Online Business Communication Tools


image courtesy of

In part one of this two-part article, we focused entirely on Microsoft Office 365 because of its dominance in the cloud based business tools market. In the final part of this series, we will focus on the competition for Office 365 as well as other applications that complement Office 365 and alternate communications strategy’s. It’s difficult to compete with a product that has such a dominating market share. To do this, the competitor must have vast resources in development and marketing. The primary competitor for Office 365 comes from Google and their product G Suite, which is built on Google’s Gmail platform. Gmail’s tremendous success in the personal email market has allowed it to be able to build a business product that is a formidable competitor with Office 365. Business Gmail, in the G suite business product, gives its customers the ability to choose an email address that includes the company domain. Additionally, it offers a shared calendar for setting appointments within and outside the group. Google voice adds additional features such as video and voice conferencing. Google has developed products that compete directly with Microsoft Office products Word, Excel and PowerPoint. These applications not only look and act like their Microsoft competitors but also interact well with them. Using Google Drive with these applications can allow collaboration on documents between users on the same account.  Despite the disadvantages of competing with the clear market leader, Google has developed a competitive product both and functionality and price.       (See figure 2 below)


To follow are some of the most popular business communication applications that provide additional functionality that Microsoft and Google’s communication platforms don’t provide.  


Slack is a cloud-based collaboration tool similar to the instant messaging platforms many of us have used in the past. This type of communication’s best place in business is when faster attention or response time is needed than email typically provides. Users can be divided into chat rooms, or channels, for specific applications such as customer service. The content of all conversations, from the start, is searchable and documents can be attached from the desktop or via integrations with Dropbox or Google Drive.


Many small and medium sized business organizations that don’t have large marketing budgets will utilize a marketing automation platform like MailChimp. Marketing automation can take over repetitive tasks such as welcoming new subscribers and reconnecting with an abandoned cart from their ecommerce website. MailChimp will also automate e-mail marketing campaigns and provide detailed analytics of their success. MailChimp‘s popularity has grown as they have developed tight integrations with e-commerce platforms like Shopify and Magneto.


Those of us who have worked in a large enterprise are familiar with customer relationship management software or CRM. These software platforms are designed to build stronger relationships with existing customers, improve communication, and increase and track sales. The companies that create and support this enterprise software are technology giants like Oracle and The barrier to entry for these platforms for the small and medium business has been the cost of the software. Not only are subscription licenses expensive but implementation and support costs are very high. More recently a group of Cloud based CRM‘s such as HubSpot has allowed the SMB market to utilize CRM. With these providers, entry costs are low and sometimes even free. Just as important, their integrations with Outlook and G Suite make it easy to implement and support. Like Office 365 described in part one of this article, this software tool has leveled the field between enterprise and SMB.

These business communications applications rely on the ubiquitous nature of the internet and the cloud for delivery. Therefore, this discussion can’t be complete without mentioning the two leaders in the cloud market: Amazon’s AWS and Microsoft Azure. While these technologies have been discussed in previous articles (Azure, AWS), an important detail must be added here. Both technologies have been made so simple to login to their console and create cloud instances it has created a business problem, cloud billing scope creep. The console administrator can select resources needed, and the services can even sense when expansion is required. However, much of the billing algorithms for both platforms are transactional or based on cloud usage. This can allow the affordability factor of the cloud to reverse itself quickly and become a costlier way to build your infrastructure. To help our clients solve that problem, Two Ears One Mouth IT Consulting has created a Cloud Billing Analysis & Savings Service (CBASS). More will be revealed later regarding this service, needless to say we can analyze your cloud billing, make adjustments and re-validate the solution.

