July 18, 2025 • 22 mins
Health Affairs' Jeff Byers welcomes Ryan Golden, Senior Reporter at HR Dive, to the pod to discuss workforce trends within the health care space pertaining to artificial intelligence, recruitment, overtime eligibility requirements, pay transparency, noncompete agreements, remote work, RTO policies, and more.
This week, Health Affairs released their second Insider trend report focusing on the health care workforce, titled "The Health Care Workforce: A Challenge In Sustainability."
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Jeff Byers (00:08):
Hello and welcome to Health Appears This Week. I'm
your host Jeff Byers. We'rerecording on 07/15/2025. Welcome
back. We took a couple of weeksoff this month for the fourth,
and I was out in the mountains,but we are back.
This week, health affairsreleased its second insider
trend report. The first one wason artificial intelligence in
(00:29):
health care. Hopefully, youcaught that. This new report is
titled The Health CareWorkforce, A Challenge in
Sustainability. It providesinsights into the key factors
surrounding the current andfuture sustainability of the
health care workforce.
You can get this report bybecoming a Health Affairs
Insider member, where you alsoget access to exclusive virtual
(00:51):
events, as well as exclusivenewsletters straight to your
inbox. One of the things thisreport touches on, but doesn't
dive into deeply, is the currentHR regulations affecting all
businesses, including providers.So to discuss those regulations,
I'm joined today by Ryan Golden,senior reporter at HR Dive. Ryan
(01:12):
and I used to work together atIndustry Dive. I used to steal
HR Dive articles for HealthcareDive on the reggae.
It was beneficial on my end. Ithink it was beneficial on their
end. We might not get to that,but here to talk about HR
regulations. Ryan Golden,welcome to the program.
Ryan Golden (01:28):
Jeff, thanks so much for having me.
Jeff Byers (01:30):
Ryan, so you are based in Baltimore. Is that
right?
Ryan Golden (01:32):
That's correct. Yeah. Born and raised.
Jeff Byers (01:34):
Born and raised. So we are a month and a half after
after the release of NeverEnough by Turnstile. Is the city
still talking about it? Is itover? What's what's the party
line there?
Ryan Golden (01:43):
Oh, I'm kidding. Turnstile is the talk of the
town. It's it's amazing to seean indie band grow from where
they where they started out andnow they're on the the national
stage. It's it's incredible. Ilove seeing Baltimore
represented, you know, in in inthe media, in the popular
sphere, and turnstiles is a hugehighlight.
Love them.
Jeff Byers (02:01):
Fantastic. Yeah. I saw them at the anthem about a
couple years ago. Fantasticshow. Absolutely.
Glad glad they're doing well. Somoving on, you know, from from
regional to more, nationalissues. So looking at HR and you
know recent regulations that youtrack while at HR Dive, know,
(02:24):
you give us a top line on what'sthe biggest changes to
employment laws that industriessuch as healthcare may need to
know about?
Ryan Golden (02:32):
Yeah. Absolutely. And I had three specific ones I
wanted to highlight for youryour folks at health affairs.
The first one is, of course,diversity, equity, and
inclusion, otherwise known asDEI. We have seen quite a bit of
rollback on DEI initiativeswithin the last few years,
pushback on the cultural levelas well as the legal level.
Of course, know that the Trumpadministration has been
(02:52):
particularly insistent oncracking down on what it has
called a legal DEI. It's putmany of the regulatory agencies
in charge of workplace law onthis subject, including the
Equal Employment OpportunityCommission, also known as the
EEOC. They have targeted lawfirms based on their DEI
programs and have tried toemphasize to employers that
(03:13):
they're very much interested incracking down on this area. And
as a related note, know, thisjust happened, you know, the
employment law sphere, theSupreme Court decision in Ames
versus Ohio Department of YouthServices, which deals with so
called reverse discriminationwhere majority group plaintiffs
alleged workplace bias. Thatdecision, which was a unanimous
decision authored by JusticeKetanji Brown Jackson, was seen
(03:36):
as a very landmark one for theworkplace.
It eliminated some standardsthat certain courts maintained
for majority group plaintiffs toallege workplace bias and the
folks who I speak to think thiswill make it easier for those
plaintiffs to bring such claimsmoving forward. So to the extent
that healthcare employers haveDEI initiatives in areas like
recruiting, hiring, promotion,or even things like employee
(03:58):
resource groups, they should beaware of these developments and
just be aware of the laser focusthat lawmakers and members of
the public are placing on DEI.The second one is religious anti
discrimination law. So we areseeing quite a bit of claims and
things like vaccinationrequirements. Of course, when
COVID happened, we saw a lot ofvaccine requirements in
healthcare and other industries.
(04:19):
Employees have filed suitssaying that these requirements
go against their religiousbeliefs and they do have
protections under federal civilrights law. So we've seen a
variety of cases on this subjectand that particular area is also
subject to a Supreme Courtdecision regarding religious
accommodation requests in Groffv. The Joy where the court said
it would lower the bar forplaintiffs to bring Title VII
(04:41):
claims based on religiousbeliefs and accommodations
against employers. So therulings on religious anti
discrimination vary from courtto court. They're very fact
specific and it's hard to reallyextract a general trend for
employers, but it's justimportant to note that it's out
there and that there are manybases at play on those
particular cases.
