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Employers Launch Effort to Reduce Unnecessary ER Use

Posted by Katie Holahan on Dec 4, 2018 9:00:00 AM

A coalition of employers led by AIM and the Massachusetts Taxpayers Foundation will formally initiate a campaign on December 11 to moderate the cost of health care by reducing avoidable use of hospital emergency departments (EDs).

EmergencyThe Massachusetts Employer Health Coalition will work with employers, employees, doctors, hospitals, and health insurers to reduce inappropriate use of emergency departments by 20 percent in two years. State officials estimate that a significant number of ED visits are potentially avoidable, a pattern that costs $300-$350 million annually for commercially insured members.

The good news is that employer coalitions in other areas of the country have already succeeded in curbing unnecessary use of emergency departments. The Massachusetts groups plan to kick off their initiative on the 11th with a breakfast at which they will hear comments from Louise Probst, Executive Director of a regional health improvement collaborative serving the state of Missouri, and the St. Louis Area Business Health Coalition, an employer coalition supporting more than 60 leading, self-insured employers.

In addition to Ms. Probst, a panel including AIM members will discuss cost savings initiatives they have implemented, as well as the challenges to reducing health-care costs for both large and small employers.

Register for the Coalition Kickoff

“The rising cost of providing health insurance to employees remains the most pressing issue facing the 4,000 employers who are members of Associated Industries of Massachusetts,” said Richard C. Lord, President and Chief Executive Officer of AIM.

“The Massachusetts Employer Health Coalition is a great example of employers stepping up and taking action to ensure that their workers can access the right care in the right place, maximizing both health care quality and affordability.”

The objective, according to Lord, is to reduce health-care costs and provide rate relief for small businesses and patients, while optimizing resources to ensure quality care for those in need of emergency care.

Most ED use is necessary, appropriate, and in many cases life-saving. However, providers and payers broadly agree that shifting ED use for non-urgent health problems to more timely, appropriate settings will improve quality and patient experience, and lower the cost of care.

The cost of an ED visit can be five times that of care provided in a primary care or urgent care setting. Upper respiratory infections, skin rashes, allergies, and back pain are among the most common conditions for which Massachusetts patients seek care in the ED unnecessarily.

The Coalition is expected to use the December 11 event to unveil resources that employers will use to engage with their workers about the importance of seeking medical care in appropriate settings. These resources will include educational materials, along with procedures to help employers and employees identify local care options.

AIM plans to provide links to the resources for its employer members.

The Coalition plans to focus on four tactics for change:

  1. Educating Employees: Work with employers to communicate information about avoidable ED use with employees and families so they can get the best possible care in settings such as primary care practices, retail clinics, and urgent care centers.
  2. Learning from Data: Track and publicly report the rate of avoidable ED visits so employers, stakeholders, and the public may understand and tackle the scope of the issue.
  3. Collaborating Across the Health Care System: Work with labor unions, health care providers, health plans, employers, and employees to reward and encourage the appropriate use of the ED by aligning financial incentives, and bolster the availability of care in the community, especially during nights and weekends.
  4. Advocating for Policy Change: Advocate for policy changes that will advance new care delivery and payment models, such as Accountable Care Organizations (ACOs), telemedicine, and mobile integrated health, which combined, can improve access to timely care in the right setting.

Topics: Health Care Costs, Controlling Health Care Costs, Health Insurance

Video Blog | Car and (Maybe No) Driver

Posted by Kristen Rupert on Dec 3, 2018 8:30:00 AM

nuTonomy, an Aptiv company, a 2018 AIM Global Trade Award honoree, is foring the future of transportation. Founded out of MIT in 2013 by Karl Iagnemma and Emilio Frazzoli, nuTonomy was the first company to test autonomous vehicles on public roads - in Singapore in 2016 and Boston in 2017.  nuTonomy reached a milestone six months ago when the company made its autonomous vehicles available to the general public in Las Vegas via the Lyft ride-hailing app. Aptiv and Nutonomy together employ 150 people in Boston’s Seaport district. 

