Many of these challenges remain, particularly around regulation, payroll management, equitable distribution, retention of health workers in hard to reach areas and improving performance to impact the quality of services provided.
And the realities of running a business can be equally mundane, from the government regulation to payroll.
"If you don't like change, this is not the industry to be in," said Lunsford, who was forced to close her Colorado business selling medical marijuana-infused topical creams because she couldn't comply with state and federal regulations, submit payroll taxes or even qualify for a business bank account.
The lack of regulation in the payroll card market, while alluring for some of the issuers, can potentially leave cardholders swimming in fees.
The cost — in time, money and worry — of preparing returns, tweaking payroll systems and complying with regulations will rise, too, they say.
The policy prescriptions that he said flow from this analysis are not surprising: they are the core of the Obama election-year agenda, and include carrying out the new health care law, further extending the payroll tax cut, maintaining strong regulations on the financial sector and ending "unnecessary tax cuts for the wealthy".
Massive call centers, actuarial risk data, government regulations and compliance, customer data, payroll, GL, HR, business analytics and company big data are key ingredients.
The Internal Revenue Service issued regulations today requiring companies and employees to pay the 15.3percentt payroll tax on the exercise of incentive stock options and proceeds from employee stock purchase plans.
For banks that are looking to recoup billions of dollars in lost income from a spate of recent limits on debit and credit card fees, issuing payroll cards can be lucrative — the products were largely untouched by recent financial regulations.
