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five small wooden stars

CMS Final Rule Stars Program Update

Overview: Changes to STARS Program

On Jan. 15, The Centers for Medicare and Medicare Services (CMS) announced changes to Calendar Year (CY) 2022 Medicare and Medicaid Programs. On Jan. 19, the Federal Registrar published the Final Rule detailing those regulatory and measure level updates for the Stars program beginning in Measurement Year (MY) 2022. These changes will force health plans to reevaluate their Stars intervention strategies and better communicate to both providers and members. The recalibrated measure weighting toward CAHPS will also put more emphasis on member experience and prove pivotal to overall contract success. The final rule also includes changes to the Quality Bonus Payment Rules. The methodology outlined by CMS clarified that the enrollment figures used in the enrollment weighted QBP rating calculations are the Nov. enrollment in the year the Star Ratings are released. This new methodology will take effect during in the 2023 Quality Bonus Payment period. It’s important to remember that success in Stars is a continuous effort. But the health of a Stars program is critical to a health plan’s growth and sustainability. These new measures are complex and can require adjustments to your in-flight strategies. But don’t worry, you are not alone! ProspHire is adept at helping our clients quickly assess the impacts of CMS measure updates and developing strategies for continuous improvement. The recent changes are summarized below:

MeasuresDescription of Change
• Improving or Maintaining Physical Health
• Improving or Maintaining Mental Health
These measures will be retired to the Display Page for at least two years (beginning in MY2022); These measures will be retired at least for SY2024 and SY2025, with the earliest return to Star Ratings in SY2026 at a weight of 1, and Star Ratings in SY2027 and beyond will be a weight of 3
Medication Reconciliation Post Discharge (MRP)This measure will be retired as a standalone measure in MY2022, SY2024
Follow-up after Emergency Department Visit for Patients with Multiple Chronic Conditions (FMC)This measure will be added in MY2022, SY2024, with a permanent weight of 1 as a process measure
Controlling Blood Pressure Measure (CBP)This measure will be added beginning in MY2021, SY2023 with a 1x-weight, increasing to 3x-weight in MY2022, SY2024
Plan All-Cause Readmissions (PCR)This measure will be added in MY2022, SY2024 with a 1x-weight, increasing to a 3xc-weight in MY2023, SY2025
  1. MY = Measurement Year, the calendar year the measures are tracked and calculated for Star Ratings; SY = Star Year, the year that the official Star Ratings are received
  2. Source: CMS-provided information and documentation

ProspHire Is Here to Help

Unlike other improvement programs, when Stars interventions are executed, they do not always create savings. Many require reinvestment to drive continued improvement. Stars is also graded against a curve. What was good enough last year, may not be good enough the next. ProspHire excels at driving continuous improvement to optimize Stars performance. Through data driven analyses and clearly defined strategies, our team of seasoned subject matter experts implement interventions to increase Stars ratings and maximize rebate potential. Our practitioners have years of experience helping large MCOs enhance quality improvement programs. If you would like to learn more about the Stars Program or have any additional questions about how ProspHire can assist, let’s have a conversation!

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ProspHire Named to 2020 Inc. 5000 List

The woman-owned, national Firm is one of the fastest growing private companies in America.

PITTSBURGH, PA., Aug. 12, 2020 – ProspHire has made the 2020 Inc. 5000 list of the fastest-growing private companies in America. The Pittsburgh-based, national healthcare consulting firm ranks #790, landing in the top 16% of companies for its continued exponential revenue growth.

The Inc. 5000 award ranks companies by overall revenue growth over a three-year period. This prestigious list of the nation’s most successful private companies has become the hallmark of entrepreneurial success and the place where industry superstars first make their mark. ProspHire now stands alongside companies like Microsoft, Vizio, Patagonia and numerous other big industry names.

“We are thrilled to receive renowned national recognition for our commitment to sustainable growth,” said Lauren Miladinovich, ProspHire’s Managing Principal and CEO. “While many companies lost serious footing due to the COVID-19 global pandemic, ProspHire was tested but refortified by the challenge. We let our core values and commitment to our people guide us. We stayed true to our value proposition and worked with our clients who were going through financial difficulties and we came out stronger for it. I don’t have many peers who can say they grew their companies during a pandemic.”    

