PITTSBURGH, PA – ProspHire, a national management consulting firm focused on healthcare advisory, project delivery and strategic resourcing, announced today that for the 3rd year in a row, the Firm has ranked in the top ten on the Modern Healthcare Best Places to Work List under the category of healthcare supplier – ranking 6th in 2022, 8th in 2021 and 5th in 2020.
Health, community, advancement and flexibility are the keys to attracting and engaging employees at the top organizations, according to the List. Each year this program singles out and recognizes outstanding employers in the healthcare industry on a national level.
“The last few years have been incredibly challenging for the healthcare industry, so it’s more important than ever to create an environment where our employees feel valued and fulfilled in their work,” said Lauren Miladinovich, ProspHire’s Co-Founder, Managing Principal and CEO. “ProspHire has such a strong and dedicated team and they are genuinely passionate about the Firm, our clients and our purpose to help people thrive every day.”
Christopher Miladinovich, ProspHire’s Co-Founder, Principal and COO, said, “This award is an absolute honor and represents the strong culture that our entire team has built. We are very proud that our culture is committee led and championed by everyone at the Firm.”
ProspHire leaders believe you must start internally with employees who then lead you to great clients. “It’s exciting to be named to Modern Healthcare’s List of Best Places to Work in Healthcare because this accolade is based on the views of our team members,” said Dan Crogan, Principal and SVP of Consulting. “Placing in the top-10 three years in a row while going through such steep growth is a true testament to our incredible people.”
2022 has been another award-winning year for ProspHire. In addition to being named to Modern Healthcare Best Places to Work List three years in a row (2020-2022), ProspHire has been named to Inc. Magazine’s annual list of America’s Fastest Growing Private Companies for three years in a row – the Inc 5000 (2020-2022). The Firm also made the list for the Pittsburgh Business Times Fastest Growing Companies in the Pittsburgh region for four years in a row (2019 – 2022). That means we have built the trust of our clients through consistent and reliable results over time and have made significant investments in experienced resources to continue to provide high quality, healthcare specific professional services.
About ProspHire
ProspHire is a national management consulting firm focused on healthcare advisory, project delivery and strategic sourcing. Founded on the core value of relationships, with the goal to “prosper together”, ProspHire partners with clients to identify and solve their most significant people, process and technology challenges. The women-owned and rapidly growing Pittsburgh-based firm has nearly a 100 dedicated practitioners and consultants who deliver on projects and services across the U.S.
Healthcare and insurance are essential for Americans, allowing them to receive necessary treatments and prescriptions. The passage of the Affordable Care Act (ACA) transformed many healthcare requirements, from more accessibility to lower premium costs.
However, the ACA also brought in new compliance regulations. Understanding the new healthcare compliance standards and how they affect insurance plans is critical, but ACA compliance requirements can vary by insurance type, making it a challenge to keep up with every regulation.
ACA compliance refers to healthcare plans that comply with the Affordable Care Act (ACA). Also known as Obamacare, the ACA was passed in 2010 to increase healthcare coverage. The law had these three goals:
Increase access to affordable health insurance.
Expand the Medicaid program.
Implement medical care delivery methods.
Overall, the ACA was a massive reform for health insurance plans in America. The act aimed to improve access, coverage and affordability of most health insurance types across the country. These are examples of some of its updates:
Health insurance exchanges: The ACA created health insurance exchanges. In these marketplaces, individuals and families can buy guaranteed issue qualified health insurance plans. A guaranteed issue plan means that issuers must offer products to all eligible individuals in the state. If an individual applies and meets all the eligibility requirements, the issuer must provide them with insurance.
Updated issue coverage: The law also updated guaranteed issue requirements. It prevents issuers from refusing coverage or charging higher premiums due to pre-existing conditions.
Premium subsidies: The ACA also offers subsidies for low- and middle-income purchasers. These subsidies can lower overall costs and make it easier for enrollees to afford coverage.
Coverage for essential health benefits: ACA-compliant plans must cover 10 essential health benefits. To comply with the ACA, health insurance plans must provide coverage for each element, from ambulance services to pregnancy care.
An ACA-compliant health insurance plan abides by all the new changes set in the ACA. All new insurance plans purchased after January 1, 2014, must be ACA-compliant. This law applies to both individual and group insurance plans. In other words, all plans after this date must reflect the changes passed by the Affordable Care Act.
What Companies Should Be ACA Compliant?
All companies offering insurance plans after January 1, 2014, must be ACA compliant. The coverage specifics depend on the type of insurance and health plan enrollees’ purchase. For instance, all companies with 50 or more employees must offer health insurance for their workers, but those with fewer than 50 aren’t required to.
Another differentiation with ACA compliance is with grandmothered or grandfathered plans. These healthcare plans took effect before 2014 and are subject to different compliance requirements.
