American Recovery and Reinvestment Act 2009 (ARRA)

American Recovery and Reinvestment Act 2009 (ARRA)

The American Recovery and Reinvestment Act of 2009 (ARRA) contains a variety of provisions intended to boost economic activity and employment in the United States. The main objective of the $787 billion American Recovery and Reinvestment Act is to lower health care costs; reduce medical errors; improve point care; improve access to data, such as healthcare IT, opportunities will arise to improve business intelligence programs in healthcare; and improve quality.

Incentive for Physicians:

Physician incentives are allocated in two different payment forms of Medicare and Medicaid reimbursements in addition to grant programs. Physician can start earning incentives in 2011 by demonstrating “meaningful use” of EMR. Physicians can earn from $2,000 to $18,000 in a given year. The department of Health and Human Services (HHS) will be defining the clear definition of “meaningful use” in the year ahead.

This "meaningful use" implies using the technology to exchange electronic health data to improve care quality and submitting care quality measures to HHS. In addition, hospitals and doctors will need to meet these requirements within a specified time frame to receive incentive money and avoid penalties.

In order to provide information about receiving incentive payments, Healthcare Information and Management Society (HIMSS) has a few suggestions:

1. Rely on Certification Commission for Health Information Technology, (CCHIT), as the certifying body for EMRs.
2. Adopt metrics that can demonstrate meaningful use, and make them increasingly more stringent over two years or so.
3. Work with Healthcare Information Technology Standards Panel (HITSP) and Integrated Healthcare Enterprise (IHE) to make sure systems are interoperable.
4. Close the existing gap between "certified EMR technologies," "best of breed," and "open source" technologies

As per the law defines, eligible providers will be treated as a meaningful user of EMR technology if they meet the following three criteria:

• Uses a certified EMR in a meaningful manner, which includes the use of Electronic prescribing (e-prescribing)
• Uses a certified EMR that can accommodate the electronic exchange of Health information to improve quality of health care
• Submit information on clinical quality measures, as chosen by the Health and Human Services (HHS) Secretary, for the reporting period

Medicare Incentive:

Those providers who are not adopting EMR by 2015 will see reductions in their Medicare reimbursements of 1% in 2015, 2% in 2016 and 3% in 2017. The possible incentive will be offered maximum of $44,000 per physician, depending on when providers implement EMR. In order to receive the full amount, physicians must be implementing EMR by 2012; therefore, no payment will be made available after 2015.

Year-EMR use is first demonstrate	Provider will receive incentives each year
	2011	2012	2013	2014	2015	2016	Total
2011	$18 K	$12 K	$8 K	$4 K	$2 K	$0	$44 K
2012	$0	$18 K	$12 K	$8 K	$4 K	$2 K	$44 K
2013	$0	$0	$15 K	$12 K	$8 K	$4 K	$39 K
2014	$0	$0	$0	$12 K	$8 K	$4 K	$24 K

Not adopting EMR by the year	Providers will see reductions in their Medicare reimbursements (%)
2015	1
2016	2
2017	3

Source: American Recovery and Reinvestment Act 2009


Providers will get incentive either from Medicare or from Medicaid under the stimulus package, because they can not get both according to the law.

Medicaid Incentive

Under the ARRA, providers will earn from $21,250 to $25,000 for the first year of payments, which may be not after 2016.

Eligibility of the provider

• Physicians, nurses and midwife nurses who are not hospital based and whose patient volume is at least 30 percent attributable to Medicare, are eligible for up to maximum 85 percent of their net allowable technology costs, which is subject to specific annual limits.
• Medicaid Incentives will be available only to non-hospital based clinicians, encompassing dentists, certified nurse midwives, and physician assistants practicing in rural health clinics.
• Medicaid incentives range up to $65K over a five-year period.
• Acute care hospitals with Medicaid patient volume of 10 percent or more and children’s hospitals with any Medicaid volumes are also eligible.
• Medicaid has not mentioned any penalties for lack of adoption of EMR.
• After obtaining startup funds, providers who will prove "meaningful use" can eligible to receive up to $10K annually payments for an additional four years.