And third, finally, youmentioned AI. I think that's
(05:04):
important to note that in HR,we're constantly looking at
developments in artificialintelligence. Executives are
expected to have a perspectiveand a vision on AI. It's going
to look different ultimately forevery industry, but in
healthcare could affect thingslike how physicians treat
patients and especially howadministrative tasks are
performed, things likescheduling patient follow ups
(05:25):
and management of employeeschedules pertinent to this
conversation. So expect to seecontinued interest in AI
solutions both inside andoutside of HR, as well as
healthy skepticism of AI.
And in the regulatory space,we're watching a case against an
HR vendor by the name of Workdayin California, which is about
the discriminatory impactpotentially of AI in hiring
specifically. So yeah, very muchan emerging area watching that
(05:49):
very closely.
Jeff Byers (05:50):
Yeah, so that case in Workday, correct me if I'm
wrong, that's kind of generallylike you upload a resume, then
they ask you to do it again andthey may use AI to filter you
out.
Ryan Golden (06:01):
Yes. The the employee in that case or the job
applicant in that case isalleging that he was screened
out of multiple roles due to hisage and he's been given class
certification in that case. Sothat could apply to far more
plaintiffs than just himself. Soit's an ongoing case and I think
it's the it's maybe the mostsignificant case we're watching
as far as AI intersecting withHR right now.
Jeff Byers (06:19):
Yeah. It will be fascinating to watch. So thanks
for that. I might want to askyou a little bit more about some
of those going forward, after wetalk about some of the things
that are touched on the report,but not too deeply. One of those
things is the changes toovertime eligibility criteria.
A little bit of a will theywon't they kind of situation
since, 2016 or so. What's thelatest on this criteria? It's a
(06:45):
final rule, but maybe it's not?
Ryan Golden (06:47):
Yeah. It's confusing. Is one of those areas
that always changes hands. It'snice to
Jeff Byers (06:53):
know I'm not alone. Thank you.
Ryan Golden (06:54):
No. No. You're absolutely not alone, Jeff. It
it is a confusing area. Itchanges whenever the White House
changes hands.
Most recently, you had the Bidenadministration attempt to raise
the overtime eligibilitycriteria for US workers. They
tried to do it in three steps.There was a July increase, a
January 2025 increase, and thenthey even implemented an
automatic increase strategy for2027 and beyond. Of course, this
(07:19):
was held up in the courts.Eventually there were federal
judges in Texas that struck downthe rule.
Currently it's technically stillin litigation, but because the
Trump administration reallyhasn't signaled it will litigate
on behalf of the Biden rule,it's very, it's pretty much dead
in the water according to thefolks I speak to. So the latest
update on overtime, you know, in2019, the first Trump
administration actuallyincreased the overtime
(07:40):
eligibility threshold. It's nowhovering around $35,000 a year.
And it depends on what dutiesyour workers perform as well as
how much they make, whetherthey're eligible for overtime
pay. In healthcare, the rulethat you need to pay attention
to is the executiveadministrative professional
designation and you know workersmay or may not fall under that.
There are other exemptions forfirst responders and other
(08:01):
categories, but it's just one ofthose issues that we continue to
watch change on because you knowespecially given that this rule
is still technically up in theair in the courts, but you know,
there's not much defense of itfrom the current administration.
It's hard to see. And I justwant to note also, you continue
to see healthcare systems dealwith overtime pay litigation.
There was a lawsuit filed inJune by nurse managers in
(08:23):
Georgia versus Humana, whichclaimed the company didn't
compensate them for overtimepay. It continues to be an issue
for not just health careemployers, but employers
generally just keeping track ofhours, keeping track of
exemptions, things of thatnature.
Jeff Byers (08:35):
Yeah. Do you foresee a future where this might be for
lack of better term settledwhere like administrators can
know what to do or how to thinkabout this?
Ryan Golden (08:46):
At the federal level
Jeff Byers (08:47):
we already hear?
Ryan Golden (08:48):
Yeah I mean at the federal level it's settled for
the time being, right? You knowfor the next four years we have
some sort of guarantee that it'snot going to go to the levels
that the Biden administrationproposed. So that's a bit of
ground for employers to look at.Whether we have future changes
again, it's one of those issuesthat just you know when a
Democrat is in office, they'revery insistent on changing it.
(09:08):
Have to recall and maybe youknow your readers are familiar
with the 2016 Obama overtimerule that was blocked similarly
by federal courts.
Before that rule, we hadn't seenan overtime threshold increase
since I think it was 02/2004. Sothis used to be an issue that
lawmakers came to back prettyinfrequently. Now it's a very
hot button topic that successiveadministrations have addressed
(09:29):
in some way shape or form. Sodefinitely wouldn't be surprised
to see it be addressed againbefore the next administration
comes into power. But it's oneof those things that for the
time being, there is a bit ofclarity going forward.
Jeff Byers (09:40):
Right. Well, thanks for providing some of that
clarity. Another hot buttonissue is pay transparency,
particularly in the wake of theCOVID nineteen pandemic. You
know, I'm sure prospectiveemployees love this, wanting to
know what the pay range is. Someemployers have given wild pay
ranges like $0 to half a milliondollars in in some job
(10:04):
descriptions.
Don't quote me, or don't quoteany particular job description
on that. But it looks it looksto be something taken up mostly
by states currently. Have weheard about how the transparency
is faring in terms of attractingor retaining talent? Like,
what's the latest on that?