Here is a closer look at these types of plans and their ACA requirements:
Grandmothered plans: These plans are also called transitional plans. They were created in the transitional period between 2010 and 2014, after the ACA had been signed into law but before it was in effect. Grandmothered plans must abide by some aspects of the ACA, such as the ban on lifetime maximums and coverage of essential health benefits. However, the rest of their coverage policies can stay the same as before 2014.
Grandfathered plans: Grandfathered plans were active before March 23, 2010. Similar to grandmothered plans, they can use their previous structures as long as they abide by some crucial ACA updates. They can remain in place indefinitely as long as providers don’t make significant changes.
While most health insurance plans must be ACA-compliant, the specifics of compliance vary. Here is an overview of the different types of health insurance types and ACA compliance requirements:
Individual and Family Coverage
Individual or family coverage plans are policies people purchase independently and not through their employer. For instance, an enrollee might buy a health insurance plan directly from a health insurance company rather than enroll through their worksite.
To comply with the ACA, individual plans must follow the outlined changes in the law. For example, all plans must feature:
Guaranteed issue to eligible applicants.
Coverage for pre-existing conditions.
Coverage for all essential health benefits.
No lifetime coverage maximum.
Small Group Coverage
The term “small group” refers to an employer or company that purchases health insurance for their employees. Businesses with 50 or fewer full-time employees are considered small groups. They are also required to comply with ACA requirements.
Small group requirements are very similar to the regulations for individual and family plans, including:
Guaranteed issue to eligible businesses.
Pre-existing conditions coverage.
No annual or lifetime limits.
All 10 essential health benefits covered.
Large Group Coverage
Employers with 51 or more full-time employees are considered large groups. The requirements for ACA compliance differ slightly for large group coverage. Many large group companies also choose self-insured plans, which can also follow large group rules.
ACA requirements for large groups include:
Mandated employee coverage: All employers with 50 or more full-time employees must offer health insurance to each employee. According to the Internal Revenue Service (IRS), a full-time employee is any worker who averages 30 hours or more of work each week.
Year-round guaranteed issue: Businesses can purchase plans year-round, allowing employees to enroll whenever necessary.
Coverage for minimum value: Large group insurance plans must cover a minimum value of at least 60% of average healthcare costs for each enrollee.
Coverage for preventative care costs: Unlike small group and individual plans, large group plans don’t need to cover all essential health benefits. However, large group plans must cover certain preventative care costs, such as cancer prevention or infectious disease prevention measures.
Contact ProspHire Today to Stay ACA Compliant
Healthcare companies must stay compliant with ACA regulations. If you have questions and concerns, use the form below to connect with one of our healthcare leaders today.
In the waning hours of September 7th , 2022, Health Plans received an HPMS memo indicating Plan Preview #2 availability for the Medicare Stars Program. Our team of Stars experts at ProspHire quickly put together a comprehensive data analysis of all cut points across each domain. Although we are still patiently waiting to understand the broader impacts to all health plans, we have some early indications of general performance – with CAHPS and other x4 weighted measures showing decreases in cut points.
HEDIS Performance – Cut Point Analysis
The HEDIS domain displayed inconsistent performance in cut points across most measures. With the lingering impacts of COVID and members forgoing preventative care, we may have anticipated more cut point decreases across the board. In terms of weighting, the x3 weighted Diabetes Blood Sugar measure showed improved performance at the 3-, 4- and 5- Star Level.
HOS Performance – Cut Point Analysis
The HOS domain remains challenging for health plans, with Reducing the Risk of Falling and Improving Bladder Control all showing a decrease in performance across nearly all cut points.
Operations Performance – Cut Point Analysis
The Operations domain (sometimes referred to as Admin domain) showed variable performance across the board. The 4x weighted measures (Call Center, Complaints, Members Leaving Plan) had non-consistent results. Cut point results indicate that there were more complaints in SY23. Additionally, the cut point analysis shows us that less members left their plan in SY23.
Pharmacy Performance – Cut Point Analysis
Following the historical trend, the Pharmacy domain continues to improve year over year. The 3x weighted Medication Adherence measures nearly showed 100% improvement across all cut points. Plans continue to do well in this category, and high-performing Stars Programs will continue to invest time and effort into this domain.
CAHPS Performance – Cut Point Analysis
As shown on the right-hand side, most measures across all star rating cut points had a drop in the cut point range, indicating that the distribution of CAHPS performance across plans saw a drop in scores from prior year. Despite much investment from Health Plans in member experience, there were no increases in any cut points across all measures.
Are you happy with your Plan Preview #2 data release? At ProspHire, we’ve been supporting Health Plans with their Stars Programs since our inception.
Healthcare is one of the fastest-growing industries in the United States. Over the decade, the Bureau of Labor Statistics (BLS) projects healthcare occupations to grow 16%, adding over 2 million new jobs to the economy. Recent U.S. census data shows that 22 million workers are employed in the healthcare industry already.