Year - EMR use is first demonstrate	Provider will receive incentives each year
	2011	2012	2013	2014	2015	2016	2017	2018	Total
2011	$25 K	$10 K	$10 K	$10 K	$10,K				$65 K
2012	$0	$25 K	$10 K	$10 K	$10 K	$10 K			$65 K
2013			$25 K	$10 K	$10 K	$10 K	$10 K		$65 K
2014				$25 K	$10 K	$10 K	$10 K	$10 K	$65 K
2015					$25 K	$10 K	$10 K	$10 K	$55 K
2016						$25 K	$10 K	$10 K	$45 K

The Congressional Budget Office estimates that approximately 90 percent of doctors and 70 percent of hospitals will be using EMR within the next decade, as a result of the American Recovery and Reinvestment Act of 2009.

To learn more about ARRA and how your practice can benefit from this incentive, contact Pranagy today!
D. Patrick Howard, MBA, PMP
COO, Pranagy Unlimited, LLC
(o) 888-454-0442 ext. 125
(c) 727-239-2483
dpatrickhoward@pranagy.com
www.pranagy.com
Single-Sourcing Solution for Healthcare Technology Projects™

Ref:
http://www.cchit.org/
http://www.himss.org/ASP/index.asp
http://www.hitsp.org/
http://www.recovery.gov/Pages/home.aspx
http://www.ihe.net/

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PranagyMed Expands to Healthcare Business Solutions Suite

PranagyMed Expands to Healthcare Business Solutions Suite

Nov. 2, 2009 (Tampa, FL) – PranagyMed, a leading health care staffing and recruiting firm based in Tampa, Florida has expanded its services to include outsourced medical billing and claims management as well as medical transcription services to meet the demand of its current client needs in administrative cost reduction.

As the American health care industry struggles with the current economic state, many hospitals and clinics are becoming ultimately concerned about revenue cycle management. PranagyMed's nationwide client base for staffing and recruiting services have been inquiring about medical billing and transcription services as they prepare to take these tasks outside of the business office to reduce in-house administrative costs that tend to cost more than the actual revenue received from medical claims and direct payments from non-insured patients.

"Processing medical claims faster and less expensively, as well as documentation processes, is one way to counteract the negative effect the current high rate of uninsured patients have on the revenue of hospitals and clinics," says Monique Marlow, CEO of PranagyMed.

Ms. Marlow began her career working for some of the nation's largest medical billing networks in the U.S. in the early 1990's and moved into health care technology as a senior project manager for companies including WebMd/Emdeon, WellCare, ACS and BlueCross/BlueShield. As the founder of PranagyMed, she brings clients a vast amount of knowledge in streamlining both business and technology processes.

PranagyMed has created a unique system to reduce the cost of medical billing and transcription as well as claim rejection rates, errors and reporting through the use of its claims management software system and dedicated goal-driven service teams and account managers. The primary mission of PranagyMed's new services is to increase on claims by twenty percent and reduce administrative costs by thirty percent compared to the client's current methods.

The company has already proven its ability to provide lower cost staffing and recruiting solutions to its current client base and believes it can further assist the health care industry with the need to cut costs in critical areas that negatively affect the bottom line. PranagyMed's outsourced billing and transcription services assist providers in the following key areas:

• Allows providers to focus on patient care and less on business
• Reduces claim rejection rates and errors to below 5%
• No overtime or employee benefits are paid (PranagyMed teams work holidays and weekends)
• No taxes paid on employees and training costs are eliminated
• Flat rate for all billing services based on a percentage of collections
• Claims are processed faster and paid faster, boosting the revenue cycle
• All claims processed meet government compliance
• Digital technology (green technology) reduces paperwork costs
• PranagyMed keeps current with healthcare reform and will be adaptable to new electronic health record technology

PranagyMed's vision with these benefits is to increase medical practice profits by 45% after the first contract year, helping to stabilize health care costs across the nation and reduce administrative strain on both small and large providers.

About PranagyMed

PranagyMed is a division of Pranagy Unlimited LLC, a healthcare project management consultancy based in Tampa, Florida. PranagyMed was launched as a staffing and recruiting solution for personalized services and cost reduction in connecting health care employers with medical professionals. As an outsourced solution, PranagyMed's mission is to strengthen the backbone of the health care industry with a suite of solutions, including staffing, billing and claims management, and medical transcription services all under one roof, immediately improving revenues and reducing the strain of health care business operations. For more information, visit http://www.pranagymed.com, 888.454.0442 or email info@pranagymed.com. For media contact and to interview Monique Marlow, please call Desiree Bryant at 888.454.0442 ext. 127 or email media@pranagymed.com.

Are you ready for the HITECH Act?

Are you ready for the HITECH Act?
What is meaningful use anyway?