If you need assistance with your current IT cloud project, please contact us at:

Jim Conwell (513) 227-4131

#cloudbillinganalysis #cloudbillingsupport #cloudstrategy #cbass

Online Business Communication Tools

online-business-toolsimage courtesy of Phoenix One Sales

One major advantage Small and Medium Businesses (SMB) have today over their predecessors are the communication tools which are available. Often these come at little or no cost, and can be purchased and delivered over the internet. Theses cloud based platforms enable SMB to run more efficiently and compete better with their rivals in large organizations. Several years ago, if a company wanted an enterprise class email platform the choices were very limited. By far, the most popular choice would be to implement a Microsoft Exchange email server. Exchange email has major advantages over the typical business email account or personal email services that small businesses relied on. Some of these include: shared calendars with meeting invitations, virtually unlimited email archiving and storage, customizable folders for organization purposes and the ability to have the email address with the business name or domain ( However, these valuable features came at a very high cost. The business first had to purchase the Exchange server licenses and the client access licenses (CALS) and then the server hardware, with plenty of RAM and storage to satisfy Exchanges resource requirements. Finally, and most costly of all, is the person who will implement and administer the Exchange server. The administrator of an exchange server is a highly paid resource that the enterprise will come to depend on 24 hours a day,7 days a week, 365 days a year. These costs previously prohibited smaller businesses from purchasing Exchange, or any other enterprise email solutions.

When Microsoft introduced Office 365, the pricing model changed dramatically, the cloud based Software as a Service platform provided email in addition to their popular business applications.  No server hardware was required, and licensing was much simpler and less expensive. An administrator was still required to add and delete email accounts, but it didn’t require the expertise to manage the hardware or the Exchange server software. Additionally, if selected, it may include up to date licenses for Office products, Word, Excel, PowerPoint and Outlook. This solved another problem for the IT manager: different licenses and versions among users for Office applications. With an Office 365 license, a user can download the current version at any time. All of this has allowed smaller companies to have the advantage access to the same level of technology of their larger rivals. Office 365 was priced in a way that made it a “no-brainer” to business with either 5 users or 50,000 users.

In this part 1 of this article, I will describe the different components of Office 365 and pricing of some of their more popular bundles for SMB. In the following post I will list and describe Office 365’s competitors as well as packages that can complement your communications strategy.

Office 365 includes bundled services as well as additional packages that can be added in a’ la carte fashion. Below in figure 1 are a couple of the most popular bundles for SMB and their cost as of the time of this post.

o   Outlook/Exchange email account- Microsoft Exchange has become the standard for email service with all the features mentioned above. Each Office 365 license offers access for up to 5 devices including tablets, phones PCs and MACs.

o   Office Applications- Bundles include the most recent versions of Microsoft’s most popular applications including Word, Outlook, Excel, PowerPoint, One Note and Access. All of these can be updated by each user as Microsoft releases new versions.

o   Web Apps- These web versions of the above applications can be used in tandem with, and stored on, One Drive. This allows users to view and edit documents without a bundle that includes the Office applications.

o   One Drive- A secure cloud storage platform where files can be stored and shared. Bundles including One Drive include at least One Terabyte of data. Business accounts supporting multiple users, a common One Drive account is provided to support SharePoint.

o   SharePoint- A common file sharing platform for documents used by employees as well as customers. Some organizations use it so their customers are able to download brochures or other documents.

o   Yammer- An internal communication and social media platform.

o   Skype for Business- A video and voice conferencing platform. It can be used for specific applications such as webinars or a voice and video conferencing bridge which can connect up to 250 people.

o   Voice over IP (VOIP) phone services- These phone services used in the Skype platform and provided through the Enterprise E5 bundle. E5 will provide everything their enterprise would expect from a VOIP PBX including direct dial numbers, call plans and voicemail with unified messaging. Unified messaging organizes all messaging types, voicemail, email and fax, in one Outlook inbox.

o   Power BI Pro- Advanced personal and organizational analytics with MyAnalytics and Power BI Pro.

Just as it was difficult to compete with Microsoft on their operating system server platforms and Office applications, Office 365 is the leader in these technologies. In my follow-up post, I will describe platforms that compete with Office 365 as well as other applications that look to complement Office 365.

figure 1- the most popular Office 365 bundles for SMB


HIPAA- The Who, When and What’s its primary purpose?


The Health Insurance Portability and Accountability Act (HIPAA) was signed into law by President Bill Clinton in 1996, it has since created some of the most sweeping changes in healthcare reform at that time and for many years after. HIPAA was designed to eliminate discrimination by protecting and securing patients’ health data. This law has since grown into a government regulation with a much larger scope and focus on information technology as it relates to healthcare. HIPAA’s three primary functions are:

  1. Protect the privacy and provide security for Protected Health Information (PHI).
  2. Increase the efficiency and effectiveness of the healthcare system.
  3. Establish standards for accessing, sharing and transmitting PHI.