Christopher Miladinovich, ProspHire’s Principal and SVP of Consulting, said, “We have been honored twice by Inc. as a Best Workplace and are very pleased to now be recognized for our exponential growth. For five years, ProspHire has grown by more than 600% and now clears nearly $10m in annual revenue. We have created 80+ jobs across the state of Pennsylvania, achieved 49% diversity and currently have 50+ practitioners.  It’s hard to say what the future holds, but we plan to continue to grow our headcount and to diversify our already national client base. We are truly proud of our responsible growth and have no plans to slow down.”

ProspHire is no stranger to workplace accolades. The Firm was just named one of Modern Healthcare’s Best Places to Work (2020). In 2019, the Pittsburgh Business Times ranked ProspHire #4 on their Fast 50 list of the fastest growing private companies in western Pennsylvania, and #1 mid-size company on their Best Workplaces list. ProspHire was also named one of Inc. Magazine’s Best Workplaces for two consecutive years (2018 and 2019).

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ProspHire is Named One of Inc. Magazine’s Best Workplaces for Two Consecutive Years

The 50+ person healthcare management consulting firm beat out thousands of U.S. companies to win the honor in both 2018 and 2019.  

PITTSBURGH, PA., May 16, 2019 – ProspHire has been named one of Inc. Magazine’s Best Workplaces for the second year in a row. This year, the Pittsburgh-based healthcare management consulting firm was one of 346 companies recognized (among thousands of applicants) for creating an exceptional workplace through a vibrant culture, deep employee engagement and exceptional benefits. 

Inc. Magazine’s 2019 Best Workplaces list is the publication’s fourth annual ranking of fast-growing, private sector American companies. Built in partnership with employee engagement experts Quantum Workplace, the Best Workplaces list places a spotlight on innovative companies that hire and retain the best talent. 

“We are thrilled to be recognized, on a national level – for the second year in a row – for our outstanding company culture,” said Lauren Miladinovich, ProspHire’s Managing Principal and CEO. “Nothing means more to us than our people, and this ranking is confirmation that we’re creating the kind of Firm our practitioners want to come to work for every day.” 

Christopher Miladinovich, Principal and SVP of Consulting, said, “In consulting, our people are our product. So, our Firm invests heavily in hiring and retaining the best. I’m especially proud of ProspHire University (PHU), the unique learning program we created to develop the industry leaders of tomorrow. PHU provides ProspHire practitioners and clients with a forum to achieve valued industry accreditations, hear from industry thought leaders and attain professional growth.”  

ProspHire’s very generous benefits package includes paid parental leave, a flexible time off policy, 100% paid medical coverage for employees and an annual fitness subsidy. Taking time off to recharge is not only encouraged at ProspHire, it’s mandatory.  

The Firm’s headquarters in downtown Pittsburgh spans three floors of the Power Building and the open loft office space includes a PGA-style putting green. At headquarters, you’ll regularly find the ProspHire team assembled for monthly employee socials, informal Facetime Fridays and PHU Lunch & Learns. 

“With today’s tight labor market, building a great corporate culture is more important than ever,” says Inc. magazine editor in chief James Ledbetter. “The companies on Inc.’s Best Workplaces list are setting an example that the whole country can learn from.” 

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ProspHire’s Conversation with Governor Tom Wolf

Pennsylvania Governor Tom Wolf visited ProspHire headquarters to celebrate the Firm as a small diverse business and discuss some of the most pressing issues in healthcare.

Pennsylvania Governor Tom Wolf arrived at ProspHire’s downtown Pittsburgh headquarters on Friday, Aug. 10 to cheers and applause. He was greeted by Firm co-founders, Lauren and Chris Miladinovich and walked the penthouse loft space shaking hands with every single event attendee.

Then the Governor settled in (to a high stool on ProspHire’s putting green) for a conversation about his views on healthcare, his administration’s accomplishments and his support for small businesses.

Speaking about Pittsburgh’s metamorphosis in the last several decades, the Governor said the city was, “one of the best in the world.” He specifically commended Pittsburgh for its diversity, accessible cost of living, appeal to youth and emphasis on equality.

Governor Wolf briefly touched on the accomplishments of his administration. Chief among them was creating the first statewide LGBTQ Affairs Commission in the U.S. He also took credit for making the education system more relevant and creating a budget surplus for the first time in decades. Governor Wolf also made it clear he believed in, “fairness for everybody, regardless of gender, color and who you love.”

Chris then led the Governor through a more in-depth discussion of healthcare and small diverse business. After sharing that ProspHire works with many of Pennsylvania’s Managed Care Organizations (MCOs), Chris asked the Governor to please speak to his view on the importance of managed care and why what we do every day is so important.

