The Best Medicine
Kern Health System’s PMO is forging a change-ready framework and better patient access
2020 PMO of the Year Finalist
PHOTOS BY SAM GRANT
From left, Jeremy McGuire, PMP, LaVonne Banks, PMP; Richard Pruitt and Angela Ahsan, PMP
FG TRADE/E+/GETTY IMAGES
Size: 9 full-time employees
Portfolio size: 38 projects
Everyone needs access to quality healthcare—
but what that should look like is a wildly contentious and ever-evolving issue in the United States. As policies shift with the political winds, healthcare providers and payers must adapt to ensure top-notch patient care.
“I like to call it a consistent wildcard,” says Angela Ahsan, PMP, director, enterprise project management office, Kern Health Systems, Bakersfield, California, USA.
At Kern Health Systems (KHS), a health plan serving members in southern California, the enterprise project management office (EPMO) helps facilitate rapid change, whether that means reshuffling projects in the pipeline or juggling resources to keep programs across the portfolio in compliance.
Formed in 2011, the EPMO has helped KHS navigate several major transitions, including the introduction and evolution of the landmark Affordable Care Act, and transform access for some of the country’s most vulnerable people.
The PMO forges “an end-to-end connection—information sharing, continual outreach, transparency—just to ensure that our providers have everything that they need,” says Ahsan.
KHS provides care to more than 280,000 recipients of Medicaid, a government program for low-income individuals. As a nonprofit, KHS must stretch its budget as far as possible—and the EPMO helps KHS find cost-effective ways to meet all of its members’ healthcare needs.
“The more efficient our company is, the better we’re able to provide grants and programs to our members and our providers, which ultimately provides better healthcare to our members,” says LaVonne Banks, PMP, EPMO manager, Kern Health Systems.
Delivering high-quality healthcare starts at the top, with KHS’ governing board and executives setting a strategic vision to increase member, provider and employee satisfaction. But the EPMO is charged with making those objectives a reality.
“We want to make sure that we are connecting corporate strategy with our business execution in an efficient manner,” says Jeremy McGuire, PMP, senior director, government relations and strategic development, Kern Health Systems.
The EPMO partners with the organization’s business intelligence unit to collect data that helps it decide which projects or programs will deliver the most business value. The team asks business owners to clearly define the anticipated benefits of their projects, and it uses analytics to solidify the rationale behind each business case.
“It is truly a transparent and collaborative process where there is measurable prioritization criteria,” Ahsan says.
For instance, KHS’ Health Homes Program set out to provide members with complex medical conditions more timely access to care. Many of these patients were struggling to get same-day or next-day appointments with their physicians, which meant many were going to the emergency room for treatment that should have come from a primary care provider. To connect members with more appropriate care, KHS rolled out a patient-centered medical home model that provides holistic care at six locations across California’s Kern County.
“The goal is to get as many services to that member as possible in one place,” Banks says.
To measure the outcomes of the program, KHS analyzed enrollment and utilization levels, as well as patient outcomes, McGuire says. The program met its targets for enrollment, and member responses to surveys have returned extremely positive anecdotal results. But the real proof lies in how the program has improved patient behavior and care. By combining services at smaller, specialized facilities, KHS was able to decrease unnecessary emergency room use by 10 percent for program participants. Enrolled members in these programs also used inpatient hospital services 22 percent less.
“Having this kind of care option available to them really delivers the message that we care—that we are connected with them, we stay on top of their health needs, and we strive to understand their gaps in care,” Ahsan says.
With so many moving parts, KHS can only be as effective as its people. As part of its process to measure project success, the EPMO also audits each project manager’s performance. It looks at how well specific tasks were completed and identifies areas where employees could benefit from training, mentoring or coaching. In addition to improving their performance, this approach helps project professionals understand their career development arc.
The EPMO has created detailed job descriptions that show how roles differ and what levels of skills and experience people need to qualify for different positions. By providing context around potential career paths, employees gain a clear line of sight into their prospects for promotion and can grasp the competencies needed to move forward. The EPMO is also in the process of establishing dedicated portfolio management tracks to enhance the business domain knowledge within the EPMO.
PHOTOS BY SAM GRANT
Photo composite of EPMO team at Kern Health
“It is really about growth,” says Ahsan. “It’s all about creating clear action plans to take them to that next level in their career.”
One of the steps on every KHS project manager’s career path is earning a PMI certification. Depending on their job title, they are required to earn either the Project Management Professional (PMP)® or the Certified Associate in Project Management (CAPM)® within two years of hire. This helps KHS align its project management processes and gives an air of expertise to the EPMO as a whole.
“We find that PMI certification brings a level of professionalism and credibility to our staff,” says Banks.
The commitment to continual improvement doesn’t stop with employees. KHS also aims to support better health outcomes in the region’s health-care sector. To this end, the EPMO has organized a group of sister health plans from across California—creating a community where PMO leaders can share lessons learned and ask for advice.
“If the state regulator is going to tell all of us what to do, we are often all in the same boat, so to speak,” says McGuire. “So it was really helpful to compare notes: What are you working on? How are you solving certain challenges or problems related to certain specific efforts?”
For instance, with so much change underway, how should a health plan communicate with its members? How can an organization keep members informed as program offerings shift?
The group also discusses portfolio planning and shares priorities for short- and long-term outlooks. By assessing each other’s project management processes, members help PMOs elevate performance across the board.
“We saw a lot of positive feedback from folks who were able to learn, collaborate and share best practices that they were then able to take and implement,” says McGuire.
A NEW PRESCRIPTION
Maturity translates to new insights and more influence. And at KHS, the EPMO has helped project leaders learn to get involved with the regulatory process sooner. That’s why McGuire, who was previously the EPMO director, recently took on a full-time government relations role so the organization can better anticipate and move the needle on change.
“There’s a lot of draft legislation that comes out every year at both the state and federal level. Some of it will or will not get finalized,” McGuire says. “We want to actually advocate and weigh in. We want to make sure that whatever’s being discussed is really in the best interest of our members and our organization.”
With that understanding—and a realization that change is the only constant—the EPMO also has helped the organization create a more dynamic work-flow system. “We have informed our team members and, both across business and IT, they have a better level of understanding of what it means to now fluctuate with such dynamic elements that come down from a regulatory perspective,” Ahsan says.
However, there is a limit to how much the EPMO can take on. So when new priorities arise, that often means pushing another project to the back burner. To decide what should move forward and what should be delayed, the EPMO gives executives a holistic view of where resources are being used, what bandwidth is available and what trade-offs might need to be made.
“We want to make sure that we learn how to say no when we’re at capacity, and that’s actually pretty hard to do,” McGuire says.
Focusing the organization’s energy has helped the EPMO deliver more consistent project results. From 2017 to 2019, the portion of projects that delivered intended benefits jumped from 78 percent to 95 percent.
“If you have to ask me which constraint is the most important, it’s value,” McGuire says. “There’s no point in finishing on time, on budget and within your scope if you didn’t actually do what you set out for.”
This value-driven mindset has made the EPMO a central part of the transformation and growth of KHS. As its membership base, provider network and organizational structure have become increasingly complex, the EPMO has kept everyone moving toward the same goals.
“It is truly the glue behind the organization,” says Ahsan. “Without this glue, it can be a challenge to stay informed, to collaborate, to translate corporate strategies or any business strategy into actionable plans and results.” PM
Source: Kern Health Systems
Lights, Camera, Action!
Check out behind-the-scenes videos of this year’s PMO of the Year Award winners and finalists on PMI’s YouTube channel.