We partner with our clients to implement and operate information-driven quality management solutions that assure measurable results. PCD Partners creates alignment between hospitals and physicians that result in improved clinical outcomes for patients and improved financial performance for providers. Physicians a nd Physician Groups Hospital Exe cutives Healthcare A ttorneys Rolling user story Rolling user story Rolling user story Rolling user story Rolling user story PCD Partners | 16 Cavendish Court | Lebanon, NH 03766 HOME | ABOUT | APPROACH | PRINCIPALS | SERVICES |RESOURCES | NEWS | CONTACT
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We partner with our clients to implement and operate information-driven quality management solutions that assure measurable results. PCD
Partners creates alignment between hospitals and physicians that result in improved clinical outcomes for patients and improved financial
performance for providers.
Physicians and Physician Groups
Hospital Executives
Healthcare Attorneys
Rolling user story Rolling user story Rolling user story Rolling user story Rolling user story
PCD Partners is comprised of highly accomplished physicians, academics, and entrepreneurs who have decades of experience with collaboration in medical quality and practice improvement systems. Our principals have a peerless record of accomplishment in improving measured clinical outcomes through the use of evidence based treatment protocols to improve quality through consistency.
PCD Partners was formed to bring together the collective experience and intellect of our principals to apply towards solving many of the challenges that physicians and hospitals are facing. Our partners are committed to playing an active role in improving the efficiency, quality and consistency of healthcare delivery. We have the clinical, administrative, quality, and systems acumen to help any healthcare delivery system.
1.2
PCD Core Competencies
• Data Process & Capture• Governance• Complex System Integration and
• Align co-dependent healthcare stakeholders (physicians, hospitals, payers and patients) using common metrics, structured relationships and financial incentives.
• Measure the right quality and efficiency variables, ensure excellent data governance and buy-in, and make the data transparent to stakeholders.
• Improve operations to reduce defects and increase efficiency using standardized tools in a way that reinforces the underlying stakeholder alignment.
What are the implications fora system wide quality initiative?
There are a myriad of alignment structures that are used to create different levels of integration between hospitals and physicians; some are more effective than others depending upon the specific objectives of creating the alignment.
A CMA can provide a structure to ensure that physicians and the hospitals that they practice in have their incentives aligned. The formation of an alignment structure requires input from all involved parties to determine physician and management roles and responsibilities, service line governance and CMA fees and compensation.
PCD’s clinical, operational and data experience enables us offer input into developing the right alignment structure. The CMA structure is the only structure that provides on-going financial rewards; it is also the only structure that requires the use of data to improve quality, and it can co-exist with any other alignment structure.
CMAs are typically implemented within a service line; once the initial service line has been implemented additional service lines can be added quickly. Having the right alignment structure that is repeatable across service lines can facilitate a facility wide quality initiative.
To be useful, the right data needs to be in the right format in the right place at the right time. Data is required to be able to measure anything in a meaningful way; without data there is no knowledge.
CMAs require that quality and efficiency performance objectives and metrics, data management, training and operations plans, and valuation must be defined. Incentive bonuses are earned by producing data to demonstrate measurable quality improvements over specified time periods.
PCD can help define quality and efficiency performance objectives and metrics, structure a data management plan, develop and deliver training and operations plans, and provide an independent 3rd party Valuation Fairness Opinion. Our real time dashboards will help you to transform data into knowledge that is meaningful for all parties.
Having the right data available and in a useful format is the key to optimizing quality across a healthcare delivery system. The majority of data required to produce an effective system wide quality system comes from outside of the EMR. In order to effectively identify, collect and transform all of the data required into useful knowledge requires experience skill and the right tools.
What are the implications for a system widequality initiative?
1.3
Improve
Improvement can come in many forms: increased throughput, reduced costs, reduced defects, improved efficiency and most importantly, improved patient outcomes. Realization of these improvements is the result analyzing and optimizing processes using best practice methodologies.
CMA quality incentive bonuses are structured to provide an incentive payment that is commensurate with measurable and demonstrable improvements that can be proven through the data in the quality system.