Vision Statement and The Balanced Scorecard

An additional point that can be made to complement a recent article by Bob Larrivee – AIIM "Whose vision is it?" is the value of the balanced scorecard.

The vision is to focal point of the organization's strategy. One tool that depends on the vision as well as the mission statement is the balanced scorecard. The balanced scorecard is a performance management tool that can measure whether the day-to-day operational activities of an organization are aligned with its larger objectives in terms of vision and strategy. Implementing a balanced scorecard will provide many benefits to organizations of all sizes. These benefits include an increased focus on strategy and result and improved organizational performance by measuring what matters most. The balanced scorecard will also improve communication of the organization’s vision and strategy as well as prioritize projects and initiatives.

The foundations of the balanced scorecard are the vision and mission statements and the strategies of the company. Once strategies have been identified, they are placed in a four-quadrant perspective matrix representing financial, customer, innovation and learning, and internal process perspectives. The balanced scorecard has evolved from its early use as a simple performance measurement framework to a full strategic planning and management system. The “new” balanced scorecard transforms an organization’s strategic plan from an attractive, but passive document, into the "marching orders" for the organization on a daily basis. It provides a framework that not only provides performance measurements, but also helps planners identify action items and measurement focus. It enables executives to truly execute their strategies.

dpatrickhoward.com

The Virtual PMO

A few of the most common questions we get at Pranagy Unlimited LLC are:

• Is a virtual project management office right for my organization?
• What does my firm need to start a PMO?
• What are the benefits of a PMO?
• How does my company start building a project management organization?

Here are a few answers...

Where the virtual PMO works

Collaborative corporate cultures are well suited to the virtual project management organization. In mid-2000, The New York Times Co. launched a virtual project management organization (PMO) with a decidedly different approach than the centralized model. The first PMO was "centralized with an iron fist," says Vice President and CIO Michael Williams. " Every task was reported, which was fine for that exercise, but it really wouldn't work in our culture. After Y2K, we adapted a new PMO to our collaborative culture." The current virtual PMO offers project management guidelines via an intranet.

What you need to start a virtual PMO

The virtual PMO starts with :
1. A Project Management methodology - this is often a collection of documents to fill out and who to send them to, and it should be supported by…

2. A Project Management Office, which contains the following:
• Guiding standards
• Business-led Enterprise Architecture preferences
• Methodologies (workflows, best practices, understandings)
• Process designs (functions, processes and procedures)
• Enterprise-wide quality and process initiatives (Balanced Scorecard, CMM, 6Sigma, ITIL, PMBOK, etc)

Communication in a virtual PMO

The matrix below is based on a table from Mastering Virtual Teams (Duarte and Snyder, 2001), can assist in choosing the appropriate technology based upon the purpose of the communication needed. As Figure 1 shows, synchronous multi-media communication is most effective. The firm's staff may need to increase the use of electronic meeting system with audio/video and text and graphics to improve communication. One example of such a tool is WebEx. The firm may also want to consider expanding its use of instant message technology both internally, as well as externally.

Care should be taken when embracing an instant messaging communication tool. Workers that utilize instant messaging need to learn how to manage their time between their existing, familiar media, and this technology. One pitfall of instant messaging, if not addressed, is the potential for disruption. Instant message software often has settings to allow or disallow “pop-ups”, as well as setting the availability of status. Workers must learn how to set their status appropriately in order to effectively limit disruptions at times when their individual productivity would be negatively affected.




Figure 1: Communication Technology Effectiveness Matrix
Source: Duarte, Deborah L. and Snyder, Nancy Tennant (2001)


Benefits of a virtual PMO

Enterprise Level Benefits - The collaborative PMO offers benefits at the enterprise level, some of which include :
• Portfolio, Program and Project alignment
• Clear alignment of all project initiatives to business benefits
• Management processes for effectively identifying, assessing, selecting, and managing programs
• A ‘centralized’ view (a single view of activity, resource allocation, etc.) of all projects across all programs
• Operational visibility which makes it easier for management to see how resources are being deployed and utilized
• Pre-selecting which programs to target so the portfolio best matches the enterprise-resource-mix for maximum on-going yield to the business

System Level Benefits - A collaborative environment for programs and projects provides:
• Rationalized IS and IT architecture support costs
• Visibility of all projects across the business
• Consistent application of best-practice project management approach and techniques across the business
• An agile environment that continually captures information
• Effective resource utilization and skills visibility
• Reduced mail-server load
• Project activity, information and communications coordinated




Moving toward a virtual PMO

The objective would be to move to a fully collaborative environment so that there is a single source of project information across the enterprise.