Ryan Golden (10:20):
Yeah. That's that's dead on. State and local
lawmakers have really taken upthis issue, and it's one of
those employment law topicswe've been tracking for a while
where it's just we call it thepatchwork, right? There are
certain states and jurisdictionswhere they address this sort of
thing in certain states wherethey don't. And those areas that
do address it tend to have a lotof employers, a lot of large
employers.
Think about places likeCalifornia, New York, New York
(10:41):
City, Pennsylvania, know all upand down the East And West Coast
and in the Midwest as well. Paytransparency you know it's
something that the research onit is still very new. Will say
that whether or not it's abeneficial thing for reducing
things like pay gaps, I've seena lot of literature on it in
both directions. I wanted tocite a few statistics. So in
2023, we got a report from SHRM,which if you're not familiar is
(11:04):
HR's biggest industry tradegroup.
They found that pay transparencyhad a positive effect on
employers who participated inpay transparency. They saw a
boost to attracting skilledapplicants and SHRM actually
specifically said that 70% ofthe employers that surveyed that
had paid transparency say thatdoing so led to an increase in
applicants. We also had a vendorreport in 2023 from Payscale,
(11:27):
which said that paidtransparency reduced turnover
among employers. As far aswhether it reduces pay gaps, I
found a little bit of mixed asfar as I have my own reading of
it, my limited reading of theresearch out there. It's sort of
mixed.
There has been some reportingthat it reduces pay gaps in some
instances while it can also havenegative effects such as
discouraging lower performingemployees from asking for higher
(11:49):
pay. And that's lower performingin terms of whether they self
perceive as lower performingcompared to other coworkers or
actually lower performing. Itdiscourages them potentially
from asking for higher pay whenthey see how their coworkers,
their cohorts are paid. So theresearch is still very new. I
would encourage people to justkeep an eye on it.
(12:10):
And I mean, or not what theemployer's perspective on pay
transparency is, it's clear thatthe states and local
jurisdictions are very active onit. We just had a new law passed
in Cleveland. So one of thebiggest cities in The US Midwest
now addressing this topic aswell.
Jeff Byers (12:26):
Yeah. Do you get a sense that this will kinda
trickle out even more patchwork,as it becomes more normalized,
or is it a yet to be determinedkinda thing?
Ryan Golden (12:37):
Yeah, it's one of those things where federal
lawmakers have tried to putforward legislation to address
it. Effort has succeeded so far.So you have this as with many
employment law topics, you'llfind there's just different
approaches on a state by statebasis and even on a city by city
basis. So for now it's very muchthat patchwork until you have a
(12:58):
federal law that provides alittle bit more, you know,
clarity and security.
Jeff Byers (13:01):
So much like pay transparency was buzzy coming
out of COVID-nineteen, alsoremote work was a big, big topic
because it was kinda necessaryin 2020 and 2021, and now you
kinda see some return to workefforts. Have you seen from an
HR, you know, retention andattracting talent perspective,
have you seen any trends fromremote or hybrid work that have
(13:24):
bared out any interestingresults that you could share?
Ryan Golden (13:28):
Yeah. I mean, this is of course a hot button topic
and it's hard for me to think ofa specific statistic, but I will
say one thing that weconsistently find looking at
surveys of job candidates isthat they value flexibility.
Flexibility continues to besomething and flexibility that
can encompass you know full timeremote work, it can also
encompass a hybrid work you knowpart time in office, part time
(13:50):
at home or somewhere else. Evenlike flexibility in hours, like
maybe you have a schedule thatyou can choose a certain number
of hours per week or you canwork a certain time frame in a
given week compared to adifferent day where you work a
different timeframe. Those kindsof options have tremendous sway
among job candidates and ofcourse it's become more in vogue
(14:11):
for employers to return tooffice or RTO as we call it.
You see more and more employersdoing that. Would say it's
fairly mainstream. We had atransition period in COVID from
like, I'm going say '22 to '24where employers were in the
middle in large part on this,but I think we fully swung in
the direction of RTO since then,at least for most large
(14:32):
companies, right? And that hasaffected employee relations,
it's affected talent, but Ithink the constant drumbeat I
hear from analysts and HR folksis that flexibility is still
valued. So even if you have anRT requirement you know, letting
people come to the office acertain amount of days and also
work from home a certain amountof days per week is still very
(14:53):
valued as is the things like youknow being able to have
flexibility in scheduling andshift changes and things like
that.
Jeff Byers (14:59):
Yeah. And another hot topic is non compete
agreements. You see this in thehealth care provider space and
in health tech space a lot, orin the start up world as well,
which includes a lot of healthtech start ups. There was a
final rule, kinda barring thesenon compete agreements, but it
looks like it's working its waythrough the courts, and non
(15:21):
competes are permissible in themeantime. What can you tell us
about this?
Ryan Golden (15:25):
Yeah. That's right. You're referring to the Federal
Trade Commission FTC ban on noncompete agreements with some
limited exceptions. This wasunder the Biden administration
in 2024. They allowed someexceptions for certain senior
executives and they sort ofoutlined what that looks like.
It was a very shot. Would say itwas kind of surprising for us in
the HR space to see that happen.However, it was effectively
(15:46):
tied. It was struck down by afederal judge months before its
September 2024 deadline. Itnever took effect and it's still
tied up in the courts.