PCD’s clinical skills, operational know-how and data expertise will combine to develop the process improvements that ensure that you achieve optimal results. PCD’s consultants are Lean Six Sigma and ISO 9001 trained to identify and reduce waste, reduce defects and develop processes and procedures that are tracked by an exception and corrective action tracking tool to ensure compliance and visibility to quality performance.
Having the right alignment structure and measurement capabilities are pre-requisites to realizing meaningful improvement, but do not assure improvement on their own. The addition of Lean Six Sigma principles does not guarantee process improvements without the role definition, process standardization and reporting infrastructure that ISO 9001 compliance assures.
What are the implications for a system wide quality initiative?
1.3
Principals
CHARLES HUTCHINSON, PhDChairmanCo-founder and CEO, GlycoFi, Inc. (acquired by Merck in 2006), Founder, M2S, Inc. and SustainX, Inc., Dean Emeritus, Thayer School of Engineering at Dartmouth, Ph.D., Stanford M. WESTON CHAPMAN CEOChairman, President & CEO, M2S (acquired by AIG affiliate), Managing Director, Oppenheimer & Co. and Donaldson, Lufkin & Jenrette, Adjunct Professor, ISO medical quality systems, Dartmouth Medical School, A.B. Dartmouth, M.B.A. Tuck GRANT BAGLEY, MD, JDPartnerPast Managing Partner, Healthcare Practice, Arnold & Porter, Past Director, Coverage and Analysis, Centers for Medicare & Medicaid Services
The founders and principals of PCD Partners have devoted their careers to establishing themselves as leaders in the healthcare field as physicians, academics, senior administrators, entrepreneurs, and lawyers. Their collective wisdom and experience is a critical component of every PCD Partners offering.
MICHAEL A. CHOUKAS PartnerPresident and CEO, Oncopartners, EVP United Biosource Corp., Chairman & CEO, Scirex Corp., Chairman & CEO Springborn Laboratories (Now STRI,NYSE),Partner, Bain & Company, Legislative Director, US Senator Patrick Leahy, B.A. Dartmouth, M.B.A. Harvard Business School
COLIN C. BLAYDON, AM, PHDPartnerDirector, Center for Private Equity & EntrepreneurshipDean Emeritus, Tuck School of Business at DartmouthProfessor, Harvard Business SchoolDept. Of Defense, OMBBEE Univ. of Virginia, AM Harvard, PhD Harvard
DONALD S BIALEK MD MPHPartnerManaging Director, Huron Consulting Group; SME, CSC Global Health Services; Physician Executive, Dearborn Advisors;CEO, Alliance Medical Practices; CEO, Paradigm Medical Teams;Faculty, Harvard University;NLM Informatics Fellow, Harvard/MIT;BSc, Univ of MD; MD, Univ of MN; MPH, Harvard University
JOHN C. COLLINS, MPH, JDPartnerChair and President, Hampden Assurance Co. Ltd.,Chief Executive Officer, Dartmouth-Hitchcock Clinic, Dartmouth-Hitchcock Medical CenterDirector BCBS of VermontAssist. Prof. Dartmouth Medical SchoolBS Cornell, MPH Michigan, JD Georgetown
JACK CRONENWETT, MDPartner, Chief Medical OfficerChair Emeritus, Section of Vascular Surgery, Dartmouth-Hitchcock Medical CenterMedical Director, Vascular Study Group of New England, Professor of Surgery, Dartmouth-Hitchcock Medical Center, B.S. Michigan, M.D. Stanford
DR. GERRY O’CONNOR, PhDPartner, Quality Program DirectorResearch Director, Northern New England Cardiovascular Disease Study Group, Corporate Consultant, Design and Implementation of Clinical Quality Programs, Principal Investigator, National Quality Program, Cystic Fibrosis Foundation, Professor, Dartmouth Medical School and The Dartmouth Institute for Health Policy & Clinical Practice, B.S. Columbia, Ph.D. Union, Sc.D. BU, M.P.A Harvard
ADAM GROFF, MD, MBAPartnerDivision Director, Bayada Nurses, Inc., Hospitalist, Dartmouth-Hitchcock Medical Center, Assistant Professor, Dartmouth Medical School and The Dartmouth Institute for Health Policy & Clinical Practice, A.B. Dartmouth, M.D. Penn, M.B.A. Wharton MARK ISRAEL, MD Partner, Chairman of the Medical Advisory BoardDirector, Norris Cotton Cancer Center, Dartmouth-Hitchcock Medical Center, Professor, Pediatrics and Genetics, Dartmouth Medical School, B.A. Hamilton, M.D. Albert Einstein
PAUL CARREIRO, PACorporate ConsultantMedical Staff Officer, U.S. Merchant Marine Consultant, New England Center for Emergency Preparedness, Dartmouth Medical SchoolBoard of Advisors, Franklin Pierce University Physician Assistant ProgramA.B. Harvard, B.S. University of Texas, JFK Special Warfare Center for Low Intensity Conflict, Flight Surgeon - School of Aviation Medicine, U.S. Army
