Amid labor talks, union unveils billboards highlighting Cedars-Sinai profits, CEO pay

https://www.beckershospitalreview.com/human-capital-and-risk/amid-labor-talks-union-unveils-billboards-highlighting-cedars-sinai-profits-ceo-pay.html

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Healthcare workers at Los Angeles-based Cedars-Sinai Medical Center revealed a series of billboards that highlights profits and CEO pay at the hospital.  

The workers, who are represented by Service Employees International Union-United Healthcare Workers West, announced the billboards April 2 amid contract negotiations. The billboards are scheduled to appear throughout April at seven locations that are all within 1.5 miles of the hospital.

A union news release says the billboards aim to draw attention to “excessive profits and CEO compensation,” as well as the amount of charity care the nonprofit hospital provides.

“The public deserves to know that this elite hospital with huge profits and obscene CEO compensation, isn’t acting in the public’s best interests,” Dave Regan, president of SEIU-UHW, said in the release. “On top of paying no income or property taxes, Cedars-Sinai skimps when it comes time to care for the poorest people in our community.”

The hospital  addressed the union’s claims.

“The Cedars-Sinai Board of Directors believes in providing every one of our employees with compensation that is based upon merit of their individual performance, a rigorous review of each position’s responsibilities, and comparisons with other organizations for positions with similar responsibilities. For the president and CEO, the review process is even more extensive,” the statement said.

“[CEO]Tom Priselac’s compensation appropriately reflects his more than two-decade tenure of successfully presiding over the western United States’ largest nonprofit hospital. Under his leadership, Cedars-Sinai has earned national recognition for delivering the highest quality care to patients and has been ranked among the top medical centers in the country.

“Over the last 10 years alone, Cedars-Sinai has invested nearly $6 billion to benefit the local community by, among other things, providing free or part-pay care for patients who cannot afford treatment; by losses caring for Medicare and Medi-Cal patients; and by providing a wide range of free health programs and clinics in neighborhoods as well as education, health and fitness services in dozens of local schools.”

SEIU-UHW represents more than 1,800 service and technical workers at the hospital. The last contract with Cedars-Sinai expired March 31.

 

 

 

Labor board will charge Kaiser for refusing to bargain, union says

https://www.healthcaredive.com/news/labor-board-will-charge-kaiser-for-refusing-to-bargain-union-says/544648/

Dive Brief:

  • The National Labor Relations Board (NLRB) is preparing to prosecute health system Kaiser Permanente for refusing bargain with SEIU United Healthcare Workers West, according to the union. SEIU-UHW, part of the Coalition of Kaiser Permanente Unions, filed a complaint with the NLRB in the spring charging Kaiser for refusing to negotiate a new contract that covers 85,000 employees across eight states and D.C. Hearings for case will likely begin in the spring.
  • In their complaint, SEIU-UHW and the Coalition of Kaiser Permanente Unions claimed Kaiser tried to set conditions on bargaining that would ban unions from engaging in political action that could affect the healthcare organization. Kaiser issued a statement last week arguing the delay was due to a split that occurred within the coalition earlier this year, and said it is “confident the NLRB will agree that Kaiser Permanente has acted lawfully and in good faith” in dealings with SEIU-UHW.
  • That may not be the case. SEIU-UHW is planning on proposing a new arrangement. If Kaiser doesn’t agree to enter into that settlement proposed by the union, the NLRB is expected to issue charges by the end of the month — if not sooner, according to an email obtained by Healthcare Dive.

Dive Insight:

Kaiser has been wracked with labor woes this year. The health system reached an agreement with the Alliance of Health Care Unions — the 21 unions that broke off from the Coalition of Kaiser Permanente Unions — earlier this year. That split occurred the day before bargaining was scheduled to begin, and negotiations with the coalition did not move forward.

That contract, according to SEIU-UHW, included a condition prohibiting those unions from taking any kind of political action against Kaiser, including ballot initiatives, legislation or public policy campaigns. That’s the same condition that led SEIU-UHW to file its complaint earlier this year.

“The Coalition of Kaiser Permanente Unions strongly opposes such a proposal,” SEIU-UHW said in a statement, “and believes this condition violates their free speech rights.”

Healthcare Dive reached out to the NLRB for confirmation on its reported decision to prosecute Kaiser, but did not receive a response in time for publishing.