HIPAA was originally segmented into 3 primary components: the Privacy Rule, the Security Rule, and the Enforcement Rule. Several years later it was amended to include the Health Information Technology for Economic and Clinical Health Act (HITECH) and the Omnibus Rule.

The Privacy Rule

The Privacy Rule was designed to protect and keep private all of our Protected Health Information (PHI). PHI includes information such as a patient’s street address, city, birth date, email addresses, social security numbers or any type of identifiable information obtained in the process of receiving care. Individuals may be charged with either civil or criminal penalties for violating HIPAA privacy rules.

The primary goal is to protect individuals’ PHI while promoting an efficient “flow” of information. It applies to covered entities, which are defined as hospitals, doctor’s offices, insurance companies or any organization that accepts health insurance. It also applies to business associates; organizations that create, maintain or transmit PHI on behalf of a covered entity. These entities must protect any PHI transmitted in any form: electronic, oral or written.

The Privacy Rule also allows for an individual’s personal right to access, review and obtain copies of their PHI. In addition, it authorizes the right to amend or request restrictions on the use of their PHI. As a part of the Privacy Rule, covered entities and business associates are required to appoint a privacy officer, complete workforce training on HIPAA compliance and construct business associate agreements with any entity with whom you are disclosing or sharing information.

The Security Rule

The Security Rule sets standards for covered entities and business associates for the security of electronic health information.

The Security Rule has three primary components:

  1. Administrative safeguards– These begin the security management process by identifying a security officer and performing a risk assessment. The goal is to evaluate risk and make sure only authorized personnel can access PHI. Also, contingency and business continuity plans must be addressed and documented in the event of a disaster or disruption of business.
  2. Physical safeguards – These cover facility access controls (badges), alarms and locks. Any PHI data must be encrypted at rest and in motion and have adequate passwords. The use of tablets, phones, etc. must also be considered.
  3. Technical safeguards- These include audit controls (SSAE), which record and monitor transactions, password, pins or biometrics.

All security Information must be documented and accessible on demand. It is required to be updated and archived for 6 years.

The Enforcement Rule

The Enforcement Rule sets the standards for penalties in the event of a HIPAA violation or breach. Initially, there were very little violations reported or penalties assessed. Today, there are still not many penalties compared to the actual violations, which occur frequently.

Most common infractions include:

  • Unauthorized disclosures of PHI
  • Lack of protection of health information
  • Inability of patients to access their health information
  • Disclosing more than the minimum necessary protected health information
  • Absence of safeguards for electronic protected health information

The following are the covered entities required to take corrective action to be in voluntary compliance according to HHS:

  • Private practices
  • Hospitals
  • Outpatient facilities
  • Group plans such as insurance groups
  • Pharmacies

(source:, 2013)

HITECH and the Omnibus Rule

In 2009 Congress passed an amendment to HIPAA: the Health Information Technology for Economic and Clinical Health Act (HITECH). This amendment was designed to reduce cost and streamline healthcare through information technology. HITECH expanded HIPAA and implemented new requirements for the protection of PHI in Information Technology.

In 2013 HHS office of civil rights issued “the final rule” or Omnibus as a means of implementing the changes of HITECH. HITECH changes included:

  • It allowed for changes requested to PHI by individuals and required direct approval before the sale of PHI.
  • Business Associates became directly liable and are required to provide items such as workforce training, privacy officer and risk assessment. HITECH also assigned liabilities to subcontractors of business associates.
  • All breaches to HIPAA must be reported to affected individuals as well as the secretary of HHS. An additional risk assessment must then be completed for each breach.
  • HITECH introduced a tiered approach to breach penalties with recurring infractions in the same year totaling up to $1,500,000. It also gave the state Attorney General the power to enforce HIPAA violations.

HIPAA is one of the most sweeping and all-encompassing changes to ever impact the Healthcare industry. It has evolved to regulate the use of Information Technology within the scope of healthcare in addition to protecting the privacy of a patient’s PHI. Unfortunately, like most government regulations, it is vague and very difficult to enforce. In contrast, it has created valuable safeguards for the protection of our personal health records and it has encouraged improvements to the flow and integration of healthcare data.