Utilizing project management is essential in such a massive industry that continues to grow at an astounding pace. Continue reading to learn more about project management in healthcare.
Why Project Management in Healthcare Matters
Besides the scale of the healthcare industry, other factors contribute to project management’s importance in healthcare.
One prominent factor is the stakes involved with patient care. There’s no denying that healthcare is an essential part of any society, ensuring its members can prosper. Further, healthcare is necessary whenever tragedy strikes. For these reasons, people depend on well-organized, quality healthcare services.
As healthcare expands and technologies develop, project management only becomes more necessary. Things like electronic health records, regulatory limitations and diverse stakeholders add countless processes and regulations around patient safety, privacy and quality of care that healthcare project managers need to be mindful of. Also, the many parties involved in healthcare interactions further complicate matters.
In any given healthcare transaction, notable parties include:
Patients
Nurses
Physicians
Health insurance providers
Government agencies
Whereas many other industries have more simplistic buyer and seller relationships, healthcare has added complexities. Thus, project teams must be diverse and adaptable enough to consider all views, concerns and party interests.
To summarize, healthcare project management is essential because of:
What Are the 5 Project Management Methodologies for Healthcare?
Project management methodologies are established principles and techniques that project developers and managers use to develop, carry out and manage projects. Here are brief explanations of five of the most popular project management methodologies:
1. Waterfall
The waterfall method is the most straightforward, linear and traditional approach to project management. It consists of several distinct phases that flow one after the other, just like a waterfall. Project managers using the waterfall method wait until each step is complete before moving on to the next one. Each phase is mapped out with clear expectations and desired outcomes and the project team regularly documents progress throughout each stage.
A key characteristic of waterfall projects is the use of Gantt charts. Such charts provide a visual overview of the project timeline with information on how long each phase will take. The waterfall approach is excellent for presenting a project to senior leadership and stakeholders.
The waterfall technique is also ideal for projects that require a rigid structure. Still, they can present difficulties for the project team to stick to the sequential, step-by-step process from beginning to end in process improvement projects when challenges inevitably arise.
2. Agile
Where the waterfall approach is slow and sequential, agile project management is fast and flexible. Agile methods follow an iterative approach of continual process refinement. The agile approach is much more open to change than waterfall project management, so long as it improves the process.
With project team structure, agile methods involve cross-functional team members who collaborate to drive the project forward. In this way, agile projects continually evolve as teams progress toward the end goal.
Still, a con of this approach is that it’s easy to get lost in minor details that provide minimal value to the project’s big picture. Agile projects especially run into this problem if the project’s big picture is vague to all team members. In the same way, they may seem less convincing to stakeholders and senior leadership when first pitched if the project’s big picture appears disorganized or lacks direction.
Agile projects involve stakeholders in project execution more than waterfall projects, which can prove beneficial if you can get past the first hurdle of getting approval. With that in mind, the agile method is great for industries with room for uncertainty and innovation.
3. Six Sigma
The Six Sigma process is all about continual process refinement. The main focus of the Six Sigma method is identifying and removing causes of defects and suboptimal efficiency in projects.
The results that the Six Sigma process aims to achieve are stable and expected. For this reason, Six Sigma project managers rely on quality management, empirical statistics and expert personnel in specific disciplines to bring the project to fruition.
Six Sigma projects require everyone from top to bottom to sustain project quality. This method works best in larger organizations.
4. Scrum
Scrum is a variation of agile project management involving project phases divided into short sprints. In contrast with the agile method, the scrum approach has smaller deliverables and more specific roles.
The lead role of a scrum project team is the scrum master, who forms and unites the group. Before each sprint, the scrum master assigns roles by asking each team member about their commitments and what they’ll accomplish concerning the project.
During each sprint, the scrum team holds daily scrum meetings to connect on progress, review commitments and address impediments. These meetings aim to sustain morale, ensure team members fulfill commitments and remove any obstacles to success. The scrum team also holds retrospective meetings at the end of each sprint to review accomplishments and what members can incorporate into the next sprint for continual process refinement.
The scrum method is great for projects that prioritize teamwork, quickness and efficiency.
5. Hybrid
The hybrid methodology merges the waterfall and agile methods, attempting to leverage the best of both. That said, the day-to-day operations of hybrid methods have a heavy focus on agile methods.
Hybrid methods use waterfall planning to present a clear roadmap to stakeholders and senior leadership for gaining approval. Having a clear roadmap also helps the execution team stay focused on the project’s big picture.
For example, a hybrid project may involve a structured rubric to present to stakeholders and senior leadership. That rubric is then broken down into detailed sets of tasks for the execution team. In this way, hybrid is a suitable method for projects that focus on improving outcomes.
Healthcare Project Management with ProspHire
ProspHire is a solutions-based healthcare consulting firm that will do everything in our power to help your organization thrive, expand and maximize ROI while remaining compliant with all regulations.