 

Topics: AIM Global Trade Symposium, AIM International Business Council, Technology

Health Insurance Costs Top Employer Concerns Heading into 2019

Posted by John Regan on Nov 29, 2018 8:00:00 AM

The rising cost of providing health insurance to employees remains the most pressing issue facing Massachusetts employers, a new AIM survey shows.

health_careThree-quarters of the employers who participated in the association’s biennial Issues Survey from September to November identified the cost of health care as one of their three policy priorities. Other major challenges include work-force availability (64 percent), regulatory issues (53 percent) and the new paid family and medical leave law (51 percent).

AIM conducts the survey to solicit employer opinions on its policy agenda for the upcoming two-year session of the Massachusetts Legislature.

“AIM members understand the value of providing good health insurance to their employees, but employers are telling us clearly that they need relief from the relentless cost increases generated by the health-care system,” said Katie Holahan, Vice President of Government Affairs at AIM.

“AIM looks forward to addressing the health-cost issue on multiple fronts, from working with industry partners on health-plan design to resolving the employer MassHealth assessment to leading an employer effort to reduce unnecessary use of emergency rooms.”

One hundred sixty-eight employers participated in the AIM survey. The top 10 issues were:

  1. The cost of health care – 74 percent
  2. The availability of work force – 64 percent
  3. Regulatory issues (including compliance) – 53 percent
  4. Paid family and medical leave – 50 percent
  5. State and local taxes – 42 percent
  6. Minimum wage & the cost of electricity (tie) – 28 percent
  7. Transportation & federal taxes (tie) – 21 percent
  8. Trade issues – 15 percent
  9. Education – 12 percent
  10. Housing – 2 percent

Several employers expressed concern about the cumulative burden of government-imposed expenses – including the $200 million MassHealth assessment, unemployment insurance and minimum-wage increases – on their ability to grow and create jobs.

Health-insurance costs have been a dominant worry for Massachusetts employers for decades.

The Massachusetts Center for Health Information and Analysis (CHIA) reported in September that health care-spending in the commonwealth grew 1.6 percent from 2016 to 2017, with costs totaling $61.1 billion, or about $8,900 per resident.

While 2017 was the second consecutive year that overall growth came in below the 3.6 percent benchmark set by the Health Policy Commission, small-business premiums rose on average 6.9 percent. Deductibles, co-pays, co-insurance and other out-of-pocket expenses were up 5.7 percent.

Contact John Regan at jregan@aimnet.org

Topics: Health Care Costs, Health Care, Skills Gap

Video Blog | Newburyport Apparel Company Maintains Global Outlook

Posted by Kristen Rupert on Nov 26, 2018 8:00:00 AM

Bennett & Co., winner of a 2018 AIM Global Trade Award, is one of the leading designers and manufacturers for women’s intimate apparel, sleepwear and lingerie worldwide. Offices located in Newburyport are home to all of Bennett & Co.’s design, research and development efforts. Founder and CEO Jacalyn Bennett owns her manufacturing facility in Guangzhou, China, from which completed products are sent around the world on behalf of Bennett’s brand-name retail clients. Bennett & Co.’s 60,000 products and styles are produced with a minimal environmental footprint.

Topics: International Trade, AIM International Business Council, Massachusetts employers

Video Blog | John Hancock Maintains Global View

Posted by Kristen Rupert on Nov 19, 2018 8:00:00 AM

John Hancock, winner of a 2018 AIM Global Trade Award, is both a major Massachusetts employer and an ambassador for the commonwealth globally.

Owned by Canadian multinational insurance company Manulife, John Hancock offers a broad range of financial products to individuals and corporations.  Equally important, as the lead sponsor of the Boston Marathon, John Hancock plays a major role in bringing global elite athletes and the world’s attention to Massachusetts each April. 

