Retaining hospital workers: a rapid methodology to determine incentive packages.

As efforts are made to increase the production of new human resources for health, simultaneous attention must be placed on retaining existing health workers in hospitals and other health facilities for as long as possible to increase access to healthcare services. The US Agency for International Development (USAID)'s CapacityPlus project is designing a rapid retention survey tool using the discrete choice experiment, a powerful, quantitative method to determine the relative importance health workers place on different characteristics related to their choice of employment. The user-friendly tool will allow human resource managers to rapidly assess retention preferences to better pinpoint the bundle of incentives and interventions that would most cost-effectively motivate health workers to take up posts in underserved facilities. The results of the survey can be used locally to create evidence-based incentive packages or to advocate with policy-makers and other decision-makers regarding the most favorable national retention policies and strategies for implementation.

Hospital employment trends in California, 1982-1994.

During the 1980s California hospitals responded to selective contracting, growth in managed care, and the Medicare prospective payment system (PPS) by controlling their level of spending. This DataWatch examines whether these hospitals achieved these savings by changing the number and/or the mix of hospital employees. We examined employment trends because wages represent the largest component of hospital budgets and because the number and mix of personnel can be changed in the short run. Analysis of the California Health Facilities Cost Report data shows that employment increased steadily during 1982-1994. There is no evidence that hospitals responded to growing competition by altering the rate of growth in hospital personnel and only weak evidence that they altered the mix of personnel by hiring a greater proportion of nonclinical staff. We conclude that increased competition had only a minor effect on hospital employment decisions.

Pension plans drift toward diversification.

Following New Jersey's seizure of Mutual Benefit Life Insurance Co. last summer, hospital associations have begun revamping their pension offerings, in some cases steering away from venerable, fixed-income insurance products and into diversified plans such as stock funds, which may offer better returns. But insurer-based plans remain a favorite as many programs stay on the conservative course.

How to get the most out of liability insurance for hospital trustees.

The year 1983 brings with it expanded coverage in the directors and officers liability policies offered to hospitals. In this article, the author discusses the impact of this added protection in terms of who and what is now covered.

A tax strategy for healthcare workers. Section 403(b) plans are an alternative to weakened IRAs.

After the Tax Reform Act of 1986 reduced the tax-deduction benefits of investing in IRAs, many healthcare employees went looking for alternative tax-shelter investments. Several options are available. One alternative for taxpayers employed by tax-exempt organizations is Section 403(b) tax-deferred annuities (TDAs). Although the Tax Reform Act left Section 403(b) TDAs largely intact, it established a comprehensive set of nondiscrimination rules for certain statutory fringe-benefit plans--including Section 403(b) plans. The new rules are designed to restrict situations that favor participation by highly paid employees to the exclusion of other employees. Perhaps one of the harshest adjustments the 1986 law mandated is the imposition of an additional 10 percent income tax on withdrawals an investor makes from Section 403(b) plans before reaching the age of 59 years and 6 months. This excise tax had already applied to early withdrawals from an IRA, but the new law extends the penalty tax to cover all qualified plans, including TDAs.