PITTSBURGH, PA – ProspHire announced today that it has ranked 4th in the $10 million to $20 million revenue category on the Pittsburgh Business Times Fast 50 List of the fastest growing private companies in the Pittsburgh Region. This is the fourth year in a row that ProspHire has made the list. The award recognizes the Firm for its exponential revenue growth between 2019 and 2021.
“We are honored to be recognized for the fourth year in a row by Pittsburgh Business Times Fastest Growing Companies. We will continue to focus on providing exceptional client service and helping to solve our clients most complex people, process and technology challenges in the healthcare industry,” said Lauren Miladinovich, ProspHire’s Managing Principal and CEO.
Christopher Miladinovich, ProspHire’s Principal and COO, said, “Our growth has been fueled by our amazing team of dedicated professionals who work tirelessly to earn the trust and confidence of our incredible clients. Growth in this climate is not an easy feat and we want to congratulate all the other Fast50 award recipients. Take in this moment.”
“Growth is a major focus at ProspHire and making the Pittsburgh Business Times Fastest 50 List is a combination of efforts from our staff and our clients,” says Dan Crogan, Principal and SVP of Consulting. “We are constantly striving to bring new and innovative solutions to our clients while also bringing rewarding career opportunities to our staff. This recognition is a sign that we are growing and going in the right direction and enables us to deliver even better results in the future.”
Learn About ProspHire
ProspHire is a national management consulting firm focused on healthcare advisory, project delivery and strategic sourcing. Founded on the core value of relationships, with the goal to “prosper together”, ProspHire partners with clients to identify and solve their most significant people, process and technology challenges. The women-owned and rapidly growing Pittsburgh-based firm has nearly a 100 dedicated practitioners and consultants who deliver on projects and services across the U.S.
The healthcare system helps provide life-saving treatments and prevention techniques to minimize the risk of negative patient outcomes. The Triple and Quadruple Aim are fundamental pillars of the healthcare field designed to ensure patients receive quality care. Learn more about the Triple and Quadruple Aim in healthcare and if there should be a 5th Aim.
What Is the Triple Aim in Healthcare?
The Institute for Healthcare Improvement (IHI) created the framework to aid healthcare organizations optimize performance with various metrics in 2007, known as the Triple Aim because it uses a three-pronged approach. The Triple Aim approach focuses on improving patient experience, reducing the cost of care and improving the health of populations.
1. Improving Patient Experience
A fundamental aspect of the Triple Aim is to improve patients’ experiences including the satisfaction and the quality of care. To improve patient experience on a population level, a healthcare organization should analyze a community’s overall health, determine specific risk areas and assess mortality rates.
Over the last few years, continuing initiatives aim to help patients visit and navigate healthcare organizations more efficiently and effectively. These initiatives focus largely on improving communication between providers. A few examples of these initiatives include accountable care organizations (ACOs), electronic health records (EHRs), shared decision-making and managed care organizations (MCOs).
Healthcare facilities can measure the effectiveness of these initiatives via patient satisfaction surveys and quality improvement measures.
The United States leads with the most expensive healthcare among wealthy democracies in the world. Despite high medical costs, the United States’ life expectancy falls short of many other countries with less expensive healthcare systems. Although medical expenses are rising, the overall quality of care isn’t.
Many other countries worldwide provide a higher level of care with significantly lower costs. Providing affordable healthcare without sacrificing quality takes a planned approach to be successful, as numerous factors directly impact healthcare costs and quality of care.
One aspect affecting cost and care quality is that the American population is aging, meaning many citizens are more prone to chronic or severe health complications. Many of these health complications arise from a larger number of people living longer lives.
Aging populations with higher life expectancies are naturally more prone to chronic or age-related medical conditions, which are often more expensive to diagnose and treat properly. Triple Aim is designed to help healthcare organizations find innovative ways to minimize costs when providing care while improving the overall quality of care.
3. Enhancing the Health of Populations
The third pillar of the Triple Aim is to prioritize the surrounding population’s health and address potential at-risk areas within the population.
Determining some of the most common reasons a specific portion of the population may need to engage with a healthcare organization can preemptively develop initiatives to minimize associated costs and offer patient-centered, coordinated care.
The IHI outlines five recommendations for healthcare systems to create new initiatives to serve their communities better:
Involve families and individuals when creating new care models
Assess and improve primary care structures and services
Increase healthcare promotion and illness prevention
Implement cost-control platforms
Prioritize system integration
What Is the Quadruple Aim in Healthcare?
The Quadruple Aim of healthcare is designed to improve overall healthcare efficiency and extend a system’s competitive advantage. The Quadruple Aim builds off the Third Aim and adds an overall goal of improving the work life of medical providers and their staff.