Topics: International Trade, AIM International Business Council, Massachusetts employers

Technology Becomes Fifth Utility for Cities

Posted by Christopher Geehern on Nov 16, 2018 11:19:01 AM

A sophisticated technology infrastructure and real-time data have allowed the Boston Police Department to reduce crime in the city by 20 percent while arresting far fewer people than in the past.

SmartCities.2“A lot of that is because we are policing smarter. All this technology allows us to do our jobs better,” retired Boston Policy Commissioner William Evans told more than 200 business leaders at an AIM Executive Forum on Smart Cities this morning.

Evans, now Chief of Police at Boston College, said police now have access to video feeds, body camera footage, “shot-spotter” sound data and predictive analytics as they assign police officers to areas most affected by crime. Beginning in January, he said, Boston police officers will collect all of that information on smart phones.

Several miles to the south in Quincy, Chris Cassani is overseeing a $1.3 million project to install an adaptive signal platform that will allow the city’s traffic signals to share data to improve traffic flow. He said the system contains a software algorithm that can grow alongside the tremendous amount of economic development taking place in Quincy.

“There has been a tremendous amount of change, a tremendous amount of investment,” said Cassani, the city’s Director of Traffic, Parking, Alarm and Lighting.

Smart Cities technologies represent a kind of “fifth utility” for municipalities alongside water, electricity, gas and waste, according to three senior executives from Dell who lead the discussion. The executives said that technology not only makes more efficient the city services upon which businesses depend, but also increasingly makes reams to data available to employers on everything from flooding history to refuse collection.

“We absolutely have to build out a digital infrastructure,” said Corky Allen, Regional Field Director for State and Local Government Affairs for Dell EMC.

Rich Barlow, Field Chief Technology Officer for Dell, described how the City of Virginia Beach recently developed the ability to coordinate data from hundreds of flood sensors to minimize damage from hurricanes and other natural disasters.

AIM President Rick Lord said all the changes have important implications for employers.”

“Technology is transforming the world outside your business,” Lord told the gathering.

“It’s changing the management of the roads your employees travel to work, the infrastructure that “provides power to your building, and the municipal emergency services you call if the worst happens.”

Topics: Technology, AIM Executive Forum

Video Blog | Universal Plastics Brings Global Growth Back Home

Posted by Kristen Rupert on Nov 13, 2018 8:00:00 AM

Universal Plastics of Holyoke, winner of the 2018 Associated Industries of Massachusetts Global Trade Award,  manufactures custom thermoformed plastic parts and manages global supply chains for some of its aerospace and medical customers.  Universal Plastics is also “re-shoring,” or bringing back some production from overseas.  The company has five manufacturing facilities in the U.S. and 300 employees in Massachusetts. Watch their story, below.

 

Topics: International Trade, Massachusetts Manufacturing, Massachusetts employers

Trade Expert: Tariffs De-Globalizing US Economy

Posted by Kristen Rupert on Nov 9, 2018 8:43:12 AM

The Trump Administration is stretching the rules and norms of international trade in a manner that will ultimately de-globalize the United States economy and undermine the nation’s prosperity, a Harvard professor and former presidential trade adviser said yesterday.

LawrenceRobert Lawrence, the Albert Williams Professor of Trade and Investment at Harvard’s Kennedy School, told 150 people at the 2018 AIM Global Trade Symposium that the imposition of tariffs by the United States and retaliatory tariffs by China and other nations will actually harm domestic manufacturing since many of the inputs for US producers come from overseas.

“We’re raising costs for American production. It’s a counterproductive strategy,” said Lawrence, who was a member of President Clinton’s Council of Economic Advisers and an adviser to the Congressional Budget Office.

Two prominent Massachusetts employers confirmed that the deepening trade war is causing them to shift manufacturing, in some cases from the United States to overseas locations.

Lisa Hill, Vice President of Global Trade Strategies at Ocean Spray in Lakeville, said the company is moving some of its processing operations to recently acquired facilities in Chile and Canada to avoid retaliatory tariffs from China, the European Union, Mexico and Canada.

“We are literally on everybody’s list,” Hill said as part of a panel discussion on trade.

