The Basics of HIPAA 5010, Mandates, Timelines, and Reasons for Upgrades

Posted on June 1, 2012 by Linda Ringquist

Original site for information is http://www.emdeon.com/5010/. The information on this site is presented in a simple easy to understand manner.

HIPAA 5010 expands HIPAA regulation to include electronic transmission of healthcare transactions, including eligibility, claim status, referrals, claims, and remittances. Covered entities are required to comply. Covered entities include: Physicians, Clearinghouses, Hospitals, Pharmacies, Payers, and Dentists. Software vendors all also expected to comply.

The following transactions are specifically cited in the new standards:

Health Care Eligibility Benefit Inquiry and Response
Health Care Claim Status Request and Response
Health Care Services Request for Review and Response
Health Care Services Notification and Acknowledgement
Payroll Deduction and Other Group Premium Payment for Insurance Products
Benefit Enrollment and Maintenance
Health Care Claim: Payment/Advice
Health Care Claim: Professional
Health Care Claim: Institutional
Health Care Claim: Dental

NCPDP Pharmacy Claim

The main reasons for the upgrade to HIPAA 5010 are:

The ability to support new-use cases brought forward by the industry
Clarification of usage to remove ambiguity
Consistency across transactions
Support of the NPI regulation
Removal of data content that are no longer used

By 2016, the healthcare industry will be required to achieve compliance with the following mandates form both HIPAA and the Affordable Care Act.

ASC X12 version 5010 and NCPDO D.O.
ICD-10
Eligibility and Claim Status Operating Rules
Health Plan ID (HPID)
EFT and ERA Operating Rules
Claims Attachment Rules
Claims, Enrollment, Authorizations Operating Rules

Following is a compliance timeline from 2009-2016:

2009

3/17/09 Modifications to code sets ICD-10 Effective
3/17/09 Modifications to transactions (5010) Effective

2011

6/30/11 Eligibility and Claim Status Operating Rules Effective

2012

1/1/12 5010 Transactions Enforcement 6/30
1/10/12 EFT Standards Effective
7/1/12 EFT/ERA Operating Rules Effective
10/1/12 Health Plan ID Prescriber Modifications to NPI Effective

2013

1/1/13 Eligibility and Claim Status Operating Rules Compliance
4/7/13 Prescriber Modifications to NPI Compliance
12/31/13 Eligibility, Claim Status, EFT, ERA Health Plan Certification

2014

1/1/14 Claims Attachment Rules Effective
1/1/14 ERA/EFT Standard and Operating Rule Compliance
1/1/14 Claims Enrollment, Authorization Premium Payment, Operating Rules Effective
10/1/14 Health Plan ID Compliance

2015

12/31/15 Claims, Enrollment, Attachments, Premium Payment, Referral Health Plan Certification

2016

1/1/16 Claims, Enrollment, Authorizations Operating Rules Compliance
1/1/16 Claims Attachment Rules Compliance

BHM Healthcare Solutions is a healthcare consulting company dedicated to providing healthcare management consulting services. One of our areas of specialty is HIPAA compliance. If you are in need of assistance with HIPAA issues in particular, please visit our HIPAA compliance page and contact us at 1-888-831-1171.

What the Hill? The Latest in Healthcare News from Capitol Hill

Posted on May 16, 2012 by Linda Ringquist

Here are some of the latest stories from Capitol Hill according to The Hill. The original stories may be found by accessing http://thehill.com/blogs/healthwatch/.

BHM Healthcare Solutions

Obama administration announces plan to fight Alzheimer’s Released from the Health and Human Services Department (HHS), there is a plan for the prevention and treatment of Alzheimer’s which will encompass clinical trials and training for doctors. The release date is 2025. “This is a national plan, not a federal one, because reducing the burden of Alzheimer’s will require the active engagement of both the public and private sectors”, according to HHS Secretary Kathleen Sebelius.