Enhance Healthcare Provider Work Life
Value-based care has become more popular and the quality of care provided has also become fundamental. Patient care, experiences and outcomes are directly tied to the providers offering medical care. Healthcare providers face immense pressure and strain, increasing the risk of negative outcomes that can lower the quality of care provided.
Lower morale and decreased staff engagement can lead to lower patient satisfaction, provider burnout, higher costs and poor outcomes, which all go against the scope of the Triple Aim. The Quadruple Aim addresses this gap, ensuring the fundamental aspects of the Triple Aim remain while adding another fundamental layer.
Should There Be a 5th Aim in Healthcare?
As the Quadruple Aim updated and refined the goals of the Triple Aim, many are now discussing what a Quintile Aim would be and if it would provide further value to healthcare providers and patients. Many believe the Quintile Aim in healthcare should focus on equity of care.
For example, medical conditions and access to medical care are widely skewed. In communities of color and communities with little to no English literacy, medical care is not as easily accessible. Unfortunately, this often means higher rates of illnesses and negative patient experiences.
While the Quadruple Aim is an important tool to address care gaps and provide standardized, high-quality care to all patients, many believe it is missing a fundamental aspect. The 5th Aim, wholistic health equity, can refine healthcare best practices and improve patient outcomes.
Wholistic Health Equity
The 5th Aim is proposed as another key aspect of efficient and effective healthcare. A fundamental element of wholistic health equity is ensuring inclusion, equity and diversity across populations with reimbursement that ensures value-based care accountability.
The 5th Aim proposes a new pillar to healthcare that serves as a quality compass for fair, equitable medical care across providers, populations and profit margins. For the 5th Aim to be successful, cultural awareness training is needed to help the healthcare system understand unconscious bias, which negatively impacts patient care.
The fundamental aspects of implementing the 5th Aim in healthcare include:
Equitable and adequate reimbursement for mental healthcare across public and private insurers
Grant funding to close gaps in treatment and care accessibility
Focus on provider shortages resulting from expanding provider networks
Attention to specialty healthcare needs, including communities of color as well as LGBTQIA+ communities
Treatment space to ensure access to quality physical and mental health services
Continuing education and training for practitioners and providers to mitigate bias and stigma
Access to mental health services without appointment delays
The healthcare field is designed to help sick and injured people become well again. While the system was created to help people, it unintentionally has harmed many communities because there is not equal access to reliable, quality care. Without equitable access, marginalized communities continue to be underserved.
An overarching goal of the 5th Aim is to address, mitigate and prevent implicit bias. Implicit biases and stigma are mental associations we make outside of our conscious thought, leading to a negative evaluation of a person based on irrelevant traits, including sexual orientation, religion, gender, ability and race.
In one study, over 83% of healthcare professionals implicitly preferred patients without disabilities. This implicit bias directly relates to negative patient experiences and poor quality of care. The 5th Aim focuses on bias training and further education to lower the prevalence of such biases.
How We Can Help
At ProspHire, we combine exceptional service and healthcare expertise for our clients. We are dedicated to helping our clients across the country provide high-quality medical care. Our team works with each client on an individual level to identify and overcome various obstacles.
We have the resources, knowledge and experience needed for success in the healthcare industry. Our team helps each of our clients improve their organization by ensuring they get the technology, tools and people they need for long-term success.
PITTSBURGH, PA – ProspHire announced today that it has been named #3337 on Inc. Magazine’s annual list of America’s Fastest-Growing Private Companies – the Inc. 5000. The rank reveal also put ProspHire at #14 in Pittsburgh, #84 in Pennsylvania and #330 in the nation for business products and services. The list represents a unique look at the most successful companies within the U.S. economy’s most dynamic segment – independent, small businesses. ProspHire, a national healthcare consulting firm, is recognized for its revenue growth.
“We are honored to be included on this prestigious list of the nation’s fastest-growing private companies for a third consecutive year,” said Lauren Miladinovich, Managing Principal and CEO of ProspHire. “This demonstrates our continued commitment to excellence as we navigate some of the toughest challenges our firm has ever faced. Our team remains focused on bringing deep healthcare industry knowledge and exceptional service to every client.”
The companies on the 2022 Inc. 5000 have not only been successful but also demonstrated resilience amid supply chain issues, the labor shortage and ongoing impact of COVID-19.
Chris Miladinovich, ProspHire’s Principal and COO, said, “The last few years have been volatile for small businesses like our Firm, so to be recognized 3 years in a row as an Inc. 5000 Fastest Growing Company is an absolute honor. We’ve had double digit growth year over year since our founding, which is a direct result of the amazing work of our employees and the partnerships with our clients. It proves our model for growth is thriving even through unprecedented economic times.”
“The accomplishment of building one of the fastest-growing companies in the U.S. cannot be overstated,” says Dan Crogan, Principal and SVP of Consulting. “It validates ProspHire’s leadership team and our employees who work tirelessly on behalf of our clients. Our success and continued growth in this highly competitive and demanding healthcare industry is a testament to that hard work and to our wonderful clients with whom we’ve been able to Prosper Together over the years.”