She told the audience that Ocean Spray has dealt with trade wars in the past but “what we are dealing with today is unprecedented.”

A similar story is unfolding at Sensata Technologies of Attleboro, which maintains operations and business centers in 12 countries around the world. Vineet Nargolwala, Senior Vice President for Performance Sensing, said that 20 percent of the high-tech sensors the company makes in China come to the United States and are thus subject to new tariffs.

The company is responding by moving international production to other sites in Southeast Asia while reserving more of its China operations to make products for the Chinese market.

“It’s definitely a new landscape we are operating in,” Nargolwala said.

Lisa Wieland, Port Director for Massport, said the peak import shipping season for Boston accelerated this year as companies tried to get product into the United States ahead of the tariffs. Massport itself, which is in the middle of an $850 million infrastructure modernization project, had to spent significant time to ensure that three massive ship-to-shore cranes made exclusively by a company in China were not included in the tariff schedule.

The comments on trade policy came as AIM and its International Business Council honored four Massachusetts companies for excellence in international trade. The recipients of the 2018 Global Trade Awards were Universal Plastics of Holyoke, John Hancock of Boston, Bennett & Company of Newburyport and nuTonomy/APTIV of Boston.

Lawrence maintained that the Trump Administration used an overly broad definition of national security to impose tariffs on imported steel and aluminum and a similarly broad interpretation of provisions that permit tariffs when foreign governments impose unreasonable burdens on US commerce.

The result, he said, has been that the United States has ceded world trade leadership to China.

“It leaves us with a severely damaged global trading system,” he said.

Topics: AIM International Business Council, International Trade, AIM Global Trade Symposium

Business Confidence Drops to 17-Month Low

Posted by Christopher Geehern on Nov 6, 2018 8:04:29 AM

Business confidence in Massachusetts declined to its lowest level in 17 months during October as the uncertainties that roiled global financial markets seeped into employer outlooks.

BCI.October.2018The Associated Industries of Massachusetts Business Confidence Index (BCI) lost 1.6 points to 61.0 last month, the fourth decline in the last five months.

The reading remains well within optimistic territory, but the BCI now sits 1.7 points lower than its level of a year ago and at its lowest point since May 2017.

Raymond G. Torto, Chair of AIM's Board of Economic Advisors (BEA) and Lecturer, Harvard Graduate School of Design, said the October decline is noteworthy because of large declines in employer confidence in their own operations, and among manufacturers.

“Fears about slowing growth, trade wars and rising interest rates buffeted financial markets this month, and some of those same fears, combined with an increasingly acrimonious mid-term election, affected employers as well,” Torto said

“The good news is that the fundamentals of the economy remain strong. MassBenchmarks reports that the Massachusetts economy grew at a 3.3 percent annual rate during the third quarter and the national economy added 250,000 jobs last month.”

The AIM Index, based on a survey of Massachusetts employers, has appeared monthly since July 1991. It is calculated on a 100-point scale, with 50 as neutral; a reading above 50 is positive, while below 50 is negative. The Index reached its historic high of 68.5 on two occasions in 1997-98, and its all-time low of 33.3 in February 2009.

The Index has remained above 50 since October 2013.

Constituent Indicators

The constituent indicators that make up the overall Business Confidence Index were almost all lower during October.

The one exception was the Massachusetts Index assessing business conditions within the commonwealth, which rose 0.2 points to 64.7. Confidence in the state economy has declined 0.4 points since October 2017.

The U.S. Index lost 2.0 points to 61.6, leaving it 0.9 points lower than a year ago.

The Company Index measuring employer assessments of their own operations dropped 2.0 points to 59.6, down 2.4 points year-to-year. The Employment Index lost 0.3 points during October while the Sales Index tumbled 3.1 points to 57.4.

The Current Index, which assesses overall business conditions at the time of the survey, fell 1.0 point last month to 63.3 and 0.3 points for the year. The Future Index, measuring expectations for six months out, lost 2.1 points for the month and 3.2 points for the year.