We're not quite sure where thatrule goes from here. We have
quite a bit of bipartisanthere's been some interesting if
you look out at the accountsthat are available in news
websites, can see that there arepoliticians and there are
(16:07):
influencers on both sides of theaisle who sort of look at non
compete bands positively, thinkthat they're a bottleneck on
competition. You also have quitea bit consensus in the business
community that you know thesekinds of agreements are valued
because they help protect thingslike trade secrets, customer
bases. You know there's quite abit of variety and perspective
there compared to some of theseother topics. So as far as where
(16:28):
let's say the Trumpadministration goes on this,
think it's really yet to beseen.
We haven't really seen theadministration firmly say where
they're going to stand on this.But what I can say is that in
the meantime, the states havemoved forward in implementing
non compete bans. So I wanted tocall a few out examples that
specifically affect thehealthcare industry. So a law
(16:49):
firm that we file, WhitlerMendelson, they've reported that
several states have enactedthese kinds of agreements
specifically affectingphysicians and other
practitioners this year. Oregonpassed a law in June which voids
non competes which involveworkers with certain medical
license.
And in Texas there are time andgeographic based limitations
according to regulations thereon non competes for a physician.
(17:10):
So I hate to be repetitive, butyou know this is very much
something where the states havetaken the lead for the time
being while the FTC rule is sortof held up in the courts.
Jeff Byers (17:22):
Is there a specific definition of the term trade
secrets yet?
Ryan Golden (17:26):
Yeah. I mean, I would probably defer to an
attorney on that one, but Okay.You know, yeah, like the non
compete as a concept, right, isto protect from competition with
a competitor right. So the mainthrust of that kind of agreement
is it's a restrictive covenantand the goal is to protect the
customer base, to protect thebusiness. There are other forms
of restrictive covenants thatemployers can look to in the
(17:48):
meantime, things like NDAs, nonsolicitation agreements.
There are things like gardenleave, which is a arrangement
where you pay someone to notwork for anywhere else you know
or work for a competitor for acertain amount of time after
they leave the business. Andthere are some wrinkles in
garden leave that you may wantto consider legally looking at,
you know, depending on wherewhat regulations are in your
(18:10):
specific little geographic area,but there are other options
besides non competes is thepoint. And there are many
motivations to pursue noncompetes, I think. But yeah,
that's that's I guess the answerto the question is it varies
depending on who you talk to.
Jeff Byers (18:25):
So as we wrap up, are there any other major
federal or state HR rules, thatyou feel our listeners should
know about?
Ryan Golden (18:32):
Yeah. Absolutely. I just wanted to call out again
the artificial intelligence andthe hiring process part of it. I
think it's relatively new. We dohave a handful of states.
We have a tracker on this on ourwebsite. We have a few states
and cities that have implementedlaws that specifically regulate
AI and hiring. The most notableones are probably New York City
(18:52):
and Colorado. Colorado is fairlyextensive. There are
requirements around notifyingapplicants about using AI,
disclosing what the AI is usedfor, what it does, and there are
even certifications.
So there are requirements. Ithink New York City has a
requirement that you have toactually recertify the system
with the city government. And Iwould check my tracker on that
(19:13):
just to be sure. But yeah, it'ssomething that's emerging and
we're actually watching inCalifornia. They are developing
regulations around this and Ibelieve a few pieces of
legislation around AI andhiring.
California, just for those whoaren't aware, is sort of seen as
a bellwether for employment law.So if California passes
something, it's very likely thatother states will move forward
and do something similar. Andgiven that California is where
(19:36):
many of these AI companies arebased, it's super, it's double
impactful because it directlyimpacts some of the biggest
players in the AI space ingeneral. So that's something to
keep in mind.
Jeff Byers (19:46):
Yeah. And that website is hrdive.com. Ryan
Golden from HR Dive. Thanksagain for joining us today on
Health Affairs This Week. Isthere anything, just as we wrap
up one final time, that youwanna promote while you're here?
Ryan Golden (20:01):
Yeah. And thanks so much for the opportunity, Jeff.
If you have an HR professionalat your practice or organization
who's struggling to keep up withall this, hey, we get it. We've
got them covered at HR Dive. Ourcontent is free to readers.
We don't have paywalls. We covernews, general tricks. We've got
daily and weekly newsletters. Sothe daily issues, they cover
general news and talent specifictrends, so recruiting, that kind
(20:23):
of thing. The weekly issuescover compliance, training, DNI
and compensation and benefits.
So I highly recommend the weeklynewsletters for those who want
snapshots of specific topics.The daily ones are more of a
broad based overview. And I alsowanted to highlight in October,
October 8, we have a free livevirtual event coming up at HR
Dive on open enrollmentplanning. So open enrollment
(20:45):
interfaces with healthcare quitea bit. If you have, if you
manage employees or manageemployee benefits plans or you
interact with employers, healthplans that may interest some of
your listeners.
And one of our reportersactually, Ginger Chris, she'll
be hosting a panel at that eventon the unsustainable health care
cost increases we've been seeingin The US. I know that's a hot
topic and she'll be specificallytalking about what strategies
(21:09):
employers are using to addressthat. So that may be of
interest. Yeah. And Jeff, youcalled out the website
hrdive.com.
We're also on social media, X,Facebook and most prominently on
LinkedIn where we not only do wepost our stories, we also have a
discussion group for HRprofessionals who are interested
in talking about, you know,professional issues, you know,
(21:30):
different trends they're seeing.We we see a lot of different
variety from our folks onLinkedIn.
Jeff Byers (21:35):
Well, great. Thanks for sharing that information.