VEKRAM JENARTHANANProject ManagerVekram has previously worked in the fields of data analytics and information management in the banking and insurance verticals. His experiences and interests in project management and TQM make him an ideal fit for PCD. His work at PCD involves the technical design and implementation of quality management systems. B.E. (Electrical and Electronics Engineering) College of Engineering Guindy - Chennai, India M.E.M. Duke University
JON LEETDirector of Sales & MarketingJon brings 25+ years of sales and marketing accomplishments with both large companies (Oracle, IBM) and startup companies across a variety of technologies and industry verticals. Jon is responsible for working with PCD management to implement a structured sales process and develop a focused marketing plan. B.A. Colorado College.
When your group or practice is considering integration alternatives with the hospitals that you practice in.
When you are feeling pressure to evaluate the economic security of hospital employment despite your desire to remain independent.
When you are seeking additional sources of revenue to replace reduced reimbursements and changing incentives under new payment models.
When you are looking to collaborate with your hospital to promote evidence-based medicine, coordination of care, outcome measurement and reporting, operational efficiencies and other organizational improvement efforts.
When you want a stepping stone to serve as a template for an accountable care organization (“ACO”) or as the foundation for a bundled payment arrangement without resorting to hospital employment or selling your practice.
Clinical (or service-line) Co-Management Arrangements (CMA) are one of the most successful strategies that hospitals and physicians are using to achieve clinical integration, strategic alignment and collaboration.
A CMA allows the physicians to share in the hospital’s service line revenue in addition to their own professional fees in exchange for providing operational oversight of the service line.
The CMA is an effective structure for creating collaboration between physicians and the hospitals where they practice. It is the only structure that provides on-going financial rewards; it is also the only structure that requires the use of data to improve quality, and it can co-exist with any other alignment structure.
A CMA provides the structure for the physicians and the hospital to work together to leverage the work done in a co-management arrangement to succeed under new payment models and to position the physicians and hospital with ACOs that are looking for efficient partners.
The Co-Management Arrangement (CMA) will specify additional administrative and bonus compensation to be paid by the hospital to the physicians to provide incentives for the physicians to take responsibility for improving metrics related to quality, efficiency, and budget in a hospital service line.
CMAs are a vehicle which permit the physicians to share in the hospital revenue for a specific service line without violating Stark, kickback or other civil monetary regulations.
Physicians earn financial bonuses for improvements in a service line’s operational, clinical and budgetary performance.
The co-management model rewards physician leadership during significant and rapid change and can be used to empower physicians to be the architects in redesigning the healthcare delivery model.
PCD Partners is comprised of world class physicians, academics, and entrepreneurs who have decades of experience with collaboration in medical quality and practice improvement systems for large scale practice management and clinical practice improvement.
The founders and principals of PCD Partners have devoted their careers to establishing themselves as leaders in the healthcare field as physicians, academics, senior administrators, entrepreneurs, and lawyers. Their collective wisdom and experience is a critical component of every PCD Partners offering.
PCD Partners was formed to bring together the combined experience and intellect of our principals to apply towards solving many of the challenges that physicians and hospitals are facing. Our partners are committed to playing an active role in improving the efficiency, quality and consistency of healthcare delivery. We have the clinical, administrative, quality, and systems acumen to help any healthcare delivery system.
PCD can help define quality and efficiency performance objectives and metrics, structure a data management plan, develop and deliver training and operations plans, and provide an independent 3rd party Valuation Fairness Opinion. Our real time dashboards will help to transform data into knowledge that is meaningful for all parties.