Non-manufacturers (61.7) were slightly more optimistic that manufacturing companies (60.3). Companies in the eastern part of Massachusetts (61.7) were more bullish than those in the west (60.3).

Medium-sized companies (62.1) registered higher confidence readings than either large companies (59.5) or small companies (60.6), an unusual result since large companies typically show the most optimism on the BCI.

Katherine A. Kiel, Professor of Economics at The College of the Holy Cross in Worcester and a member of the BEA, suggested that large companies may be particularly concerned about the ratcheting up of trade tensions between the United States, China and other trading partners.

“Employers responding to the survey are expressing fears about the potential effects of rising tariffs both on the price of raw materials and their ability to expand overseas markets,” Kiel said.
Intersection of Politics, Economy

AIM President and CEO Richard C. Lord, also BEA member, agreed that international trade friction and uncertainty about the duration and scope of new tariffs are clouding employer views of an otherwise solid economy.

“Concerns about trade and tariffs are likely to influence employer decisions as we move toward the end of 2018 and into the New Year. Hopefully, the results of the mid-term elections today will shed some light on the direction of trade policy moving forward.”

Topics: AIM Business Confidence Index, Massachusetts economy, Massachusetts employers

Potential Legislative Involvement in Lockout Sets Dangerous Precedent

Posted by John Regan on Nov 2, 2018 8:34:04 AM

Proposed legislation that would penalize National Grid during the ongoing lockout of gas workers represents a troubling – and perhaps unconstitutional – foray by Beacon Hill into a private-sector labor dispute.

State House 2015The bill, called An Act relative to the employment of certain workers by National Grid, would prohibit National Grid from:

  • receiving public funds for the upgrade, repair, installation or maintenance of its gas distribution system
  • applying for funds to assist in paying the costs of gate box maintenance and improvements, or
  • receiving from the Massachusetts Department of Public Utilities any increase in its rates for consumer gas or electric distribution.

The bill would also require National Grid to continue to provide health insurance under its expired collective bargaining agreements with Steelworkers Locals 12003 and 12012-04.

The House of Representatives has admitted the bill, but no hearing has been scheduled. The measure is unlikely to pass before January since the Legislature remains in informal session when a single legislator may stop a bill.

National Grid, which provides natural-gas service to 116 Massachusetts communities, has 85 communities impacted by a lockout of 1,250 workers after the Steelworkers rejected a five-year contract offer that will boost the current average employee salary, including overtime, from $120,000 a year to $137,000.

The offer also includes a 10 percent increase in the pension plan for current employees, while new employees would be assigned to a completely company-funded defined contribution plan with a 3 to 9 percent company match, in addition to a regular 401 (k) with a company match. The company’s health insurance proposal would also introduce modest deductibles and coinsurance, which the unions currently do not pay.

Intervention in a private labor dispute is beyond the scope of the Massachusetts Legislature and sets a dangerous precedent for the ability of government to takes sides in negotiations between companies and their workers. If lawmakers interject themselves in the National Grid lockout, what would prevent them from also becoming involved in disputes involving manufacturing, service or technology companies across the commonwealth?

The bill would tread upon and regulate a sphere of private sector collective bargaining that is intended to be unregulated by the U.S. Congress.  As such, the legislation is pre-empted by the National Labor Relations Act.  Strikes and lockouts are both federally protected actions.

The federal courts have a long history of pre-empting local and state efforts to shape labor disputes. In 1986, for example, the U.S. Supreme Court pre-empted the Los Angeles City Council’s bid to condition renewal of a taxi license on the resolution of a labor dispute.

The proposal could also violate the United States Constitution because, in targeting National Grid and only National Grid, it constitutes a Bill of Attainder proscribed by Article 1 of the Constitution. 

No one likes labor disputes and AIM joins others in hoping that National Grid and its unions can find common ground soon. That hope should not, however, lead elected officials down the road of political expediency.

Topics: Organized Labor, Massachusetts Legislature, Energy

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