Sequestered cuts keep K Street on high alert According to lobbying disclosure records, several interests lobbied on the budget sequestration last quarter. Defense contractors as well as healthcare groups were closely monitoring the budget cuts proposed for next year. The proposed budget cuts include a reduction of $123 billion in payments to Medicare providers. According to Ken Raske, president and CEO of the Greater New York Hospital Association, “the budget cuts will add to the financial burden on the healthcare system. This could be a compounded horror show for the hospitals The spending cuts could hinder hospitals providing care to patients.

Nurse practitioners push for bigger role as coverage expands Nurse practitioners are pushing to expand their role in healthcare. The American Academy of Nurse Practitioners (AANP) states their role should become more important as Obama’s healthcare law pushes through. The new law will provide coverage to millions of people which will increase the importance of nurse practitioners.

Senator Leahy hopeful that John Roberts will vote to uphold health law Before the court heard arguments in the healthcare case, Supreme Court Chief Justice John Roberts was mentioned as a potential swing vote. “I thought I saw a chief justice who understands the importance of this case to all Americans, including those millions who would otherwise continue without health care insurance and access to affordable health care”, Senate Judiciary Committee Chairman Patrick Leahy said in a floor speech. The court is supposed to make a decision next month whether the healthcare law, which requires everyone to purchase insurance, is constitutional or not. If the mandate is nixed, the court will have to decide whether the entire law will be nixed or if the rest will pass.

Study: Insurers to lose $1 trillion if health law struck down According to the Bloomberg Government, at stake in the Supreme Court’s decision on healthcare reform is nearly $1 trillion of the insurance industry’s total revenue through 2020. “It’s a confirmation of, one, how much money we’re spending as a nation on healthcare, and two, how much is riding on this court case and the Supreme Court’s decision”, according to Matt Barry. “You’re talking about an amount of money here that can affect the economy, not just an industry. The revenue would come from both the expansion of Medicaid and from additional subsidies to individuals purchasing insurance. The Supreme Court is expected to issue a decision by the end of June 2012.

The financial management of health care and healthcare financial analysis are important topics of discussion. If you don’t want to see the same things happen to your company as are proposed for our nation, please review BHM Healthcare Solution’s financial improvement page and/or contact BHM Healthcare Solutions at 1-888-831-1171. Following are a few of our many financial improvement services offered: healthcare financial analysis, revenue cycle, cost variance analysis, and consolidations and mergers. BHM is a one of the top healthcare management consulting firms with a large array of services provided.

Success of PCMH Could Mean Expansion

Posted on May 10, 2012 by Kathleen Rand

Patient-centered medical home (PCMH) projects implemented by Independence Blue Cross (IBC) and BlueCross BlueShield of Tennessee (BCBST) have been so successful in improving patient outcomes and keeping medical costs under control that they are looking to increase the programs to more primary care physician (PCP) practices and into other therapy areas as well like behavioral health, cardiology and oncology.

Under the PCMH model, PCPs lead care teams to keep members healthy by using registries to track conditions and ensure that they receive needed care —essentially creating a hands-on approach. And physicians are also rewarded with a per-member per-month (PMPM) fee and other shared savings based on the health outcomes their patients achieve.

In fact, PCMH-focused practices will be eligible for shared savings beginning next year under the Affordable Care Act requisites. To illustrate, a practice with 1,000 chronic care patients could potentially net between $10,000 and $12,000 in shared savings and performance bonuses.

While the PCMH model incorporates many different elements, these five key points more than likely led to the success of the Tennessee Blues’ PCMH effort:

(1) Better access to physicians because of improved after-hours consultation and appointment scheduling for chronic care patients.

(2) Care coordinators at practice sites such as a licensed practical nurse – coordination is supported by total health management services and interactive reporting.

(3) IT infrastructure development to improve health information exchange and communication, resulting from a business stipend for IT efforts such as electronic health records and disease registries.