We'll post links to HR Dive andhopefully the event in the show
notes for this episode. RyanGolden, thanks again for joining
me today on Health Fairs ThisWeek. And to you, the listener,
if you enjoyed this episode,please send it to, the recruiter
in your life.
Thanks again, and we'll see younext week.
Hello and welcome to Health Appears This Week. I'm
your host Jeff Byers. We'rerecording on 07/15/2025. Welcome
back. We took a couple of weeksoff this month for the fourth,
and I was out in the mountains,but we are back.
This week, health affairsreleased its second insider
trend report. The first one wason artificial intelligence in
(00:29):
health care. Hopefully, youcaught that. This new report is
titled The Health CareWorkforce, A Challenge in
Sustainability. It providesinsights into the key factors
surrounding the current andfuture sustainability of the
health care workforce.
You can get this report bybecoming a Health Affairs
Insider member, where you alsoget access to exclusive virtual
(00:51):
events, as well as exclusivenewsletters straight to your
inbox. One of the things thisreport touches on, but doesn't
dive into deeply, is the currentHR regulations affecting all
businesses, including providers.So to discuss those regulations,
I'm joined today by Ryan Golden,senior reporter at HR Dive. Ryan
(01:12):
and I used to work together atIndustry Dive. I used to steal
HR Dive articles for HealthcareDive on the reggae.
It was beneficial on my end. Ithink it was beneficial on their
end. We might not get to that,but here to talk about HR
regulations. Ryan Golden,welcome to the program.
Ryan Golden (01:28):
Jeff, thanks so much for having me.
Jeff Byers (01:30):
Ryan, so you are based in Baltimore. Is that
right?
Ryan Golden (01:32):
That's correct. Yeah. Born and raised.
Jeff Byers (01:34):
Born and raised. So we are a month and a half after
after the release of NeverEnough by Turnstile. Is the city
still talking about it? Is itover? What's what's the party
line there?
Ryan Golden (01:43):
Oh, I'm kidding. Turnstile is the talk of the
town. It's it's amazing to seean indie band grow from where
they where they started out andnow they're on the the national
stage. It's it's incredible. Ilove seeing Baltimore
represented, you know, in in inthe media, in the popular
sphere, and turnstiles is a hugehighlight.
Love them.
Jeff Byers (02:01):
Fantastic. Yeah. I saw them at the anthem about a
couple years ago. Fantasticshow. Absolutely.
Glad glad they're doing well. Somoving on, you know, from from
regional to more, nationalissues. So looking at HR and you
know recent regulations that youtrack while at HR Dive, know,
(02:24):
you give us a top line on what'sthe biggest changes to
employment laws that industriessuch as healthcare may need to
know about?
Ryan Golden (02:32):
Yeah. Absolutely. And I had three specific ones I
wanted to highlight for youryour folks at health affairs.
The first one is, of course,diversity, equity, and
inclusion, otherwise known asDEI. We have seen quite a bit of
rollback on DEI initiativeswithin the last few years,
pushback on the cultural levelas well as the legal level.
Of course, know that the Trumpadministration has been
(02:52):
particularly insistent oncracking down on what it has
called a legal DEI. It's putmany of the regulatory agencies
in charge of workplace law onthis subject, including the
Equal Employment OpportunityCommission, also known as the
EEOC. They have targeted lawfirms based on their DEI
programs and have tried toemphasize to employers that
(03:13):
they're very much interested incracking down on this area. And
as a related note, know, thisjust happened, you know, the
employment law sphere, theSupreme Court decision in Ames
versus Ohio Department of YouthServices, which deals with so
called reverse discriminationwhere majority group plaintiffs
alleged workplace bias. Thatdecision, which was a unanimous
decision authored by JusticeKetanji Brown Jackson, was seen
(03:36):
as a very landmark one for theworkplace.
It eliminated some standardsthat certain courts maintained
for majority group plaintiffs toallege workplace bias and the
folks who I speak to think thiswill make it easier for those
plaintiffs to bring such claimsmoving forward. So to the extent
that healthcare employers haveDEI initiatives in areas like
recruiting, hiring, promotion,or even things like employee
(03:58):
resource groups, they should beaware of these developments and
just be aware of the laser focusthat lawmakers and members of
the public are placing on DEI.The second one is religious anti
discrimination law. So we areseeing quite a bit of claims and
things like vaccinationrequirements. Of course, when
COVID happened, we saw a lot ofvaccine requirements in
healthcare and other industries.
(04:19):
Employees have filed suitssaying that these requirements
go against their religiousbeliefs and they do have
protections under federal civilrights law. So we've seen a
variety of cases on this subjectand that particular area is also
subject to a Supreme Courtdecision regarding religious
accommodation requests in Groffv. The Joy where the court said
it would lower the bar forplaintiffs to bring Title VII
(04:41):
claims based on religiousbeliefs and accommodations
against employers. So therulings on religious anti
discrimination vary from courtto court. They're very fact
specific and it's hard to reallyextract a general trend for
employers, but it's justimportant to note that it's out
there and that there are manybases at play on those
particular cases.
And third, finally, youmentioned AI. I think that's
(05:04):
important to note that in HR,we're constantly looking at
developments in artificialintelligence. Executives are
expected to have a perspectiveand a vision on AI. It's going
to look different ultimately forevery industry, but in
healthcare could affect thingslike how physicians treat
patients and especially howadministrative tasks are
performed, things likescheduling patient follow ups
(05:25):
and management of employeeschedules pertinent to this
conversation. So expect to seecontinued interest in AI
solutions both inside andoutside of HR, as well as
healthy skepticism of AI.