PCD can help to maximize the incentive bonuses by leveraging our experience in gathering meaningful clinical data and transforming it into knowledge to improve patient outcomes.
PCD has the clinical skills, operational know-how and the data expertise to help to develop the process improvements that ensure the realization of measurable and meaningful results.
PCD’s consultants are trained in Lean Six Sigma and ISO 9001 to identify and reduce waste, reduce defects and develop processes and procedures that are reinforced by a variance reporting and corrective action tracking tool to ensure compliance and visibility to quality improvements.
When Should a Hospital Talk to PCD Partners about Co-Management Arrangements (CMAs)?
When it is seeking a strategy to engage physicians in strategic planning, managing hospital product and service lines, or in programs to improve efficiency, clinical quality, and patient safety.
When it needs to collaborate with its disconnected silos of currently employed physicians, independently owned practices, and joint ventures to manage costs and quality.
When it needs a way to recruit, retain and involve private practice physicians who not interested in hospital employment.
When its existing quality initiatives are not delivering optimal results.
When it wants to build a foundation for measuring and improving quality to better position itself for shared risk reimbursement models and accountable care.
When it is struggling to create a single hospital-physician “brand.”
Clinical (or service-line) Co-Management Arrangements (CMA) are one of the most successful strategies that physicians and hospitals can use to achieve clinical integration, strategic alignment and collaboration.
The CMA can be used to define physician and management roles and responsibilities, service line governance, quality metrics and on-going financial rewards for physicians without violating Stark, anti-kickback or other regulations.
The CMA can co-exist with any other alignment structure and it is the only structure that requires the use of data to improve quality.
A CMA allows physicians to share in the hospital’s service line revenue in exchange for providing operational oversight of the service line and achieving defined quality goals.
A CMA can foster a close working relationship between a hospital and its physicians to place a priority on working toward common economic and patient-centered goals.
A CMA can be used to build the foundation to position physicians and hospitals with ACOs that are looking for efficient partners.
A co-management agreement is generally set up to provide additional administrative and bonus compensation to reward physicians for taking responsibility for improving metrics related to quality, efficiency, and budget in a hospital service line.
Physicians are directly rewarded for improvements in a service line’s operational, clinical and budgetary performance and compensated in addition to their professional fees.
The CMA can provide the incentive for physicians to do more work in that particular hospital, subsidize the physicians’ incomes, and reduce the incentive for the physician to compete with the hospital.
The CMA incentive compensation can be an attractive alternative to hospital employment, while still aligning interests to help the hospital to become more competitive.
PCD Partners is comprised of world class physicians, academics, and entrepreneurs who have decades of experience with collaboration in medical quality and practice improvement systems for large scale practice management and clinical practice improvement.
The founders and principals of PCD Partners have devoted their careers to establishing themselves as leaders in the healthcare field as physicians, academics, senior administrators, entrepreneurs, and lawyers. Their collective wisdom and experience is a critical component of every PCD Partners offering.
PCD Partners was formed to bring together the combined experience and intellect of our principals to apply towards solving many of the challenges that physicians and hospitals are facing. Our partners are committed to playing an active role in improving the efficiency, quality and consistency of healthcare delivery. We have the clinical, administrative, quality, and systems acumen to help any healthcare delivery system.
PCD can help define quality and efficiency performance objectives and metrics, structure a data management plan, develop and deliver training and operations plans, and provide an independent 3rd party Valuation Fairness Opinion. Our real time dashboards will help to transform data into knowledge that is meaningful for all parties.
PCD can help to maximize quality improvements by leveraging our experience in gathering meaningful clinical data and transforming it into evidence based treatment protocols to improve patient outcomes.
PCD has the clinical skills, operational know-how and the data expertise to help to develop the process improvements that ensure the realization of measurable and meaningful results.
PCD’s consultants are trained in Lean Six Sigma and ISO 9001 to identify and reduce waste, reduce defects and develop processes and procedures that are reinforced by a variance reporting and corrective action tracking tool to ensure compliance and visibility to quality improvements.
Why Should Attorneys Consider Recommending a Co-Management Arrangement to Healthcare Clients?
The health care industry’s increasing emphasis on quality of care and improving outcomes has created a need for innovative business models that align the interests of physicians and hospitals without conflicting with fraud and abuse laws.