(4) Improving outcomes and performance measurement through metrics such as fewer emergency department visits and lower inpatient utilization, improving the financial management of healthcare for providers over the long term.

(5) Controlling cost efficiency through reporting to practices on utilization and cost metrics, and providing incentives to physicians through performance bonuses and shared savings.

These insurers realized that building a PCMH is a way to stabilize and grow the PCP network, boost patient outcomes, and improve access to care.

BCBST found that members enrolled in a PCMH had less emergency room utilization and lower inpatient admissions compared with non-PCMH members. It appears that PCMHs are proving a better pattern of utilization and cost efficiency due to the fact that patients are more engaged with their physicians and care coordinators.

PCHCH Program Accreditation – A Brief Summary

Posted on April 9, 2012 by Kathleen Rand

URAC PCHCH Accreditation Summary

Providers are always striving to improve profitability and enhance patient care. URAC’s Patient Centered Health Care Home approach can facilitate compliance with healthcare reform. Some of the aspects of this approach are streamlining coordination across the continuum of care, increasing patient access to information and boosting efficiency and effectiveness. URAC’s concept uses a step approach with high level of flexibility and customizable elements, providing educational support and cost advantages.

PCMC is a team-based healthcare delivery model led by a physician that provides comprehensive and continuous medical care to patients with the goal of obtaining maximized health outcomes. The provision of medical homes may allow better access to health care, increase satisfaction with care, and help with the financial management of healthcare.

URAC’s Patient Centered Health Care Home (PCHCH) Programs instruct and direct healthcare providers, insurers, or healthcare management consulting organizations on how to transform a practice into a truly patient centered health care home. Further, URAC’s PCHCH Achievement standards align directly with the Meaningful Use requirements, thereby promoting practice recognitions for meeting these standard elements.

The URAC PCHCH Practice Achievement Program assesses practices on key URAC PCHCH Practice Standards from the URAC PCHCH Program Toolkit. These standards are considered critical elements of a patient centered health care home and include seven mandatory standards. The standards align to the Joint Principles of the Patient Centered Medical Home and address key requirements for all Meaningful Use requirements for electronic medical records, quality data submission and e-prescribing.

To qualify for URAC’s PCHCH Practice Achievement, an organization must be reviewed on-site by a URAC PCHCH Certified Auditor or a URAC clinical reviewer. A one or two day onsite review will occur, dependent on the size of the practice. Upon successful completion, URAC PCHCH Practice Achievement is awarded for a two-year time frame.

Exploring the Epidemic of Untreated Pain: The Importance of Pain Management

Posted on April 9, 2012 by Kathleen Rand

Management of pain is crucial for providers

The Journal of Managed Care Medicine which is published by the National Association of Managed Care Physicians has consistently served as a trustworthy resource for industry providers. In the most recent publication, Volume 15, Number 1, JMCM once again proved itself both timely and reliable by featuring an article that explored the epidemic of untreated pain and the importance of pain management. The article discussed not only the high cost of ineffectively-controlled pain but the knowledge and abilities that pain-management clinicians need to possess to deliver effective care.

Adequate pain management calls for an inclusive evaluation and very often a multi-modality treatment strategy. Pain, chronic or untreated, can indicate high healthcare utilization and can produce significant societal costs. In fact, the total annual cost of poorly controlled persistent pain amounts to close to $100 billion per year. “Identifying healthcare issues which have a tendency to drive costs up over time, and impact the health of both patients and society is an important part of the financial management of healthcare. Because of its complexity, pain management requires a comprehensive approach to assessment and the use of validated tools and guidelines in order to optimize pain treatment methods, and benefit both the patient through superior care, and society through decreased costs,” stated Danyell Jones, a Senior Vice President with BHM.