Complete results of the Inc, 5000, including company profiles and an interactive database that can be sorted by industry, region, and other criteria can be found at www.inc.com/inc5000.
About ProspHire
ProspHire is a national management consulting firm focused on healthcare advisory, project delivery and strategic sourcing. Founded on the core value of relationships, with the goal to “prosper together”, ProspHire partners with clients to identify and solve their most significant people, process and technology challenges. The women-owned and rapidly growing Pittsburgh-based firm has nearly a 100 dedicated practitioners and consultants who deliver on projects and services across the U.S.
As any healthcare executive knows, running a healthcare organization is complex and fast-paced, with many moving parts and minimal margin for error. A robust project resource management system is essential to respond to this tension well.
Hospitals and healthcare organizations provide essential services in any society, keeping us healthy, helping us live our lives well and providing care when we need it most. Learn more about the importance of project resource management for hospitals and healthcare organizations below.
What Is Project Resource Management?
Project resource management helps organizations control costs, reduce risks and improve outcomes. In the late 1960s, when project management emerged through a non-profit organization called the Project Management Institute (PMI), its initial goal was to:
Advance careers
Strengthen organizational success
Teach project management professionals new skills and enable them to maximize their impact
Even as new technologies have caused project management to grow exponentially, those goals remain relevant today.
What Parties Are Involved in Healthcare Project Management?
Strong project management involves several individuals working to streamline workflow. Significant positions within project management include:
Project managers: A project manager helps plan, organize and oversee the daily workflow of a particular team. Their guidance advances specific projects so the organization can achieve its goals in efficient ways.
Project sponsors: A project sponsor initiates the project and defines the desired outcomes. Sponsors also liaison with stakeholders and provide resources so the project team can fulfill their role.
Project teams: The project team involves any individuals who carry out work related to the project. These individuals include the project manager, sponsor and any non-management workers involved.
Project stakeholders: Any person that the project impacts is a project stakeholder. Stakeholders can include investors, customers, patients, employees or other organizations.
What Are the Phases of Project Management?
The four phases of traditional project management are:
Project initiation: When a project begins, the project sponsors review background information, market research and other pertinent data. After defining and aligning goals with organizational aims, the sponsors send the goals to relevant stakeholders for approval. Once the sponsors receive approval, they select a project manager to develop a project team and vision for execution.
Project planning: The project manager reviews the project goals that the sponsor has highlighted and develops a step-by-step execution plan. This plan outlines the budget, project-related activities and all individuals necessary to carry it out.
Project execution: While the project team carries out the activities, the project manager measures progress. The manager also monitors any significant deviations from the plan and responds appropriately.
Project closure: The project manager and sponsor review the results and report them to relevant stakeholders and team members. If necessary, they create an updated budget and timeline to compare to the original project scope.
Depending on the method used, a project management team may reorder or add to these phases to achieve the desired outcome. At ProspHire, our approach to project management is:
Project initiation: We align our approach with the business case and organizational benefits.
Project planning: We define the scope and project management strategy.
Project execution: We develop cadence with leadership and deliver the product.
Our outcomes include an improved speed to market, better communication models, stakeholder alignment and increased productivity. For example, we helped a managed care organization complete a large-scale software migration. Our oversight and expertise helped the client complete the project on time while staying within their scope and budget. As a result, they received a 2-3x return on investment.
How Is Project Management Beneficial for Healthcare?
While project resource management is beneficial for every industry, some of project management’s benefits for your hospital or healthcare organization include:
Enhancing patient care quality by streamlining processes involved in providing patient care.
Increasing productivity and sharpening communication among healthcare staff.
Strengthening organizational planning and refining budgeting to align resources with high-priority work.
Augmenting processes designed to decrease lawsuit risks through improved quality of patient care.
Improving relations with stakeholders such as insurance companies, clinicians, patients, caregivers or government agencies.
Importance of Resource Management in Healthcare
Healthcare is one of the U.S.’s largest growing industries and foundational to any well-functioning society. Effective resource management can prepare healthcare organizations for crises and help all patients receive adequate care.
As the U.S. population ages and more Americans obtain health insurance, the need for efficient and effective healthcare delivery processes increases. Additionally, crises like the COVID-19 pandemic or an economic recession can lead to patients delaying or canceling procedures. With less income from elective procedures, hospitals can lose revenue and struggle to provide adequate care to all patients. A robust project management system can help healthcare workers meet these inevitable challenges with readiness and confident action.
Medical error accounts for over 22,000 deaths per year, often due to miscommunication, mismanaged data or faulty processes. An effective project resource management system can help reduce errors by putting sound processes in place, upgrading facilities and software and improving staff training for best practices.
