According to a Pew Research Center analysis, retirement looms for 3.5 million retirees over the next year, including the most recent labor force data.1 Many organizations face this worrisome predicament, yet many health information management departments struggle with being proactive in their planning efforts.
This week's blog post asked three healthcare industry leaders about their awareness and planning methods to prepare for retirees, especially around the holidays.
Bibi Von Moulder is the Corporate Health Information Management (H.I.M.) Director at Signature Healthcare in Brockton, Massachusetts. Bibi has 31 years of experience in healthcare and previously served as the President of the Massachusetts Health Information Management Association (MaHIMA), where she contributed to shaping medico-legal policy for health information management leaders throughout the state. She was the recipient of the MaHIMA Advocacy Award in 2019.
Lisa Kellogg is the Health Information Management System (HIMS) Chief for the V.A. Medical Center in Las Vegas, NV. Lisa has 30 years of experience in healthcare. She was recruited as the H.I.M. Manager for Cleveland Clinic for six years, responsible for all aspects of chart completion, scanning, and medical record handling. Lisa has led all aspects of H.I.M. for the last ten years and is considered a transformative leader in the field.
Cyndi Ouellette is the Health Information Management (H.I.M.) Director and H.I.M. Coding Manager at Steward Health Care in Methuen, Massachusetts. Cyndi has 42 years of experience in the healthcare field. She oversees two acute care facilities and a free-standing ambulatory surgery center and is considered a pioneer in H.I.M.
Question: Do you support and encourage your line managers or yourself to have retirement planning discussions?
Bibi's Answer: Yes, but you must be careful about age discrimination. Often, the employee will come to us first out of courtesy.
Lisa's Answer: I don't really go there with them because you have to be careful. Our staff is unionized, and the government operates differently than acute care facilities.
Cyndi's Answer: Yes, but I'm lucky that none of my on-site coding staff is nearing retirement. If anyone is set to retire on the operations side, as my Master Patient Index Coordinator is, we will fill in any gaps with cross-trained staff. I have one inpatient coder at retirement age and may choose to retire. Many of our coders are cross-trained as well.
Question: Do you have a succession plan for your employees? If so, what is your planning process?
Bibi's Answer: I am always thinking ahead for ways to move people up internally to that next level and give them a chance to learn and grow. A coder notified me that she is retiring in January, and this gives us a little time to do some preplanning. After I look internally, next, I bring in new coders that would start in the entry-level position. For example, I would push my lab coder up to code radiology accounts, and the new person (entry-level position) would start with coding labs.
Lisa's Answer: Once an employee informs me, they are retiring, I can't do anything about the job until they walk out the door. Once the person leaves, I advise my supervisor and the Specialist liaison between me and human resources. Next, I send H.R. the position description to get it posted. If the job does not get posted immediately and needs to get done, overtime is allowed. Either another staff member will get assigned to take care of it, or the HIMS Chief will fill in.
Cyndi's Answer: I ensure my staff is cross-trained, but if there is a coder shortage and none of my present coders want to step up, I rely on global coders to handle it.
Question: What do you consider when thinking about and planning for staff retirement?
Bibi's Answer: Placement and shifting coders or operations staff around and then posting the position for entry-level.
Lisa's Answer: I connect the retiree with the Specialist who links H.R. and H.I.M. H.I.M.'s hands are out of it. I try to offer overtime when workload warrants it. We can throw a little retirement party as long as no gifts are involved.
Question: How many of your workforce is at or close to retirement age?
Bibi's Answer: Out of 58 employees, 5 coders are either at or close to retirement age.
Lisa's Answer: Ten percent and the ones I see retiring are coders and release of information staff.
Cyndi's Answer: Ten percent of coders and 14% of operations are retirement eligible. Contract and global coders are cheaper in the long run as they do not need benefits or time off.
Question: Why is it hard for you to find coders and release of information staff?
Bibi's Answer: No one knows our profession, and no one is out there advocating to the high schools, saying they can be coders. Many people work 100% remotely, and coders enjoy working remotely. We will be losing a lot of employees if the hospitals continue to keep the same policies and do not allow remote work.
Lisa's Answer: I have not found a release of information company that I like. It is challenging to find someone who has worked at the government and knows how to use our antiquated E.M.R. At the V.A., you have to go with a veteran-owned company.