If you need assistance with any current IT projects (Cincinnati or remote), or risk assessment for your practice please contact us at:

Jim Conwell (513) 227-4131

Project Management, Considering the OutSource

Project Management- Inside or Outsource?

Information Technology (IT) doesn’t deserve the credit for starting the Project Management (PM) process, but no business unit in the enterprises has developed it more. Since computers were introduced into business, and more with the advent of the personal computer, a well-defined process has to be required to keep these tools effective. A skilled Project Manager can guarantee the vision and goals of the project are maintained. In addition, the Project Manager will mitigate security risk and effectively and efficiently use all available resources. They will communicate expectations of responsibility to all team members and make sure the project is completed on time and within the budget.

PM challenges for IT

One reason IT is so challenged with effective PM is the diversity of its projects. Every other business unit is dependent on IT. In larger organizations, the IT will be working directly with finance, sales and the executive suite at the same time. All these groups have unique expectations for IT. Finance may question why the department isn’t running on the latest version of their Enterprise Resource Planning (ERP) software. Sales may wonder how they can use the corporate email to communicate their products and services to their prospects. These requests, in addition to internal infrastructure repair services, keep IT departments overwhelmed and in a reactive mode. These unique and diverse requests have driven IT departments to develop and utilize different PM methodologies some of which are detailed below.

PM Methodologies

  1. Waterfall Method

    – The waterfall method is the most common PM methodology as well as the easiest to implement. Each step is developed in a logical order with one step leading to the next. The current step must be completed before the following step begins. Although this method is easy to implement, it can get complicated as the customers need change. A change in the customer’s needs can create a roadblock and set the project off track.

  2. PMI/PMBOK Method

    – PM has become so vital to all businesses that a Project Management organization has evolved, the Project Management Institute (PMI). Some managers have taken PMI’s conventions and used them to develop a methodology. Their primary conventions, or steps in the project process, are: initiating, planning, executing, controlling and closing. While this creates a very broad methodology, these five standards are universally accepted.

  3. Agile Method

-The Agile method is a product of the 21st century. It was created out of the need to collaborate with your customer through the project process. Agile collaboration is valued over following a rigid plan. Project objectives are developed by the customer and the final deliverable will most likely change the process. Agile has many flavors, or sub-categories, of its methods. The most popular Agile framework to date is Scrum. Scrum is a team-based process with the team led by the Scrum Master. A Scrum Master’s primary focus is to support the team by clearing obstacles and making sure the work is getting completed in the most efficient manner. The teams meet frequently and will break down segments of the project into units called sprints. Agile, and Scrum, allows for flexibility and quick development that many times lead to a satisfied customer.

While all these methodologies will work in IT projects, each has its own set of circumstances where it is the best fit. Many articles have been written about PM and its methodologies including online training and certifications. This free information is valuable, however, the greatest value comes from an seasoned project manager that has experience with successful implementations.  Finally, the most important thing to know is that Project Management is a process, and as well know, processes can always be made better.

If you need assistance with your current IT project (Cincinnati or remote), please contact us:

.Jim Conwell (513) 227-4131

Death of the Salesman?


Lately I’ve been thinking about the beginning of my sales career and how different things are for today’s salesperson. I don’t believe salespeople have exclusivity to the story “How the Internet has changed Business”, but it is the business story I know the best.

I was fortunate my beginnings in telecom in the 1980’s was in project management (PM), not in sales. This allowed me to work closely with sales people, as well as learn the technical side of the business first. The company I worked for, InfiNET, sold and installed phone systems of 100 users or more. After a few customer meetings of discovery, we would typically “cutover” the phone system after 5 pm on a Friday evening.  Our customers had no tolerance for phones to be down for even a moment during business hours, at that time it was their most critical application.

Inevitably, there would be unplanned problems we would resolve on site. This allowed me to create a close relationship with my best technician, a bi-polar genius named David. David knew more about the phone company network, and the equipment we installed, than anyone I’ve ever known. It was on these working weekends, watching David systematically troubleshoot issues, that I sharpened my technical expertise.