Hospital/Physician alignment is a prerequisite for hospitals to be able to realize meaningful change.
There are many alignment structures that can be used depending on the goals of the alignment.
The CMA is a very versatile and effective structure because:• It can co-exist with any other alignment structure,• It provides on-going financial rewards for the physicians,• It’s flexible and adaptable,• It can provide a first step towards accountable care , and• It leads to improved patient outcomes and establishes a process for
Acquiring Entity Continuity of PhysiciansEstablish Quality MetricsFinancial Incentives for Physician ContributionsInfrastructure for Protocol Based Care
Being Acquired Assure continuity of available physiciansEmpirically demonstrate quality achievements
Elevate Service Line Incentives for physicians for leadership of service line and attainment of quality improvements
Physician Independence
Assures joint hospital/physician management and financial incentives for high performance
ACO readiness Establish a durable quality infrastructureIncentives for providing accountable careDefines protocols for multiple providers
Retention & Recruiting Can be used to create favorable and flexible work conditions while providing financial incentives.
PCD Partners is comprised of world class physicians, academics, and entrepreneurs who have decades of experience with collaboration in medical quality and practice improvement systems for large scale practice management and clinical practice improvement.
The founders and principals of PCD Partners have devoted their careers to establishing themselves as leaders in the healthcare field as physicians, academics, senior administrators, entrepreneurs, and lawyers. Their collective wisdom and experience is a critical component of every PCD Partners offering.
PCD Partners was formed to bring together the combined experience and intellect of our principals to apply towards solving many of the challenges that physicians and hospitals are facing. Our partners are committed to playing an active role in improving the efficiency, quality and consistency of healthcare delivery. We have the clinical, administrative, quality, and systems acumen to help any healthcare delivery system.
PCD can help define quality and efficiency performance objectives and metrics, structure a data management plan, develop and deliver training and operations plans, and provide an independent 3rd party Valuation Fairness Opinion. Our real time dashboards will help to transform data into knowledge that is meaningful for all parties.
PCD can help to maximize quality improvements by leveraging our experience in gathering meaningful clinical data and transforming it into evidence based treatment protocols to improve patient outcomes.
PCD has the clinical skills, operational know-how and the data expertise to help to develop the process improvements that ensure the realization of measurable and meaningful results.
PCD’s consultants are trained in Lean Six Sigma and ISO 9001 to identify and reduce waste, reduce defects and develop processes and procedures that are reinforced by a variance reporting and corrective action tracking tool to ensure compliance and visibility to quality improvements.
PCD Partners’ world class physicians, academics, and entrepreneurs have decades of experience with collaboration in medical quality and practice improvement systems for large scale practice management and clinical practice improvement. Their collective wisdom and experience is a critical component of every PCD Partners offering.
PCD Partners offers a variety of services that our built around our core competencies comprised of:
• Extensive clinical skills,
• Capture, design, implementation and presentation of clinical data,
• Effective operational expertise,
• Lean Six Sigma and ISO 9001 based process design and implementation. 5.1
PCD Services
Co-Management Arrangements
Quality Data Capture System
Service Line Process Redesign and Optimization
Design, Implementation and Operation of Multi-Center Registries
Quality System Design, Implementation and Operation
PCD helps your organization – whether it is a physician group, hospital or integrated delivery system – develop the best structure for aligning stakeholders to allow for improved integration, enhanced performance and increased value and quality.
•CMAs are permitted contractual relationships to establish a quality systemwith financial incentives for meeting aligned performance goals
•CMAs allow hospitals to share facility fees with non-staff physicianswithout violating Stark and anti-kickback laws
•CMAs require the development and collection of metrics for process quality and efficiency measurement and management, with a prohibitionof measures that could induce denial of service
•CMAs were first created in 2008 based on the Advisory Opinion 08-16and are not affected by PPACA
We support your healthcare organization's alignment structure
Quality Data Capture System
Our platform includes a Data Capture and Reporting interface designed to create a robust, secure and HIPAA-compliant quality solution with minimal set-up costs.
Physician group and hospital executives are provided with real-time dashboards that display information on key performance measures. Data that is collected from source systems is validated through a transparent governance process to ensure physicians and hospitals can trust the results.