And in the regulatory space,we're watching a case against an
HR vendor by the name of Workdayin California, which is about
the discriminatory impactpotentially of AI in hiring
specifically. So yeah, very muchan emerging area watching that
(05:49):
very closely.
Jeff Byers (05:50):
Yeah, so that case in Workday, correct me if I'm
wrong, that's kind of generallylike you upload a resume, then
they ask you to do it again andthey may use AI to filter you
out.
Ryan Golden (06:01):
Yes. The the employee in that case or the job
applicant in that case isalleging that he was screened
out of multiple roles due to hisage and he's been given class
certification in that case. Sothat could apply to far more
plaintiffs than just himself. Soit's an ongoing case and I think
it's the it's maybe the mostsignificant case we're watching
as far as AI intersecting withHR right now.
Jeff Byers (06:19):
Yeah. It will be fascinating to watch. So thanks
for that. I might want to askyou a little bit more about some
of those going forward, after wetalk about some of the things
that are touched on the report,but not too deeply. One of those
things is the changes toovertime eligibility criteria.
A little bit of a will theywon't they kind of situation
since, 2016 or so. What's thelatest on this criteria? It's a
(06:45):
final rule, but maybe it's not?
Ryan Golden (06:47):
Yeah. It's confusing. Is one of those areas
that always changes hands. It'snice to
Jeff Byers (06:53):
know I'm not alone. Thank you.
Ryan Golden (06:54):
No. No. You're absolutely not alone, Jeff. It
it is a confusing area. Itchanges whenever the White House
changes hands.
Most recently, you had the Bidenadministration attempt to raise
the overtime eligibilitycriteria for US workers. They
tried to do it in three steps.There was a July increase, a
January 2025 increase, and thenthey even implemented an
automatic increase strategy for2027 and beyond. Of course, this
(07:19):
was held up in the courts.Eventually there were federal
judges in Texas that struck downthe rule.
Currently it's technically stillin litigation, but because the
Trump administration reallyhasn't signaled it will litigate
on behalf of the Biden rule,it's very, it's pretty much dead
in the water according to thefolks I speak to. So the latest
update on overtime, you know, in2019, the first Trump
administration actuallyincreased the overtime
(07:40):
eligibility threshold. It's nowhovering around $35,000 a year.
And it depends on what dutiesyour workers perform as well as
how much they make, whetherthey're eligible for overtime
pay. In healthcare, the rulethat you need to pay attention
to is the executiveadministrative professional
designation and you know workersmay or may not fall under that.
There are other exemptions forfirst responders and other
(08:01):
categories, but it's just one ofthose issues that we continue to
watch change on because you knowespecially given that this rule
is still technically up in theair in the courts, but you know,
there's not much defense of itfrom the current administration.
It's hard to see. And I justwant to note also, you continue
to see healthcare systems dealwith overtime pay litigation.
There was a lawsuit filed inJune by nurse managers in
(08:23):
Georgia versus Humana, whichclaimed the company didn't
compensate them for overtimepay. It continues to be an issue
for not just health careemployers, but employers
generally just keeping track ofhours, keeping track of
exemptions, things of thatnature.
Jeff Byers (08:35):
Yeah. Do you foresee a future where this might be for
lack of better term settledwhere like administrators can
know what to do or how to thinkabout this?
Ryan Golden (08:46):
At the federal level
Jeff Byers (08:47):
we already hear?
Ryan Golden (08:48):
Yeah I mean at the federal level it's settled for
the time being, right? You knowfor the next four years we have
some sort of guarantee that it'snot going to go to the levels
that the Biden administrationproposed. So that's a bit of
ground for employers to look at.Whether we have future changes
again, it's one of those issuesthat just you know when a
Democrat is in office, they'revery insistent on changing it.
(09:08):
Have to recall and maybe youknow your readers are familiar
with the 2016 Obama overtimerule that was blocked similarly
by federal courts.
Before that rule, we hadn't seenan overtime threshold increase
since I think it was 02/2004. Sothis used to be an issue that
lawmakers came to back prettyinfrequently. Now it's a very
hot button topic that successiveadministrations have addressed
(09:29):
in some way shape or form. Sodefinitely wouldn't be surprised
to see it be addressed againbefore the next administration
comes into power. But it's oneof those things that for the
time being, there is a bit ofclarity going forward.
Jeff Byers (09:40):
Right. Well, thanks for providing some of that
clarity. Another hot buttonissue is pay transparency,
particularly in the wake of theCOVID nineteen pandemic. You
know, I'm sure prospectiveemployees love this, wanting to
know what the pay range is. Someemployers have given wild pay
ranges like $0 to half a milliondollars in in some job
(10:04):
descriptions.
Don't quote me, or don't quoteany particular job description
on that. But it looks it looksto be something taken up mostly
by states currently. Have weheard about how the transparency
is faring in terms of attractingor retaining talent? Like,
what's the latest on that?
Ryan Golden (10:20):
Yeah. That's that's dead on. State and local
lawmakers have really taken upthis issue, and it's one of
those employment law topicswe've been tracking for a while
where it's just we call it thepatchwork, right? There are
certain states and jurisdictionswhere they address this sort of
thing in certain states wherethey don't. And those areas that
do address it tend to have a lotof employers, a lot of large
employers.