The owner of that company, as I was just getting comfortable in PM, asked me if I would like to try sales. I laughed out loud, and gave an emphatic “NO!” Soon I realized that it really wasn’t a question, and my sales journey began. My technical and application knowledge was deep, and my customers trusted me already, so my sales career began with huge success. It wasn’t long before I needed to sharpen my sales skills to keep my funnel growing.

At this time I discovered at the time that the salesperson was a trusted counselor, educator and guide through the process of acquiring goods and services. When I would first meet my prospects for large phone system they had no idea how these systems worked, the components and how to make the right purchase. Business Telecom was still young and businesses were used to paying rent to the monopolistic phone companies for their phone systems. For that reason, the decision makers were primarily financial leaders, not the IT managers that handle the process today.

Fast forward to today, the technology has matured and the advent of the internet has affected the purchase process greatly. Cold calling has become very rare with voicemail and email. Telecommunication has integrated with IT and the primary decision maker is the IT manager. The IT manager, as with most buyers today, has a completely different process for purchasing. The trusted counselor, educator, and guide is dead. The internet has eliminated the role of intermediary for the salesperson. I recently read that 90% of B2B purchases start with a web search, a complete turnaround from when I started.

Where does sales go from here?

Contrary to the messages above, sales is not dead, it’s not even sick. It’s changed, so we need to change. My examples above are about the businesses of technology, but the internet has affected all business. Just ask your travel agent or taxi driver the next time you can find one. The salesperson plays a vital role in business and always will. So how can the salesperson still provide value in today’s environment?

  1. Bridging the Gap– As much as the buyer thinks he knows from his research, the salesperson knows more about the product and service he represents. I’ve seen a gap between what the buyer believes he’s getting and what he’s actually going to get. Once he knows the buyers perspective the salesperson can then see that gap. At that point he can help the purchaser by eliminating mistakes and confusion he has seen others make.
  2. Connecting People– With the demise of traditional prospecting methods, new ones must be developed. Networking is a huge part of this; the salesperson of today spends hours every week building his network. He can share these valuable resources through referrals. It can be a risky exercise to introduce a prospect to others that could offer value independently. Ultimately, he should trust the process of helping decision makers and organizations in this way.
  3. Provide and Display Expertise– Another technique to be developed is sharing knowledge and expertise. Today this is through blogging and social media. The information should be given away in hopes that when the prospects need help they will come to the expert. I’ve see this process work, you need to trust the

These are some of the ways I’ve found, if you have feedback or know of other ways of providing value please share them with me at or call me at (513) 227-4131

Preparing for the Cost of a Data Breach


One of the biggest challenges, particularly for small and medium businesses (SMB), is trying to anticipate and budget for the cost of a data breach. While larger, often publicly owned, corporations can sustain huge financial losses to litigation or regulatory penalties, organizations with less than $100 million in revenue cannot. Even with the leadership of the SMB becoming aware of the inevitability of an attack, they don’t understand what the potential costs could be and how to prepare for them. This may cause them to task their Chief Information Officer (CIO) or Chief Information Security Officer (CISO) to estimate the cost of a breach for budgetary purposes. The CISO, understanding that addressing the breach issue starts with IT governance, may attempt to educate their company’s leadership on the tools necessary to help to prevent a breach. Both leaders face a difficult decision: what monies are put aside for data security and do we focus on prevention or recovery? Most would agree the answer is a combination of the two: for this exercise I will focus on the components of cost once the data breach has occurred. The four primary silos of cost are response and notification, litigation, regulatory fines and the negative impact to reputation. When the affected enterprise forecasts costs for a potential breach, it not only gives the company an idea of the financial burden it will incur but it also helps those affected to consider documenting the steps to take in the event a breach is discovered.

Notification, the first cost incurred, is the easiest to forecast. Most businesses have a good idea of who their customers are and how best to notify them. A good social media presence can simplify this as well as reduce total costs. After the breach is discovered, the first task is to try to discover which customers were affected. Once that is determined, the business needs to decide the best way to notify them. US Mail, email or social media are the most common methods. The most efficient process for each must be determined. Many states have laws around breach notification and timing, which need to be considered and understood as a part of the process. The larger the organization, and the associated breach, the more complicated this process becomes. In a recent breach of a large healthcare organization, deciding how to contact the affected customers took longer than it should have because the company wasn’t prepared for a breach of the magnitude they faced. The breach affected tens of millions of customers. It was decided that a conventional mail notification was required at a cost of several million dollars!