Governor Wolf said, “There is a real mistrust from people about what we as a society can give each other.” He stressed that cost-effectiveness in healthcare is paramount and insisted that trust in government needs to be rebuilt so individuals can get the care they need.

When asked what MCOs can do better, the Governor admitted he didn’t have a definitive answer. But he said we all have to adopt a, “continuous improvement mindset.” The key, he stressed, is to have, “open and honest dialogue.” Aligning with that belief, Governor Wolf discussed Community Health Choices in Southwestern Pennsylvania and how it positively impacts the lives of senior citizens. Through Health Choices, his administration is committed to increasing opportunities for older Pennsylvanians and individuals with physical disabilities to receive the services they need to remain in their home.

To close, Governor Wolf was asked about his passion for small business, to which he said, “small businesses are where big businesses come from.” Speaking from his experience as a business owner, he referred to small businesses as, “the breeding grounds for fairness and ethical behavior” and said there is more we can all do to build trust with our employees that will lead to better outcomes and results.

The ProspHire team then presented the Governor with a “Re-elect Tom Wolf” golf flag and the Governor posed for pictures with event attendees.

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ProspHire is One of Inc. Magazine’s Best Workplaces for 2018

ProspHire was one of the highest scoring businesses with standout employee engagement.

PITTSBURGH, PA., May 23, 2018 – ProspHire has been named one of Inc. Magazine’s Best Workplaces for 2018. The woman-owned and rapidly growing healthcare management consulting firm was one of 285 companies recognized (among thousands of applicants) for creating an exceptional workplace through a vibrant culture, deep employee engagement and stellar benefits.

Inc. Magazine’s 2018 Best Workplaces list is the publication’s third annual ranking of fast-growing, private sector American companies. Built in partnership with employee engagement experts Quantum Workplace, the Best Workplaces list places a spotlight on innovative companies that hire and retain the best talent.

“We are thrilled to be honored on a national level for our hard work and dedication to our people,” said Lauren Miladinovich, ProspHire’s Co-Founder and CEO. “Our Firm’s Leadership Team have previously worked for companies like Deloitte, Pfizer, Williams, Mylan, Ernst & Young and PNC. We’ve taken the best people practices from those places, shed the bad, and built the kind of Firm we want to come to work for every day.”

Christopher Miladinovich, Co-Founder and SVP of Consulting, said, “We work tirelessly to find and retain the best talent. We reinvest in our people and empower decision making. The result is an electric culture that allows our people to be the best version of themselves.”

ProspHire’s very generous benefits package includes paid parental leave, a flexible time off policy, 100% paid medical coverage and a wellness subsidy. Taking time off to recharge is not only encouraged, it’s mandatory.

The ProspHire team meets regularly for community service events, monthly employee socials and informal Facetime Fridays. And the Firm’s penthouse loft office space in downtown Pittsburgh includes all amenities you would expect, and some you would not (e.g. a PGA-style putting green).    

About ProspHire
ProspHire is a woman-owned and rapidly growing management consulting firm that focuses on healthcare strategy and project delivery. 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 Pittsburgh-based company has a deep experience in healthcare, and proficiency helping clients define and execute medium to large-scale enterprise initiatives that deliver results. ProspHire specializes in strategy, project delivery and strategic resourcing for healthcare companies. They also create and deliver healthcare-specific mobile applications. www.prosphire.com

About Inc. Media
Founded in 1979 and acquired in 2005 by Mansueto Ventures, Inc. is the only major brand dedicated exclusively to owners and managers of growing private companies, with the aim to deliver real solutions for today’s innovative company builders. Winner of Advertising Age’s “The A-List” in January 2015, and the National Magazine Award for General Excellence in both 2014 and 2012. Total monthly audience reach for the brand has grown significantly from 2,000,000 in 2010 to over 20,000,000 today. For more information, visit http://www.inc.com/

About Quantum Workplace
Quantum Workplace is an HR technology company that serves organizations through employee engagement surveys, action-planning tools, exit surveys, peer-to-peer recognition, performance evaluations, goal tracking, and leadership assessment. For more information, visit https://www.quantumworkplace.com/.