Think about places likeCalifornia, New York, New York
(10:41):
City, Pennsylvania, know all upand down the East And West Coast
and in the Midwest as well. Paytransparency you know it's
something that the research onit is still very new. Will say
that whether or not it's abeneficial thing for reducing
things like pay gaps, I've seena lot of literature on it in
both directions. I wanted tocite a few statistics. So in
2023, we got a report from SHRM,which if you're not familiar is
(11:04):
HR's biggest industry tradegroup.
They found that pay transparencyhad a positive effect on
employers who participated inpay transparency. They saw a
boost to attracting skilledapplicants and SHRM actually
specifically said that 70% ofthe employers that surveyed that
had paid transparency say thatdoing so led to an increase in
applicants. We also had a vendorreport in 2023 from Payscale,
(11:27):
which said that paidtransparency reduced turnover
among employers. As far aswhether it reduces pay gaps, I
found a little bit of mixed asfar as I have my own reading of
it, my limited reading of theresearch out there. It's sort of
mixed.
There has been some reportingthat it reduces pay gaps in some
instances while it can also havenegative effects such as
discouraging lower performingemployees from asking for higher
(11:49):
pay. And that's lower performingin terms of whether they self
perceive as lower performingcompared to other coworkers or
actually lower performing. Itdiscourages them potentially
from asking for higher pay whenthey see how their coworkers,
their cohorts are paid. So theresearch is still very new. I
would encourage people to justkeep an eye on it.
(12:10):
And I mean, or not what theemployer's perspective on pay
transparency is, it's clear thatthe states and local
jurisdictions are very active onit. We just had a new law passed
in Cleveland. So one of thebiggest cities in The US Midwest
now addressing this topic aswell.
Jeff Byers (12:26):
Yeah. Do you get a sense that this will kinda
trickle out even more patchwork,as it becomes more normalized,
or is it a yet to be determinedkinda thing?
Ryan Golden (12:37):
Yeah, it's one of those things where federal
lawmakers have tried to putforward legislation to address
it. Effort has succeeded so far.So you have this as with many
employment law topics, you'llfind there's just different
approaches on a state by statebasis and even on a city by city
basis. So for now it's very muchthat patchwork until you have a
(12:58):
federal law that provides alittle bit more, you know,
clarity and security.
Jeff Byers (13:01):
So much like pay transparency was buzzy coming
out of COVID-nineteen, alsoremote work was a big, big topic
because it was kinda necessaryin 2020 and 2021, and now you
kinda see some return to workefforts. Have you seen from an
HR, you know, retention andattracting talent perspective,
have you seen any trends fromremote or hybrid work that have
(13:24):
bared out any interestingresults that you could share?
Ryan Golden (13:28):
Yeah. I mean, this is of course a hot button topic
and it's hard for me to think ofa specific statistic, but I will
say one thing that weconsistently find looking at
surveys of job candidates isthat they value flexibility.
Flexibility continues to besomething and flexibility that
can encompass you know full timeremote work, it can also
encompass a hybrid work you knowpart time in office, part time
(13:50):
at home or somewhere else. Evenlike flexibility in hours, like
maybe you have a schedule thatyou can choose a certain number
of hours per week or you canwork a certain time frame in a
given week compared to adifferent day where you work a
different timeframe. Those kindsof options have tremendous sway
among job candidates and ofcourse it's become more in vogue
(14:11):
for employers to return tooffice or RTO as we call it.
You see more and more employersdoing that. Would say it's
fairly mainstream. We had atransition period in COVID from
like, I'm going say '22 to '24where employers were in the
middle in large part on this,but I think we fully swung in
the direction of RTO since then,at least for most large
(14:32):
companies, right? And that hasaffected employee relations,
it's affected talent, but Ithink the constant drumbeat I
hear from analysts and HR folksis that flexibility is still
valued. So even if you have anRT requirement you know, letting
people come to the office acertain amount of days and also
work from home a certain amountof days per week is still very
(14:53):
valued as is the things like youknow being able to have
flexibility in scheduling andshift changes and things like
that.
Jeff Byers (14:59):
Yeah. And another hot topic is non compete
agreements. You see this in thehealth care provider space and
in health tech space a lot, orin the start up world as well,
which includes a lot of healthtech start ups. There was a
final rule, kinda barring thesenon compete agreements, but it
looks like it's working its waythrough the courts, and non
(15:21):
competes are permissible in themeantime. What can you tell us
about this?
Ryan Golden (15:25):
Yeah. That's right. You're referring to the Federal
Trade Commission FTC ban on noncompete agreements with some
limited exceptions. This wasunder the Biden administration
in 2024. They allowed someexceptions for certain senior
executives and they sort ofoutlined what that looks like.
It was a very shot. Would say itwas kind of surprising for us in
the HR space to see that happen.However, it was effectively
(15:46):
tied. It was struck down by afederal judge months before its
September 2024 deadline. Itnever took effect and it's still
tied up in the courts.
We're not quite sure where thatrule goes from here. We have
quite a bit of bipartisanthere's been some interesting if
you look out at the accountsthat are available in news
websites, can see that there arepoliticians and there are
(16:07):
influencers on both sides of theaisle who sort of look at non
compete bands positively, thinkthat they're a bottleneck on
competition. You also have quitea bit consensus in the business
community that you know thesekinds of agreements are valued
because they help protect thingslike trade secrets, customer
bases. You know there's quite abit of variety and perspective
there compared to some of theseother topics. So as far as where
(16:28):
let's say the Trumpadministration goes on this,
think it's really yet to beseen.