“The decision confirms what has been clear to workers for months now: Kaiser isn’t the labor friendly employer it claims to be, nor is it as committed to patient care as it claims to be,” Lanette Griffin, a laboratory assistant at Kaiser Permanente, said in a statement. “If Kaiser was committed to improving patient care, you would expect it to want to negotiate a contract to retain and attract the outstanding caregivers who have driven the corporation’s success. But Kaiser is showing its true colors when it avoids bargaining and wants to silence our voices.”

Last week, 4,000 mental health workers represented by National United Healthcare Workers engaged in a five-day strike against Kaiser, causing the system to postpone some surgeries. Kaiser has attributed the cancellations to California Nurses Association nurses joined the picket line in an authorized sympathy strike.

“The determination by the district 32 office of the National Labor Relations Board is not a verdict. It is the beginning of the NLRB’s process to hold evidentiary hearings to fully understand this complicated case,” Kaiser said in its statement.

 

 

4,000 Kaiser mental health clinic workers launch 5-day strike in California

https://www.beckershospitalreview.com/human-capital-and-risk/4-000-kaiser-mental-health-clinic-workers-launch-5-day-strike-in-california.html

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Four thousand California mental health clinicians began a five-day strike Dec. 10 to protest what they call understaffing issues that lead to long wait times for therapy appointments.

The strike affects more than 100 Kaiser Permanente clinics and medical facilities, according to the National Union of Healthcare Workers, which represents psychologists, therapists, social workers, addiction medicine specialists and other mental health clinicians.

Workers are striking at Los Angeles Medical Center, Anaheim Medical Center, Fontana Medical Center, San Diego Medical Center, Fresno Medical Center, Sacramento Medical Center, San Francisco Medical Center and San Jose Medical Center.

“The situation inside Kaiser clinics has become untenable,” said Kenneth Rogers, a psychologist for Oakland, Calif.-based Kaiser. “We don’t have enough hours in the day to see patients and do all the preparation and follow-up work that goes into every appointment. Patients are suffering and unable to access clinically appropriate care.”

Union president Sal Rosselli told The Mercury News mental health workers also seek benefits and pensions that are equal to what about 100,000 other Kaiser employees receive.

John Nelson, vice president of communications at Kaiser Permanente, expressed disappointment about the strike.

“We are disappointed the leadership of the National Union of Healthcare Workers would ask our highly valued mental health staff to go out on strike, when we’ve been in active negotiations since the summer, having met in 16 bargaining sessions over five months, and with two more bargaining sessions scheduled for next week,” he told Becker’s last month.

“There are no takeaways in our contract proposal,” Mr. Nelson said. “We are offering guaranteed wage increases which would keep our expert therapists among the best compensated in their profession and continue to ensure that we attract and retain the most highly skilled professionals.”  

Kaiser told The Mercury News its medical centers and medical offices are scheduled to remain open during the walkout, although “some nonurgent mental health and other appointments may need to be rescheduled.”

 

 

 

300 nurses walk off job at Pennsylvania hospital

https://www.beckershospitalreview.com/human-capital-and-risk/300-nurses-walk-off-job-at-pennsylvania-hospital.html

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More than 300 Indiana (Pa.) Regional Medical Center nurses went on strike on Nov. 26, according to a KDKA report.

Nurses walked off the job at 7 a.m., despite hospital leaders previously asking them to cancel the strike due to the $1.5 million in estimated costs to hire temporary workers.

Nurses initially scheduled a one-day strike. But hospital leaders have said striking nurses who don’t report to work Nov. 26 won’t be able to return to work for an additional four days because of a minimum five-day commitment required to hire temporary staff.

According to the report, no scheduled surgeries and appointments were canceled due to the strike.

The hospital has been in negotiations with the Indiana Registered Nurses Association, which represents about 380 nurses at the hospital. Health insurance costs and wages reportedly have been key sticking points in the negotiations.

Both sides are scheduled to return to the bargaining table Nov. 29.

The Last Company You Would Expect Is Reinventing Health Benefits

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Frustrated with insurers, some large companies — including a certain cable behemoth — are shedding long-held practices and adopting a do-it-yourself approach.

It’s hard to think of a company that seems less likely to transform health care.