Cyndi's Answer: Tight budgets will not allow.
Question: Can you augment, or would you consider augmenting any of your staff in the interim until you find a replacement?
Bibi's Answer: Yes, first we offer overtime internally, and outpatient coders will always take it. Inpatient coders feel burnt out and will not take it, so we will find out how many hours are needed for X number of weeks and if we need additional coverage, I reach out to my contract coding companies to help fill in the gap.
Lisa's Answer: Yes, but they must be veteran-owned. Our leaders have made decisions and have chosen vendors approved by the government, so contracts you can use to augment have already been signed for the year.
Cyndi's Answer: Yes, for coding help, but currently, the budget counts on us utilizing cross-training.
Question: Do you promote retirement flexibilities? (lead time notification requirements on the length of time staff take to retire)
Bib's Answer: We don't require any specific lead time; however, the employee is very considerate and gives us ample time to acquire a replacement.
Lisa's Answer: At the V.A., they have a Roth, 401k, and a defined benefit plan. An employee's years accrue in retirement years.
Cyndi's Answer: There are no retirement policies or timelines. A team member can work as long as they fulfill their job duties. We do not offer early buyouts.
Question: What are the barriers to and concerns about staff retirement?
Bibi's Answer: My biggest concern is filling the position and getting the new employee up to speed. There is a lot of time training and a learning curve for a few months.
Lisa's Answer: Filling those vacancies, especially in coding. Sometimes H.R. can be the most significant barrier – getting the position posted timely and correctly. There can be a lot of red tape. Sometimes we have shortages and working through Teams and email can make things more difficult.
Cyndi's Answer: I do not have any barriers or concerns. Healthcare is changing daily, and you have to deal with it and move on.
Question: Do you allow staff to step down in their role? (work part-time, reduce # of days, lighter duty?)
Bibi's Answer: Yes, depending on the position and circumstances. I try to accommodate them as much as possible.
Lisa's Answer: I have not had that situation, but depending on whether they are a good worker, I would fight for it; although, I am not sure my facility would allow it.
Cyndi's Answer: Staff is allowed to cut hours if necessary.
Question: How do you coordinate with H.R.?
Bib's Answer: I submit a requisition to replace the position, and they post it and go through the process of interviewing and hiring the person. It is up to the employee to let H.R. know that they are retiring, and I tell them that. The onus is on the employee, not H.I.M.
Lisa's Answer: The liaison between H.I.M. and H.R. handles hiring people. The Supervisory Medical Administration Specialist works for my supervisor.
Cyndi's Answer: I have not had to do this step yet; however, I would call them to inform them.
Predicting the timing of retirees can be tricky, so being proactive makes the most sense. Employees can retire whenever they want and may not give a long lead time for notification. For employers to protect themselves against the loss of talent and aging Baby Boomer knowledge base, they need to look at their workforce, review its state, and predict when workers will retire, both potential soon-to-be retirees and those retirees in the future.
Maintain a Dialogue
Having a dialogue doesn't mean asking the employee directly when they plan to retire. If employees offer information about when they want to retire, that discussion becomes an opportunity to structure a working arrangement to support a longer work life or transition period.2 Using annual review time to discuss career plans and short and long-term goals is a good time to flesh out wants and needs from both sides.
Design a plan with the options retirees present. Does the employee choose to work full-time until they no longer can do so physically? Some employees identify the age when they plan to retire, inform you, and start tapering their hours a year beforehand. Some choose to reduce their hours to part-time to allow time for other activities but want to keep some income flowing. There are many options for how retirement looks.
Involve H.R. at the Start
H.R. or a designated liaison between H.R. and H.I.M. will provide the employee with guidance on finances and healthcare information, so they are well-prepared. Often, they will discuss creative, flexible work arrangements such as possibly consulting, PRN or working seasonally to keep the knowledge base and talent within the organization.
Consider Augmenting Staff
Consider staff augmentation early in the process, whether in the interim or permanently, depending on your facility's needs, as utilizing an outsourced company can save you time, money and keep your revenue cycle flowing.
Is your organization prepared? With the holidays coming up, how may MRA assist with your holiday coverage needs?
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