What Are Effective Resource Management Strategies for Healthcare?
You can choose from several resource management methodologies and strategies depending on what works best for your organization and project. Some standard resource management methods include:
Waterfall method: One of the most common project management methods, the waterfall method organizes projects in a sequential and linear pattern through several phases. Because the project team completes each stage before starting the next, the waterfall method offers fixed costs and predictability.
Agile method: Planning and execution co-occur in the agile method. Project teams collaborate with customers to break objectives into smaller tasks and rank them according to importance. The agile method is more versatile and adaptable than the waterfall method, allowing you to adjust your parameters and strategies as you go rather than following a linear path to reach your goals.
Hybrid method: The hybrid method combines the waterfall and agile approaches to bolster adaptability with effective planning. This method usually relies most on agile methodologies, incorporating waterfall methods at strategic phases.
Scrum method: Scrum is an agile methodology that organizes project tasks into “sprints” lasting one to four weeks. The Scrum master is the project manager, tasked with removing barriers and protecting the project team from outside forces that may impede progress. Regular team meetings to review the progress of each “sprint” are a defining feature of the scrum method.
Six Sigma method: While waterfall focuses on defined steps and agile emphasizes adaptability, Six Sigma is statistically driven. This method has a more hierarchical structure than other methodologies, prioritizing a standardized process by reducing defects and increasing the repeatability of optimal results.
The methodologies above are only a few examples of the many project resource management strategies used for hospitals and healthcare organizations. Our project management professionals at ProspHire have extensive knowledge of each method. Our team understands the ideal circumstances for each one and the most effective strategies for implementing them.
Optimize Your Project Resource Management with ProspHire
If your healthcare company could use enhanced project management strategies, our professionals at ProspHire would love to speak with you! We are committed to delivering results that provide value to every sector of your organization so you can give the highest quality of care to your clients and patients. We welcome you to fill out our contact form below to get in touch with us and learn more about how we can optimize your project resource management.
Healthcare payers are constantly looking for ways to reduce or improve costs. One way to do that is to acquire another company in the healthcare industry or join with another payer.
If your organization is looking for ways to grow and improve, you might consider merging with or acquiring another. Learn more about the difference between healthcare mergers and acquisitions (M&A), the benefits of each and how to successfully navigate one or the other.
What Is an Acquisition in Healthcare?
During an acquisition, one healthcare organization gains control of another. For example, one insurer could acquire another to increase membership or enter a new market with enhanced products and services. Though larger companies typically buy up smaller ones, in some cases, one insurer might purchase another similarly sized one.
Following an acquisition, the purchasing organization takes over the operations of the practice it bought, often changing the hiring policies, operating hours and HR standards.
A healthcare payer might decide to purchase another payer or service provider for various reasons.
To start offering a new service: Acquiring a company that offers a service related to healthcare, such as a telehealth network, allows a payer to offer a new service to patients. If an insurer acquires a telehealth vendor, it can direct members to that vendor, reducing its healthcare costs.
To increase its member base: Acquiring another healthcare payer allows the first payer organization to expand the size of its member base. For example, if a larger insurer purchases another, it gets access to the acquired payer’s members.
To reduce costs: An acquisition can be a cost-cutting move, as well. An organization can purchase a company that produces specific types of medical equipment or offers certain services, reducing its expenses in that department.
To expand geographically: Acquiring another insurer allows a healthcare payer to increase its geographic footprint. For example, a New York-based insurer can purchase a payer based in Philadelphia, allowing it to expand into another regional market.
Acquisitions can be friendly or hostile. During a friendly acquisition, the two companies cooperate throughout the process. The organization’s leadership team has accepted the offer and given their approval.
During a hostile acquisition, the management of the acquired organization isn’t in favor of the purchase. The management team might reject the offer from the acquiring company or try to block the sale.
During an acquisition, one organization absorbs the other. In contrast, the two organizations join forces during a merger. A payer merger might involve two similarly sized insurance companies teaming up to create a new, separate, larger organization. A payer might combine with a services provider to create a more robust product offering. Usually, mergers occur between two similarly sized organizations.
After a merger, the two organizations become the same legal entity. For example, if two healthcare payers merge, the new organization might change its name to reflect the shared market or to unify the formerly separate names.
Here are some of the reasons to consider a merger.
Reduce costs: When two healthcare payers become one, they share expenses, which can help save money. For example, the two payers might move into the same office space, significantly reducing the cost of rent. Some employees could become redundant, lowering the cost of labor.
Increase market share: Merging two healthcare payers allows them to increase their market share. The two insurance companies share members after the merger.
Improve patient care: The less work there is for the patient, the better their quality of care. When a healthcare payer merges with a company that provides services such as telehealth, getting access to care becomes much more straightforward. Patients can also feel more confident that their insurance will cover the cost of services they receive from all companies connected to the payer.
