their organization is required to file, noted FitSmallBusiness. Companies that align with the following are required to file reports for ACA: Businesses that have 50 or more full-time staff members, or employees that work 30 hours per week or more. Organizations that have parent or subsidiary organizations that, when combined with their staff, create a total of more than 50 full-time employees. Companies that utilize self-insured employer plans. Incomplete reporting There are two required elements involved in ACA filing that revolve around Form 1095 C. A common mistake that many companies make is completing the proper filing of this form with the Internal Revenue Service, but failing to send copies of the form to employees. On the other hand, providing form copies for staff members and forgetting to file them with the IRS occasionally takes place as well. It's imperative that HR leaders complete both required steps. Failing to observe deadlines The ACA includes specific deadlines, and any late reporting or filing can result in penalties for the employer. In this way, HR stakeholders must be aware of all the important ACA deadlines, including due dates for reporting and the beginning and end of open enrollment. Avoiding ACA mistakes: Prepare accordingly In order to maintain compliance and guarantee alignment with the requirements of ACA, HR leaders must make sure that their organization is prepared. Partnering with an expert human resources administration solution provider and incorporating systems that can help streamline ACA reporting, tracking, eligibility and overall compliance is one of the best ways to prevent making common ACA mistakes. To find out more, check out our website and connect with Secova for a demo of our ACA Management solutions today.

25 Mar 2021
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