It Will Take Teamwork to Navigate the Bumpy Road to Health Care Reform

If you haven’t taken the time to grab a cup of coffee with the folks at legal, or had lunch with your friends in accounting, now would be a good time.

Over the next eight years, your company will need to examine — and implement where needed — a significant number of provisions associated with the Patient Protection and Affordable Care Act.

Everyone will have an important role to play in a long and complex process that is sure to test each department’s patience, flexibility, and maybe even sense of humor.

Whether all these departments are under one roof or whether you work with external vendors, the message is the same: The magnitude of work and uncertainty around it means you’ll need to work together like never before to ensure the new rules are incorporated with as few problems as possible.

It gets complicated after 2011

Although PPACA took effect Sept. 23, 2010, most employees and their families won’t see the changes until Jan. 1, 2011, when the majority of employer-sponsored plans begin.

Many of the guidelines for the provisions taking effect in 2011, including the change in over-the-counter drug reimbursement, have been released. Some of them, such as adult children coverage to age 26, have even received significant press coverage.

But beyond 2011? Well, that’s where it gets complicated.

There is a chance that what we know today about the provisions that take effect in 2012 and later will change. That’s because of the political firestorm the legislation created before it was even passed in March 2010 and that continues today.

There already have been legal challenges to the legislation as a whole — in particular to the individual mandate.

Politicians are promising to reexamine the legislation and change it if necessary. And the federal government has yet to issue regulatory guidance on all the provisions, which means no one really knows what some of these will require from employers.

All of which adds up to a whole lot of uncertainty and a whole lot of work for groups that may not see or understand the scope of change and their direct involvement in health care reform implementation for the organization. You need to tell them!

Get to know the other side of the building

The first step in ensuring that your functional areas stick together during the coming years is to establish credibility with each other.

Set up a meeting with your functional areas as soon as possible. You’ll be working very closely with departments who, while not strangers, may only work with you a few times a year during open enrollment or special notices. Get ready to become best friends.
Explain the long, winding road ahead. Health care reform will go up, down, left and right before it goes straight. All departments need to be ready for a bumpy road. They’ll all be involved in benefits like never before, so it’s important they know – to the best of your knowledge – which provisions will require their involvement and when. Also, encourage them to speak up if they are confused.
Remind them that there will be many changes. Sometimes they’ll get five months of notice on a provision. Sometimes they’ll get five minutes. Other times, they’ll have to change retroactively something that was in place. Each department will have to decide whether it has the resources now and the future to handle this workload.

We’re all in this together

As you can imagine, this will require the departments to run like a well-oiled machine. That means trusting each other and maintaining that credibility during what will surely be some crazy times.

Promote a culture of mutual respect and understanding. You’ll be relying on each other a lot over the next eight years. Involve each other in key health care reform meetings.
Provide comprehensive communication. As a new significant responsibility for many areas, it will be important to provide as much information as possible (even if it is not complete). This is the better alternative to waiting for complete information and then providing five minutes notice. It will give the functional areas time to plan.
Propose the creation of cross-functional teams or other efficient solutions. See this as an opportunity to create a health care reform task team to increase operational efficiency.

The challenge is daunting, no doubt. But employees and their families are depending on their leaders to provide answers and clarity. This map is a good starting point to getting there. Plus, you’ll gain some new friends (and greater respect) along the way.

This article was co-authored with Ed Bray, Director of Compliance at Burnham Benefits. You can reach him at bray@burnhambenefits.com.