Implementation steps

To implement a collaborative PMO a staged approach must be taken. The first stage has two objectives. The first objective is to conduct an analysis of the current state in order to assess project operation and methodologies.

This is combined with a secondary objective of communicating the business framework that the new environment will operate within.

The objectives are:

1. Analysis of your current methodology and its delivery mechanisms to understand and clarify potential impact

2. Communicating a business environment for collaboration framework
This is followed by a requirements analysis and a situational report that includes:
• Development of ROI
• Securing high-level management support and funding based on ROI
• Establishment of a stakeholder-led Project Review Committee

The virtual PMO framework is established within the context of portfolio, program and project management operations. When the virtual PMO framework is established and supported by collaboration it becomes an automated framework for the governance and operations management of programs and project management. An electronic ‘wrapper’ that delivers end user project services across the enterprise.

The collaborative business environment of the virtual PMO framework wrapper focuses on electronically delivering information, the workflows associated with program and project management and at a later stage, possibly automating the product/solution configuration processes. A collaborative business environment decreases politics, organizational resistance, and business silos.

Using a collaborative approach will also enable HR management services to be integrated into the process and indicate the operational, management and control mechanisms managing and delivering the outcomes of programs and projects which may be lacking, or are inconsistent across a number of areas of business operation.

The virtual PMO framework provides the organizational structure and technical enablers required to capture information effectively, continuously leverage knowledge in order to support increased economies of scale of operation and effectively manage business complexity.

Learn more about the virtual project management office at www.pranagy.com

References:

http://www.pmolink.com/articles/540.5106WhyYouNeedaPMO.pdf
Megan Santosus, Why You Need a Project Management Office; Jul. 1, 2003 Issue of CIO Magazine

BvW Global Pty Ltd and its Associated Partners Page 2 of 10; White Paper: Collaborative Project Management Office (PMO) New Ways of Thinking…

WHAT MAKES AN OUTSTANDING HEALTHCARE PMO?

A Project Management Office (PMO) is general terms is a group within an organization that has a primary goal of maintaining standards of process as it relates to project management. The PMO is tasked with standardizing redundant tasks and introducing economies of repetition in the execution of projects. As with most tasks that follow a process, repetition and adherence to standards can reduce mistakes and increase the quality of the outcome. As the saying goes, “practice makes perfect.”

To accomplish this standardization, the PMO is the source of documentation, guidance and measurements on the practice of project management and execution.

So, how would a healthcare PMO differ from that of a typical PMO? Lets consider it a given that a successful PMO will use industry standards methodologies and tools, such as PMBOK, Agile or SCRUM. Those best practices relate to the art and discipline of managing projects on the broadest of terms. The collective knowledge of project management can be applied to many disciplines and business models.

What makes a PMO within a healthcare organization’s IT shop successful? For a PMO in a healthcare business to achieve peak effectiveness, the group must have specific knowledge of healthcare subject matter. Healthcare is rich with government regulations which constantly change the landscape of IT. New legislation is written almost daily which mandates changes in healthcare organizations. The IT departments and PMO within healthcare organization must constantly stay informed of these changes and navigate the treacherous waters of implementing changes in existing enterprise systems.

The language and nomenclature of healthcare is vast. Commanding the lingo of healthcare as it relates to information technology projects can take many years to master. An experienced and seasoned healthcare PMO has these environmental aspects of healthcare woven throughout the DNA of its members.

In integral part of the PMO is the ability to analyze the requirements of the healthcare business and select and utilize project management software. The seasoned healthcare PMO has members that are fluent in the dialect and acronyms of the business of healthcare. This knowledge and understanding is critical in reducing misunderstandings and acts as a filter to the technical side of the IT function.

Verbal and written communication skills are critical to successful PMO function. Knowing the healthcare parlance enables the members of the PMO, from business analysts to project managers to grasp key concepts and translate those concepts into action. A significant amount of communication is done in the form of online project management. It is also important to mention that the lack of understanding of healthcare phraseology and terminology can lead to disastrous work estimation mistakes, wasted time and money.

In summary, I believe that an outstanding healthcare PMO has a solid foundation in project management best practices. Built on this foundation is a group of seasoned professionals that have invested significant time learning the business and language of both healthcare and information technology.

How are projects managed in your organization?