Dr. Mark Rosenberg, President of BHM Healthcare Solutions and author of the recent article, has been focused on helping various providers and delivery systems to improve their methods of treating pain, while simultaneously ensuring that pain treatment options are viable from a financial perspective. Additionally, as a leader within the healthcare management consulting industry, Dr. Rosenberg has delivered several notable presentations and learning-series talks at national conventions dedicated to this topic. “Pain is costly on many levels, impacting the patient, managed care organizations, employers, and society in general. It is critical for providers to be unbiased in their assessments, to use and reference current evidence-based pain management standards and guidelines, and to advocate for each patient by collaborating with experts to formulate an interdisciplinary treatment plan,” commented Dr. Rosenberg. He continued, “An important strategy for healthcare management is to mitigate the cost associated with the loss in productivity resulting from persistent pain.”

To view the article “Untreated Pain Epidemic: Multi-Modality Approach to Pain Management” in its entirety, please visit http://issuu.com/namcp/docs/jmcm_15.1.

Financial Management and Health Insurance Exchanges

Posted on April 6, 2012 by Kathleen Rand

Financial management is vial in healthcare

A health insurance exchange is a set of state-regulated and standardized health care plans in the United States, from which individuals may purchase health insurance eligible for federal subsidies. All exchanges must be fully certified and operational by January 1, 2014 under healthcare reform.

Exchanges of this type were intended as a governmental entity to help insurers comply with consumer protections and to compete in cost-efficient ways, and to facilitate the expansion of insurance coverage to more people. Exchanges are not themselves insurers, so they do not bear risk themselves, but determine the insurance companies that are allowed to participate in them. Ideally, a well-designed exchange will promote insurance transparency and accountability, facilitate increased enrollment and the delivery of subsidies, and play roles in spreading risk to ensure that the costs associated with those with high medical needs are shared more broadly across large groups rather than spread across just a few beneficiaries. This is what has occurred in the state-run Health Connector exchange in Massachusetts. Some hope that insurance exchanges also will help to contain overall costs in relation to the financial management of healthcare.

Hospitals will see some increase in revenue as the uninsured gain medical coverage through Medicaid or still-to-be-formed insurance exchanges. They also, however, will see cuts in Medicare and Medicaid as well as unevenly shared payments, and will still have a sizable self-pay population as businesses shift greater numbers of employees to high deductible or consumer-driven health plans.

New healthcare law will further complicate the revenue cycle for hospitals by fostering alignment with physicians and bundling payment. Providers will have to manage the revenue cycle from both the hospital and the physician side and coordinate processes within financial clearance, eligibility, and price estimates as they move to accommodate patients throughout the healthcare encounter.

Faced with having to do more with less, hospitals will be challenged to protect revenue and accelerate and increase cash collection, avoiding process failures that result in a denial or a decrease in payment due to medical necessity. They also will likely consolidate or leverage front-end resources to gain more efficiency from the technologies and processes they already employ.

As an ultimate strategy, hospitals should focus on revenue cycle initiatives that drive optimal performance: charge capture, pricing, and patient access. There is this sweeping vision of a ‘no-wrong-door’ enrollment system within the exchanges through which millions of people will have their eligibility determined in real-time.

The Importance of Engaging a Transaction Expert – Part Four

Posted on March 29, 2012 by Tom Bednarek

Finding the right fit is essential in business.

“It ain’t what you don’t know that gets you into trouble. It’s what you know for sure that just ain’t so.” Mark Twain

The unstable and rapidly changing environment of today’s healthcare marketplace has intensified the interest of healthcare executives, physicians and business owners in the benefits of merging with, acquiring or being acquired by another entity with a common vision. When undertaking these endeavors there are many advantages to be gained, but there are many pitfalls that must be circumnavigated. In this posting I’ll share my thoughts on the importance of engaging a transaction expert to help assure an effective and efficient process.

When opportunity knocks you may want to look through the peephole before opening the door. The decision to embark on a merger should be made only after performing a feasibility analysis that examines key indicators such as financial advantages, operational compatibility, agreement among the parties about what the transaction is expected to accomplish and whether or not the newly formed entity would in fact generate business benefits not possible if each entity remained solo. The fact of the matter is that some prospective suitors may have hidden agendas and you do not want to be adversely impacted by the burden of their financial or operational difficulties.