What Are the Benefits of Mergers and Acquisitions in Healthcare Organizations?
If growth is one of your healthcare organization’s goals, a merger or acquisition can help you achieve it. In addition to expanding your organization’s reach and market share, here are some of the benefits of a merger or acquisition.
Creates a more patient-centric organization: Whether you acquire another payer or join forces with an organization, you can build a patient-focused organization. Expanding the size of your administrative staff by merging with another payer or a healthcare services provider can improve claims processing and increase efficient, accurate billing. An acquisition or merger can also increase the size of your member support teams, such as call center representatives. You can also offer direct services to patients, such as through telehealth nurses and physician’s assistants, creating more care opportunities..
Raises employee engagement: Smaller payers often expect employees to take on extra tasks, potentially leading to burnout. When more people share duties and the efforts of two organizations have combined, the workload lightens. That can lead to more engaged employees who are excited to come to work daily.
Creates more opportunities for your organization: Acquiring another healthcare payer or organization lets you move into regions you wouldn’t otherwise have access to or add services your organization didn’t previously offer. The more geographically diverse or well-rounded your organization is, the further its reach and the more potential it has to establish itself as a leader in the healthcare industry.
How Do You Negotiate a Healthcare Merger or Acquisition?
During a merger or friendly acquisition, you want an outcome that works for both parties. The secret to a successful healthcare merger or acquisition is having a specific idea of what you want to gain from it before beginning the process. Knowing what your organization needs to grow will guide you through the process of choosing another healthcare company to merge with or another practice to acquire. Don’t rush the process.
It can be helpful to get outside support during the M&A process. ProspHire’s growth and expansion services can help you develop a strategy to improve your organization’s profits and to secure its future.
ProspHire Can Help Your Healthcare Organization Grow Through M&A
If you’re ready to transform your healthcare organization, ProspHire is here to help. Our business growth and expansion division has experience providing support to organizations that want to grow internally and externally. We work with you to develop a strategy and roadmap to guide you to where you want to be. Contact us below to learn more.
PITTSBURGH, PA – ProspHire, a national management consulting firm focused on healthcare advisory, project delivery and strategic resourcing, announced today an expansion of its presence through the addition of 3,500 square feet of office space in the Philadelphia market to accommodate the Firm’s fast-growing client-base.
The expansion will help to better serve local health insurance and provider systems in the market. ProspHire’s expertise in managed care programs (Medicaid, Medicare and DSNP markets) will be especially relevant to local health plans who are facing challenges with rapidly changing regulations and membership changes because of the “new normal” that is emerging from the COVID-19 pandemic.
Located in King of Prussia, this new, modern office space offers a wide array of meeting areas from enclosed glass rooms with large flat-screen TVs, community seating areas and a town hall area to host larger team gatherings. Additional features include a fully stocked kitchen, TVs integrated with cutting-edge screen sharing and communications systems and community seating for up to 50. Our clients will also be able to leverage these spaces for in-person collaboration while partnering with ProspHire on their engagements.
ProspHire has had tremendous growth since its founding in 2015. “We’re opening the office in Philadelphia at such a vibrant time, hoping to take advantage of the city’s energy and making it easier for healthcare consulting talent to take the next step in their career with us,” said Lauren Miladinovich, Managing Principal and CEO. “We believe King of Prussia is the perfect location for our clients and our employees alike. We’re excited to experience all the area has to offer and expand our business to Philadelphia and the surrounding market.”
Since ProspHire’s inception, the Firm has provided clients with unmatched quality and service and helped a variety of healthcare organizations implement transformational solutions that have allowed their businesses to thrive. The Leadership Team believes that a boutique healthcare consulting firm can truly make a bigger difference in Pittsburgh, Philadelphia and across the United States for healthcare organizations that need innovative, value-add solutions. Being in the Philadelphia market also enables ProspHire to hire motivated practitioners who know and understand local clients. The hope is to inspire them in building closer connections and providing innovative solutions for complex health plan challenges.
ProspHire continues to receive workplace accolades for its culture. In 2022, Modern Healthcare named ProspHire a Best Places to Work in Healthcare for the third year in a row. In 2021, the Firm also ranked in the top ten on the Pittsburgh Business Times Fast 50 List of the Fastest Growing Private Companies in the Pittsburgh Region. Additionally, ProspHire was named an unprecedented 2 years in a row to 2021 Inc. Magazine’s annual list of America’s Fastest-Growing Private Companies – the Inc. 5000.
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ProspHire is a national management consulting firm focused on healthcare advisory, project delivery and strategic resourcing. Founded on the core value of relationships, with the goal to “prosper together,” ProspHire partners with clients to identify and solve their most significant people, process and technology challenges. The woman-owned and rapidly growing Pittsburgh-based firm has nearly 100 practitioners and consultants who deliver exceptional service to each one of our clients across the U.S. Visit www.prosphire.com.