We haven't really seen theadministration firmly say where
they're going to stand on this.But what I can say is that in
the meantime, the states havemoved forward in implementing
non compete bans. So I wanted tocall a few out examples that
specifically affect thehealthcare industry. So a law
(16:49):
firm that we file, WhitlerMendelson, they've reported that
several states have enactedthese kinds of agreements
specifically affectingphysicians and other
practitioners this year. Oregonpassed a law in June which voids
non competes which involveworkers with certain medical
license.
And in Texas there are time andgeographic based limitations
according to regulations thereon non competes for a physician.
(17:10):
So I hate to be repetitive, butyou know this is very much
something where the states havetaken the lead for the time
being while the FTC rule is sortof held up in the courts.
Jeff Byers (17:22):
Is there a specific definition of the term trade
secrets yet?
Ryan Golden (17:26):
Yeah. I mean, I would probably defer to an
attorney on that one, but Okay.You know, yeah, like the non
compete as a concept, right, isto protect from competition with
a competitor right. So the mainthrust of that kind of agreement
is it's a restrictive covenantand the goal is to protect the
customer base, to protect thebusiness. There are other forms
of restrictive covenants thatemployers can look to in the
(17:48):
meantime, things like NDAs, nonsolicitation agreements.
There are things like gardenleave, which is a arrangement
where you pay someone to notwork for anywhere else you know
or work for a competitor for acertain amount of time after
they leave the business. Andthere are some wrinkles in
garden leave that you may wantto consider legally looking at,
you know, depending on wherewhat regulations are in your
(18:10):
specific little geographic area,but there are other options
besides non competes is thepoint. And there are many
motivations to pursue noncompetes, I think. But yeah,
that's that's I guess the answerto the question is it varies
depending on who you talk to.
Jeff Byers (18:25):
So as we wrap up, are there any other major
federal or state HR rules, thatyou feel our listeners should
know about?
Ryan Golden (18:32):
Yeah. Absolutely. I just wanted to call out again
the artificial intelligence andthe hiring process part of it. I
think it's relatively new. We dohave a handful of states.
We have a tracker on this on ourwebsite. We have a few states
and cities that have implementedlaws that specifically regulate
AI and hiring. The most notableones are probably New York City
(18:52):
and Colorado. Colorado is fairlyextensive. There are
requirements around notifyingapplicants about using AI,
disclosing what the AI is usedfor, what it does, and there are
even certifications.
So there are requirements. Ithink New York City has a
requirement that you have toactually recertify the system
with the city government. And Iwould check my tracker on that
(19:13):
just to be sure. But yeah, it'ssomething that's emerging and
we're actually watching inCalifornia. They are developing
regulations around this and Ibelieve a few pieces of
legislation around AI andhiring.
California, just for those whoaren't aware, is sort of seen as
a bellwether for employment law.So if California passes
something, it's very likely thatother states will move forward
and do something similar. Andgiven that California is where
(19:36):
many of these AI companies arebased, it's super, it's double
impactful because it directlyimpacts some of the biggest
players in the AI space ingeneral. So that's something to
keep in mind.
Jeff Byers (19:46):
Yeah. And that website is hrdive.com. Ryan
Golden from HR Dive. Thanksagain for joining us today on
Health Affairs This Week. Isthere anything, just as we wrap
up one final time, that youwanna promote while you're here?
Ryan Golden (20:01):
Yeah. And thanks so much for the opportunity, Jeff.
If you have an HR professionalat your practice or organization
who's struggling to keep up withall this, hey, we get it. We've
got them covered at HR Dive. Ourcontent is free to readers.
We don't have paywalls. We covernews, general tricks. We've got
daily and weekly newsletters. Sothe daily issues, they cover
general news and talent specifictrends, so recruiting, that kind
(20:23):
of thing. The weekly issuescover compliance, training, DNI
and compensation and benefits.
So I highly recommend the weeklynewsletters for those who want
snapshots of specific topics.The daily ones are more of a
broad based overview. And I alsowanted to highlight in October,
October 8, we have a free livevirtual event coming up at HR
Dive on open enrollmentplanning. So open enrollment
(20:45):
interfaces with healthcare quitea bit. If you have, if you
manage employees or manageemployee benefits plans or you
interact with employers, healthplans that may interest some of
your listeners.
And one of our reportersactually, Ginger Chris, she'll
be hosting a panel at that eventon the unsustainable health care
cost increases we've been seeingin The US. I know that's a hot
topic and she'll be specificallytalking about what strategies
(21:09):
employers are using to addressthat. So that may be of
interest. Yeah. And Jeff, youcalled out the website
hrdive.com.
We're also on social media, X,Facebook and most prominently on
LinkedIn where we not only do wepost our stories, we also have a
discussion group for HRprofessionals who are interested
in talking about, you know,professional issues, you know,
(21:30):
different trends they're seeing.We we see a lot of different
variety from our folks onLinkedIn.
Jeff Byers (21:35):
Well, great. Thanks for sharing that information.
We'll post links to HR Dive andhopefully the event in the show
notes for this episode. RyanGolden, thanks again for joining
me today on Health Fairs ThisWeek. And to you, the listener,
if you enjoyed this episode,please send it to, the recruiter
in your life.
Thanks again, and we'll see younext week.
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