Once the proposed transaction passes the feasibility analysis, what follows is a time consuming and complicated process. Because of their broad experience, transaction consultants see a wide set of business scenarios in diverse, as well as common, business models. This range of experience will serve to accentuate the transaction’s benefits and be of great help if unexpected issues arise; and unexpected issues almost always arise. The consultant can effectively deal with each issue and move the transaction to completion.

The consultant will also help you leverage your time. Successful transactions require a tremendous amount of communication and coordination with the various parties involved, including but not limited to, you and your management team, the management team from the other company, outside accountants, attorneys and numerous support groups such as medical billing/collection firms. As the transaction process ensues you still have a business or a practice to run. If the attempts at a transaction fail, and most of them do, you do not want to exit the process with a diminished organization that is in need of repair.

The seasoned transaction consultant also brings a wide set of relationships. Perhaps most importantly, if the decision is definitively made to find a suitor and the initial transaction does not come to fruition, then the consultant can not only pinpoint strategic buyers within the industry, but they also have relationships with other potential buyers, such as private equity groups that, in fact, typically pay more than a strategic buyer.

A good transaction consultant is also a financial expert. The components of a transaction are often complicated and you can leverage their financial acumen to fetch the highest price possible for your organization. Effective communication with the various internal and external accountants is imperative, so the ability to navigate through, understand and apply the content of complicated and voluminous financial statements will provide many benefits to your cause. The importance of the benefits you will receive from this understanding of the financial intricacies of the deal cannot be overstated.

It is important for executive leaders to know how much they don’t know. Utilizing the talents of a transaction consultant during the merger & acquisition process will help you achieve the outcome you desire, and help you avoid learning expensive lessons along the way.

To schedule a one to one free initial consultation with one of BHMs leading healthcare consultants please email us at results@bhmpc.com or call us at 1-888-831-1171. BHM consultants provide real value and measurable results to healthcare firms, government agencies, and insurers through data driven and strategic management analysis, and assist organizations with Clinical Operations, Financial Management Improvement, Physician Advisor Services and Accreditation.

Is Your Organization Creative Enough to Meet the Challenges of Adversity? – Part Three

Posted on March 27, 2012 by Tom Bednarek

Creative strategies are essential in today's economy.

“Frugality without creativity is deprivation.”

- Amy Dacyczyn

Credit is tight, consumer confidence is low, and you have the growing realization that increasing the net profit shown on your income statement is as much a function of lowering expenses as it is attributable to boosting revenue. When austerity measures are undertaken your creativity can often times make the difference between success and failure. In this posting I’ll identify some creative measures that will help you successfully grow your business during times of economic malaise.

The first thing you have to determine is whether or not your organization embraces change, and its driving force which is creativity. To make an accurate assessment you can ask yourself when was the last time that you: entered a new market, did something innovative, utilized social media, sought out a strategic partner or rolled out a new product or service. If the prevailing answer is either “I can’t remember,” “not lately” or “never,” then you may want to acknowledge that the first step in solving a problem is admitting that you have one. If the prevailing answer is “what was the question?” then you may have larger issues that need to be addressed.

The fact of the matter is that cost effective solutions exist for those who are not satisfied with the status quo. Here are a few techniques will not only help your business meet the challenge of adversity, but they can provide benefits to your organization in perpetuity.

Utilize Joint Ventures: A joint venture can offer an array of economic benefits to both partner organizations through access to: new geographic markets, complementary products and/or services, additional distribution networks, increased capacity, additional staff skill sets, purchasing economies of scale, technology/intellectual property, and financial resources.