It isn’t headquartered in Silicon Valley, with all the venture-backed start-ups. It’s not among the corporate giants — Amazon, Berkshire Hathaway and JPMorgan Chase — that recently announced, with much fanfare, a plan to overhaul the medical-industrial complex for their employees.

And it is among the most hated companies in the United States, according to many surveys on customer satisfaction.

It’s Comcast. The nation’s largest cable company — the $169 billion Philadelphia-based behemoth that also controls Universal Parks & Resorts, “Sunday Night Football” and MSNBC — is among a handful of employers declaring progress in reaching a much-desired goal. In the last five years, the company says, its health care costs have stayed nearly flat. They are increasing by about 1 percent a year, well under the 3 percent average of other large employers and below general inflation.

“They’re the most interesting and creative employer when it comes to health care benefits,” said Dr. Bob Kocher, a partner at Venrock, a venture capital firm whose portfolio companies have done business with Comcast. (The cable company declined over several months to provide executives for an interview on this topic.)

Comcast, which spends roughly $1.3 billion a year on health care for its 225,000 employees and families, has steered away from some of the traditional methods other companies impose to contain medical expenses. It rejected the popular corporate tack of getting employees to shoulder more of the rising costs — high-deductible plans, a mechanism that is notorious for discouraging people from seeking medical help.

Most employers now require their workers to pay a deductible before their insurance kicks in, with individuals on the hook for $1,500, on average, in upfront payouts, according to the Kaiser Family Foundation. Instead, Comcast lowered its deductible to $250 for most of its workers.

“We believe that no one should be required to be an expert in health care,” Shawn Leavitt, the executive overseeing benefits at Comcast, said in a 2015 interview with a consultant. “Our model is based on providing employees support and assistance in making the right decisions for themselves and their families. Employees should not feel alone, confused and overwhelmed when it comes to understanding and selecting their benefits.”

Cable TV subscribers who have felt confused and overwhelmed when dealing with Comcast customer service may be surprised to learn how nimbly the company has upgraded services for its employees. While Comcast continues to work with insurers, it has largely shunned them as a source of innovation. Instead, it has assembled its own portfolio of companies that it contracts with, and invests in some of them through a venture capital arm, Comcast Ventures.

Turning to health start-ups for new benefits

One such company is Accolade, in which Comcast is an investor, and which provides independent guides called navigators to help employees use their health benefits. Another, called Grand Rounds, offers second opinions and help in finding a doctor. Comcast was also among the first major employers to offer workers access to a doctor via cellphone through Doctor on Demand, a telehealth company.

“We see the start-up community as where the real disruption is taking place,” said Brian Marcotte, the chief executive of the National Business Group on Health, which represents large employers. “We weren’t seeing enough innovation.” The group now vets some of these companies for employers, including Comcast.

Comcast “is the tip of the spear,” Mr. Marcotte said.

The corporation, of course, is controlling costs and offering these unusual benefits out of self-interest. And these services are sometimes handed out at the expense of improving wages. In a tight labor market, Comcast also needs to remain competitive for not only highly skilled employees, but also lower-wage workers whose direct contact with customers has generated so much dissatisfaction over the years. “We do these things because it’s great for business,” Mr. Leavitt said.

But much of what sets Comcast apart is its willingness to directly tackle its medical costs rather than relying on others — insurers, consultants or associations. It’s a luxury only the largest companies can afford, and roughly a fifth of big companies continue to see annual cost increases of more than 10 percent, according to Mercer, a benefits consultant.

While fate may play a role — a single expensive medical claim can drive up a company’s costs in any given year — employers, like Comcast, that use a variety of strategies tend to have the lowest annual increases. “You attack this thing from different angles,” said Beth Umland, Mercer’s director of research for health and benefits. “The intensity of effort pays off.”

Some companies are shaking up hospitals and doctors

Other employers are focusing more attention on unsatisfying hospitals and doctors. Walmart has been at the forefront of efforts to direct employees to specific providers to get medical care, even if it means paying their travel to places like the Mayo Clinic.

The retailer said it had found, for example, that employees were being told they needed back surgery even when they would not benefit from the procedure. “Walmart isn’t going to stand for this,” said Marcus Osborne, a benefits executive, at a health business conference. “We aren’t going to sit around to try to build another coalition or bureaucracy.”