As a "data arbiter", PCD ensures that the measurements used to monitor quality and drive financial incentives are valid and trusted by all stakeholders.
Service Line Prioritization: Diagnoses service line performance vís a vís one another System-Wide Service Line Rationalization: Prioritizes system growth at service line and sub-service line Technology Evaluation Process Redesign: Identifies opportunities to improve innovation management Capital Prioritization: Investigates need- and nice-to-have capital equipment in the coming years
White PapersDr. Grant Bagley and Wes Chapman offer insights on how Co-Management Arrangements provide a realistic strategy for efficiency, quality & alignment.
Dr. Vekram and Wes Chapman discuss complexity and its impact on the selection of quality systems.
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Dr. Vekram and Wes Chapman offer insights on how volume impacts quality.
Dr. Vekram and Wes Chapman provide a roadmap for using your quality system to make you money.
User Stories“I want to be able to go to my computer and be able to see all of my quality measures and get a quick assessment of their effectiveness……….
“I want to build a registry to collect all of the pertinent data on a certain procedure, initially to get an internal perspective, but ultimately I would like to be able to merge that data across a broader sample………..”
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“I would like a single view of all of my quality projects…………”
“I have this CMA contract but I don’t know what quality measures to use and I can’t get an IT resource to save my life…………”
We are seeking talented individuals who want to have ameaningful impact on improving our healthcare systemIf you enjoy working with smart and ambitious people who know how to build successful venture backed companies, this is the place for you.Summer InternDepartment: Quality AssuranceDuration of Internship: 3 months Job SummaryWe are currently seeking summer interns to support configuration and validation of the internal document management system, and general technical support. This may include creating and maintaining records in accordance with ISO 9001 standards and PCD Partners' standard operating procedures. Qualifications/Requirements•Must be enrolled in a degree seeking program of study; preferablycomputer science, computer engineering, or equivalent technical discipline•Proficiency with MS Office, databases, and imaging/scanning systems;knowledge of document management systems desirable•Motivated self-starter; extreme attention to detail•Working knowledge of ISO 9001, or willingness to gain working knowledgeof ISO 9001 Responsibilities•Help configure and validate a cloud-based document management systemthat adheres to ISO 9001 standards•Establish that all key aspects of the document management systeminstallation adhere to the PCD's predetermined specifications•Establish process control limits and action levels which result in a productthat meets all predetermined requirements•Establish that the process, under anticipated conditions, consistently produces aproduct which meets all predetermined requirements•Confirmation by examination and provision of objective evidence that the specified requirements have been fulfilled•Create a document stating in detail the validation protocol, including testparameters, product characteristics, and decision points on what constitutesacceptable test results •Tactical and strategic planning capabilities as dictated by the Position•Assist as technical resource as neededHow to ApplyPlease send an email indicating your interest with your resume attached to Vekram Jenarthanan: [email protected]
Lean Six SigmaLean hospital and physician group techniques improve the velocity of your processes by eliminating waste to improve efficiency and utilization. Six Sigma reduces defects by applying a proven methodology to help you to optimize your processes to improve care quality. Together, Lean Six Sigma allows your staff to improve both outcomes and cost, thus driving value.
Along with faculty from the Dartmouth community, PCD has developed a custom Lean Six Sigma for Clinical Healthcare training program to support your staff in executing your organization's improvement structure and quality improvement goals.
As part of its web-based technology platform, PCD provides Lean Six Sigma project management software. Corrective actions are ranked on a cost / benefit scale on our integrated Lean Six Sigma Project Management tool. We assist your team in selecting projects that yield the maximum value for the lowest cost
ISO 9001 Quality SystemRobust documentation and standardized roles are critical for sustainable improvement and quality initiatives. ISO 9001 is the proven system that manages these quality management standards.
This ISO 9001 Quality System standardizes processes, transmits procedures, keeps records of training completed and provides a way for clients to initiate and track corrective actions on their quality improvement projects.
We guarantee ISO 9001 certification for your quality system. In addition, we act as an independent third-party to manage data and processes, oversee quality improvement projects, and channel the flow of incentive payments through the CMA to keep your organization and stakeholders aligned and compliant.