Identify and Nurture Thought Leaders: Unfortunately it is not uncommon for people in organizations to laugh at new ideas and look down upon other employees that point out problems. In the March 5, 2012 issue of Forbes, Shel Israel provides the following definition: “A thought leader is someone who looks at the future and sets a course for it that others will follow. Thought leaders look at existing best practices then come up with better practices. They foment change, often causing great disruption.” It costs you little more than a bit of time and a pat on the back to tap into the benefits that these individuals can provide your organization.

Outsource: Two heads are better than one, and in the constant pursuit of access to the finest human capital outsourcing provides the most cost effective exposure to a more diverse base of skill sets and core competencies that have a proven track record of success.

Leverage Social Media: Social Media can help your organization better understand, respond to, and attract the attention of its target audience. It allows you to get your message out fast, and to a large number of people. Unlike traditional media, Social Media provides the added benefit of being able to instantaneously generate customer feedback which will allow you to gain insight into your target market and identify new product or service opportunities. If used creatively it also allows you to track your competition, quickly identify problems with your product and drive people to your website, thereby improving the ROI vis a vis your technology CAPEX.

If your desire is to cultivate creativity then it is incumbent upon you, as an executive, to inspire your employees to become innovators by virtue of a corporate culture that embraces change. If you proactively inspire change and innovation then your organization will circumvent obstacles encountered during lean times and reap many rewards for years to come.

To schedule a one-to-one free initial consultation with one of BHM’s leading healthcare consultants, please email us at results@bhmpc.com or call us at 1-888-831-1171. BHM consultants provide real value and measurable results to healthcare firms, government agencies, and insurers through data-driven and strategic management analysis, and assist organizations with Clinical Operations, Financial Management Improvement, Physician Advisor Services and Accreditation.

In Crisis Management, Your Silence is Deafening-Part Two

Posted on March 24, 2012 by Tom Bednarek

Communication in business is crucial to success.

“A good plan violently executed now is better than a perfect plan executed next week.”

General George S. Patton

If you are in business for any length of time, sooner or later, you will be exposed to a crisis that can affect not only the company you work for, but your career as well. We have all experienced a vitriolic situation with a friend or family member that, once resolved, ultimately resulted in a stronger bond between the two individuals. In this posting I’ll discuss the assertions that effective communication is the key to crisis management and how timely and effective communication can actually result in a stronger organization.

Organizations that either don’t react, react slowly, or react improperly to adverse events will likely see erosion in brand equity, and in many cases, see forced resignations and firings at the C-level. As a native son of Pennsylvania I am aware of no better example of poor crisis management than what resulted in the wake of the sex abuse scandal that rocked Penn State University in late 2011. The adverse effects of this modern day Greek tragedy on Penn State resulted as much from poor communication as they did from the criminal behavior of University officials. A partial list of missteps includes: no visible leadership once the scandal broke, no message to the public for days, (which fueled the fire, let speculation run rampant & allowed the angry mob of public opinion convict coach Paterno without so much as a whiff of due process), and holding an obviously incendiary news conference late at night…did they really think there wouldn’t be an alcohol fueled student uproar?

The bottom line is that the public hates the unknown. If they know of trouble, but don’t have vision as to the likely outcome then the company stock, its corporate brand, and the personal brands of corporate executives and board members will be severely penalized. In the Penn State scenario the public’s perception of Penn State and its leadership began to be shaped by the speculation and innuendo of the media zealots and other third parties, which differed radically from the facts of the situation.

In smaller organizations, even though a crisis may be largely confined to the four walls of your company you must keep in mind that the same principles apply. What your employees crave is clear, concise, and open dialogue in times of trouble. You must proactively shape the opinions of others as opposed to having others determine the perception of your corporate and personal brand. By being proactive in your approach to crisis management you turn breaking news, speculation and innuendo into old news by putting a face to a position. By taking a visible and open position, you will take the natural desire to create a corporate villain, and turn this instead into a positive outcome by offering evidence of a corporation and executive team that operates with honesty and transparency by taking swift, prudent, and corrective action address to the problems at hand.