The majority of working-age Americans — some 155 million — get their health insurance through an employer, and most companies cover their own medical costs. The companies rely on insurers to handle the paperwork and to contract with hospitals and doctors. Insurers may also suggest programs like disease management or wellness to help companies control costs.

But employers, including that Amazon-Berkshire-JPMorgan alliance, are increasingly unhappy with the nation’s health care systems. Companies are paying more than they ever have. And their employees, saddled with escalating out-of-pocket costs and a confusing maze, aren’t well served, either. “The results haven’t been there,” said Jim Winkler, a senior executive at Aon, a benefits consultant. “There’s frustration.”

At Comcast, some workers probably miss out on the new ventures altogether and others don’t have much choice but to go along. The company’s relationship with labor is often strained, and it has largely managed to fend off efforts by groups like the Communications Workers of America to organize its employees. Robert Speer, an official with a local of the International Brotherhood of Electrical Workers in New Jersey that represents about 180 workers, noted the company’s use of independent contractors to do much of its work, none of whom are eligible for benefits and can be paid by the job rather than hourly. “You are making no money,” he said.

And, like many other workers, many employees are being pinched by the rising cost of premiums, Mr. Speer said.

Comcast workers with company coverage are told to go to Accolade first. Its phone number appears on the back of their insurance cards and on the benefits website. “The key to Accolade’s success is being the one place to go,” said Tom Spann, a co-founder of the company.

Geoff Girardin, 27, used Accolade when he worked at Comcast a few years ago and he and his wife were expecting. “Our introduction to Accolade was our introduction to our first kid,” Mr. Girardin said. He credits Accolade for telling him his wife was eligible for a free breast pump and helping find a pediatrician when the family moved. “It was a huge, huge help to have somebody who knew the ins and outs” of the system, he said.

For employees like Jerry Kosturko, 63, who survived colon cancer, Accolade was helpful in steering him through complicated medical decisions. When he needed an M.R.I., his navigator recommended a free-standing imaging center to save money. “They will tell me what things will cost ahead of time,” Mr. Kosturko said.

A nurse at Accolade helped him manage symptoms after he had surgery for bladder cancer in 2014. He developed terrible spasms because, he said, he wasn’t warned to avoid caffeine. The Accolade nurse thought to ask him and quickly urged him to call his doctor for medicine to ease his symptoms.

Mr. Kosturko also turned to Grand Rounds when his doctor thought he might need to stay overnight in the hospital to be tested for sleep apnea. The second opinion convinced him he did not.

In complicated cases, Grand Rounds can serve as a check on the network assembled by the insurer. It pointed to the case of Ana Reyes, 39, who does not work for Comcast and had contacted Grand Rounds after treatment for cervical cancer. When she continued to have symptoms, she says, she was told to wait to see if they persisted.

“This is my life at stake,” she recalled in an interview. “I need to know what I’m doing is the best plan.” Grand Rounds asked a specialist at Duke University School of Medicine, Dr. Andrew Berchuck, to review her case.

“Grand Rounds was able to get all my medical records, which is over 1,000 pages,” Ms. Reyes said. Dr. Berchuck reviewed and wrote his opinion in one week, recommending a hysterectomy because she was likely to have some residual cancer. “The same day, my treating physician, she called me to schedule a hysterectomy,” Ms. Reyes said.

Insurers are usually none too pleased with the employers’ use of alternatives: They’re reluctant to share information with an outside company and poised to undercut a potential competitor by offering a cheaper price. They may even refuse to work with some of the companies.

The largest employers push back. Fidelity Investments insists on cooperation between insurers and outsiders, said Jennifer Hanson, an executive at Fidelity Investments. “Those who don’t will be fired,” she said at a health business conference.

For Comcast, the next frontier is the financial well-being of its employees, many of whom live paycheck to paycheck and may not be able to afford even a small co-payment toward a doctor’s visit. Employees who run into financial trouble have no independent source of information, Mr. Spann said.

After talking to hundreds of companies, Comcast Ventures could not find a financial services start-up that would help employees without trying to sell them a product or earning their money on commissions. So Comcast recruited Mr. Spann to serve as chief executive of a new company, Brightside, that it created and invested in.

Employees who are less worried about their finances may be less likely to miss work or suffer from health problems, Mr. Leavitt said. Ultimately, he said, “there is a productivity play for Comcast.”