1. Understand the aim of benefits. While benefits are generally used to attract and retain great employees, the aim can be more specific, such as to compete for talent with the local hospitals, says Sami Spencer, CEO of Missoula (Mont.) Bone & Joint and Surgery Center. Therefore, centers should have a good idea what benefits local hospitals are offering. In Ms. Spencer's area, "the hospitals' wages are higher but they don't have as good benefits as we have" and "our employees don't have to work evenings and weekends," she says.
Becky Otis, administrator of Ambulatory Surgery Center of Stevens Point (Wis.), also looks at competing employers' offerings. "Part of deciding benefits is dependent on what is found in the local community," she says. "Benefits along with culture are important. You want to be seen as an employer of choice in the community."
2. Regularly review benefit plan. Kimberly Tude Thuot, administrator of Yakima (Wash.) Ambulatory Surgical Center, meets every year with her insurance broker to review changes in rates and plan design. Experts recommend reviewing employees' use of benefits, looking for benefits that may not be appreciated or valued. They say employers should examine how much it can spend on benefits, based on current revenues.
Ms. Otis tries to find out what employees want. While some employers directly survey employees on what they want, Ms. Otis thinks this approach may send the wrong message to employees. "They may interpret it negatively if you don't provide what they chose," she says.
3. Clearly define benefits. Make sure benefits are clear and that they are consistently applied, Ms. Otis says. Decide which benefits apply to full-time employees and exactly how many hours you have to work per week to be seen as full time. Be consistent about offering paid time off. "Do not fall into the trap of allowing new employees to negotiate PTO days based on what they had in a prior position," she says. "Eventually other employees will find this out and it leads to staff resentment and morale issues."
Ms. Tude Thuot says she prorates benefits for part-time employees who work a minimum of 20 hours a week.
4. Consider ways to control spending. With costs of items like health insurance — the most expensive benefit — steadily rising, ASCs have to consider ways to limit benefit spending. Before cutting, however, CEOConsultant, a blog for medium and small businesses, advises benefits planners to consider the implications. "Don't cut benefits for short-term cost-control," the blog advised. "This can lead to higher employee turnover." Here are some ways to control benefits spending.
- Raise health insurance deductibles. Health insurance is a very popular ASC benefit — covered by 98 percent of centers, according to in a 2009 ASC Association survey — and ASCs are not looking to limit utilization. However, raising the deductible is an option because it allows the ASC to preserve the scope of benefits, Ms. Otis says.
- Take advantage of tax credits. ASCs may want to consider Health Reimbursement Arrangements. These IRS-sanctioned programs allow an employer to set aside funds to reimburse medical expenses paid by employees. Another option is Health Savings Accounts, which allow employers and employees to deposit funds into tax-free accounts to cover medical expenses. In addition, the healthcare reform law gives small employers a tax credit of up to 35 percent of the cost of providing benefits. To qualify, employers must have less than 25 employees and an average wage, exclusive of owners, of less than $50,000.
- Look for a new insurer. While switching insurers can be confusing for employees, it would be worthwhile if rates rise steeply or the center can get a better deal by combining different benefit programs under one insurer, Ms. Tude Thuot says. "We have not switched health insurers, but this year we moved life insurance coverage to the same carrier that provides dental and long-term disability," she says.
- Remove some benefits. Ms. Spencer says her ASC has dropped life and reduced retirement benefits. She says employees would rather have a raise than keep a smaller benefit like life insurance. "They didn't want anything coming out of their pockets," she says. Ms. Spencer says the ASC still matches a 401(k) retirement benefit at up to 6 percent of salary for the employee, but it reduced an additional contribution from 8 percent to 4 percent, which lowered the ASC's total maximum contribution from 14 percent to 10 percent.
5. Connect benefits to work needs. Several benefits are directly related to the needs of the ASC. For example, some centers provide advanced cardiac life support classes, ergonomic assessments and scrubs free of charge. Many centers also contribute toward staff members' continuing education and certification. At Ms. Spencer's center, for example, a set amount is set aside each year, depending on the position. Nurses have a higher amount, because they have more skills to maintain than other workers. Some ASCs also offer extra incentive programs for performance. Such programs are used at Summit Ambulatory Surgery Centers in Maryland. At Summit, employees who pitch ideas that the center uses receive rewards and teams that exceed patient expectations earn special breakfasts.
6. Look for unusual benefits. "After you determine what is provided locally, consider offering non-traditional benefits to make yourself stand out from other businesses in the community," Ms. Otis says. One example is courtesy discounts for employees who receive surgery at the center. Ms. Spencer reports her ASC provides up to $1,000 in courtesy discounts each year for employees and their immediate families, an offering that is quite popular.
Ms. Tude Thuot says her center offers a long-term sickness program if employees are absent for five days or more. Food is a popular and low-cost benefit. For example, Ms. Tude Thuot's ASC puts out treats for physicians, staff and patients and provides staff lunches monthly.
Related Articles on Employee Benefits:
4 Creative Employee Benefits Your Surgery Center May Not Have Considered
3 Options to Consider for Surgery Center Employee Benefits
10 ASC Salary Statistics From the ASC Association 2009 ASC Employee Salary & Benefits Survey