When a crisis occurs you can run but you can’t hide so you have a choice to make. You can put your head in the sand and ignore the problem, you can skirt the issue, or you can take the bull by the horns and simply do the right things. Delaying the inevitable will result in increased scrutiny and eventually produce substantial negative consequences. Prompt communication is imperative to producing positive results. Get the issues out in the open, adopt a position, and do the right things regardless of short-term cost. If you subscribe to the latter tact as opposed to either of the former, you will give yourself the best chance of coming out on the right side of the fray and achieving enduring benefits to your organization.

Are You Positioned to Grow in an Improving Economy? Part One

Posted on March 21, 2012 by Tom Bednarek

: There are ways to improve your business.

“The ultimate measure of a man is not where he stands in moments of comfort and convenience, but where he stands at times of challenge and controversy.” Martin Luther King, Jr.

Regardless of what the economy is doing, as an executive you are still responsible for creating growth. Although it seems counter-intuitive, prosperity in an improving economy is not a foregone conclusion. Metaphorically speaking, your ship can be severely damaged or even sunk by the economic storm it has just endured. Tough economic times are no excuse for a lack of performance, and in fact, they are all the more reason to focus on catalyzing innovation and growth. In this posting I’ll share my thoughts on how to successfully lead your business out of an economic downturn.

Lagging economic data is not the information you should use to make strategic business decisions. Don’t wait until there is a formal acknowledgement of a burgeoning economy to start planning how you’ll navigate out of tough times. Rather, use the many present forecasting signs of an improving economy (better job growth, rising dollar, more availability of capital and credit, growing retail sales, greater consumer confidence, correcting stock market, mundane inflationary trends, etc.) to adjust your strategy and tactics. This is easier said than done because the long, devastating recession has made maneuvering difficult.

The lack of clever and proactive thinking by your executive team in an economy that is poised to improve can make it much more difficult to survive the large challenges that likely lay ahead. If you are like me you, then you regularly hear statements like: “I’m concerned about the stability of the economy, and want to wait and see how everything shakes out before I make any decisions”, or “I’m cutting back on all expenditures until I see how bad healthcare reform is really going to get.”

The simple truth of the matter is that rewards exist for those astute enough to move forward and strategically leverage their business model to exploit opportunities while their competition pulls back and braces for tough times. The following business principles will help your business thrive regardless of the state of the economy:

Outsource: Be very strategic about bringing on new employees. Only make key hires that produce an immediate and significant impact. It has been proven time and again that the most chaotic and financially inefficient implementations are conducted with new employees.

Keep Growing. Stay aggressive while your competition pulls back, slashes costs, and has their heads in the sand. While it is certainly necessary to reduce frivolous expenses, resist the temptation to cut budgets in the areas of sales, marketing, and business development.

Outsource: There is significant leverage to be had in outsourcing implementations to competent experts. Outsourcing frees your internal resources to focus on activities that allow for continuity of your mission.

Leverage Technology: Use technology to provide increased efficiency. Strategic investments into process improvement will allow you to weed out system inefficiencies. If your company replaces innovation with caution and pervasive cost cutting, you will not only find survival more difficult, but if you’re still around when the economy recovers you will find yourself at an operating disadvantage compared to more savvy competitors who did not make the same mistake.

Outsource: Outsourcing will offer the following benefits: shorter time frame to implementation, more cost effective implementation, access to existing toolsets and solution sets that have a proven track record of success, access to a more diverse base of skill sets and core competencies, access to best in class human capital within the area of domain expertise required, and reduction of investment into infrastructure expenditures.

In a down economy the stakes are higher, the money and resources are tighter, and the tactical decisions made by you and your management team will be the difference between success and failure. If your management team can streamline operations, deliver solid strategic planning, conduct a prudent execution of business initiatives, and retain best in class human capital (both organically & via outsourcing), your business will gain ground while your competition is stagnating and will be properly positioned for accelerated growth during the next economic boom.