ProspHire logo on a wall

ProspHire Raises Over $35k to Win the Boys & Girls Clubs of Western Pennsylvania’s Annual “Kiss a Pig” Campaign

ProspHire also served as the platinum sponsor for the campaign’s fourth annual Great Futures Gala

PITTSBURGH, PA., March. 15, 2018 – ProspHire, a woman-owned and rapidly growing healthcare management consulting firm, exceeded their goal to raise $30k for the Boys & Girls Clubs of Western Pennsylvania’s annual “Kiss a Pig” campaign.

ProspHire principals, Lauren and Chris Miladinovich raised over $35k for the campaign and took the stage at the Sheraton Station Square last night to victory kiss their own domestic mini pig Nola, who also bestowed kisses on runners up from PNC and the LaRosa Club of McKeesport. ProspHire served as the platinum sponsor of the fourth annual Great Futures Gala, and Lauren and Chris are well on their way to meet their commitment to help the Boys & Girls Clubs of Western Pennsylvania raise $1 million (with Nola) through the “Kiss a Pig” campaign. To date, the campaign has raised $306k.  

Lauren and Chris have supported the Boys & Girls Clubs of Western Pennsylvania for many years. The two were honored with the organization’s 2017 Commitment to Youth Award and were also recognized at the 2017 Celebration of Champions event for their, “remarkable leadership, inspiring community achievement and extraordinary entrepreneurial spirit” in the healthcare industry.

About ProspHire
ProspHire is a woman-owned and rapidly growing management consulting firm that focuses on healthcare strategy and project delivery. 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 Pittsburgh-based company has a deep experience in healthcare, and proficiency helping clients define and execute medium to large-scale enterprise initiatives that deliver results. ProspHire specializes in strategy, project delivery and strategic resourcing for healthcare companies. They also create and deliver healthcare-specific mobile applications. www.prosphire.com

About Boys & Girls Club of Western Pennsylvania
Boys & Girls Clubs of Western Pennsylvania is a non-profit organization that is part of a national network of Boys & Girls Clubs united in this mission: “To inspire and enable all young people, especially those from disadvantaged circumstances, to reach their full potential as productive, responsible, and caring citizens of their community, America, and the world.” The agency is governed by an active and engaged Board of Directors with a formal committee structure representing a cross section of community leaders. Boys & Girls Clubs of Western Pennsylvania began their service to the young people of our community in 1888, and currently serves over 7,600 children and young people between the ages of 5-18 years old. The long-standing history of successful service to youth in the community sets the organization apart from others. Staff and volunteers operate year-round programs in eight neighborhoods throughout Pittsburgh and Allegheny County. https://www.bgcwpa.org/

ProspHire workers under ProspHire University sign

ProspHire Launches ProspHire University

ProspHire University is a unique learning program led by healthcare professionals, for healthcare professionals to develop the industry leaders of tomorrow.

PITTSBURGH, PA., Feb. 28, 2018 – ProspHire, a woman-owned and rapidly growing management consulting firm focused on healthcare strategy and project delivery, is proud to launch ProspHire University (PHU).

PHU is a unique learning program led by healthcare professionals, for healthcare professionals, to develop the industry leaders of tomorrow. PHU provides ProspHire employees and clients with a forum to achieve valued industry accreditations, hear from industry thought leaders and attain professional growth.

The program includes a ProspHire curriculum with custom courses (by level) for the Firm’s practitioners, as well as a Project Management Professional (PMP) certification program and healthcare thought leadership series that are open to clients.

Courses are taught by internal practitioners and external industry leaders and present unprecedented opportunities for relationship building and business development. 

This year, ProspHire will complete renovation on a second floor of their headquarters building dedicated to PHU and the professional development of their practitioners.

Lauren Miladinovich, ProspHire’s Co-Founder and CEO, said, “In 2018, ProspHire created an internal PMP Program that enabled six of our consultants to obtain the highly sought-after accreditation. In 2019, we doubled down on our commitment to professional development and officially launched PHU.“

“In management consulting, our people are our product, and ProspHire has long been committed to the professional development of our employees. This investment, for a firm our size, certainly sets us apart,” said Christopher Miladinovich, Co-Founder and SVP of Consulting.

About ProspHire
ProspHire is a woman-owned and rapidly growing management consulting firm that focuses on healthcare strategy, 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 Pittsburgh-based firm has 40+ practitioners and was named one of Inc. Magazine’s 2018 Best Workplaces. The firm has deep healthcare industry experience and proficiency helping clients define and execute medium to large-scale enterprise initiatives that deliver results. www.prosphire.com

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