Litigation and regulatory penalties are similar and can be prepared for in the same way. While regulatory penalties can be better estimated up front, both costs can get out of control quickly. The best way to prepare for these types of costs are with Data Breach Insurance, also known as Cyber Liability Insurance. Cyber Liability Insurance provides coverage for the loss of both first-party and third-party data. This means that whether the data breach happens directly to your company or to a company whose data you are working with, the coverage will be in effect. While most of the time Cyber Liability Insurance is considered for the larger expenses, like lawsuits and regulatory penalties, the right plan can be used for all four types of aforementioned costs: notification, litigation, regulatory fines and damage to reputation.

The hardest to define, and many times the costliest, is the damage to the breached company’s reputation. In a recent study, the three occurrences that have the greatest impact on brand reputation are data breaches, inadequate customer service, and environmental disasters. Of these, the survey found that data breaches have the most negative impact on reputation. If the affected company is in the IT industry, and specifically IT security, the effects are likely to be devastating to the organization. The only trend that seems to be softening that damage is that breaches have become so common that people are more likely to disregard the notification. Greater frequency certainly is occurring, but it isn’t anything the affected company can include in their plan. What you must include in your plan is the message you will communicate with the public to lessen the negative consequences. This should include how you fixed the problem and how you plan to prevent additional breaches in the future. In a recent healthcare breach, the organization partnered with a well-known security platform to better protect patient records going forward.

Considering these four primary areas affected is critical to helping leadership determine the costs associated with a data breach. If you have any questions about determining the cost for your business, contact us today.

Contact us so we can learn more about the IT challenges with your organization.

.Jim Conwell (513) 227-4131

From Meaningful Use to MACRA or… When the MIPS comes Down?!


Most of us who have been in the business of healthcare for 5 years or more are familiar with the term “Meaningful Use.” For others, let me define “Meaningful Use” at it will serve as the basis for this blog. Meaningful Use was a program implemented by the governmental agency, “Centers for Medicare and Medicaid Services” (CMS) to measure and reward medical practices for the use of Electronic Health Record (EHR) technology. EHR is the software a medical practice uses to manage its business and store all Protected Health Information (PHI). I believe Meaningful Use was a success. It brought a much greater awareness to EHR technologies, and pushed practices small and large to evolve, and store their PHI electronically. Storing information electronically in turn allowed medical practices to provide a better level of service, care coordination and sensitive data security to its patients.

You may have noted I used 3 three letter acronyms (TLAs) in the first paragraph. This comes with working with information technology and is multiplied by government bureaucracy.   There are plenty more to come, so I will document the rest up front, right now! 

1.    MACRA- Medicare Access and Chip Reauthorization Act

2.    QPP- Quality Payment Program

3.    APM- Alternative Payment Model

4.    MIPS- Merit-Based Incentive Payment System

5.    EC- Eligible Clinician

The next year brings the sequel to Meaningful Use, MACRA and the payment system within it: MIPS. The QPP final rules were posted on November 2, 2017 giving participants two months before reporting starts on January 1, 2018. Nearly all healthcare providers, physicians, physician assistants and nurses must participate. The scoring for MIPS will be based on a point system, look for future BLOG’s to take a deeper dive on MIPS including the point system.

A practice that bills Medicare Part B* claims in an amount less than $90,000 or has fewer than 2,000 Medicare claims is not required to participate. The smaller practices that do report receive some breaks; groups from 1-15 clinicians get an automatic 5 points, even if completing the minimum amount of reporting. Groups of 1-10 clinicians can team up with other smaller groups to combine reporting, regardless of location or specialty. This will allow some “rock-star” practices to report with lesser groups allowing all to benefit from the payment program.

MIPS reporting for 2018 will be divided into 4 categories, each of which will have a different weighting. Additionally, the weighting percentages are set to change in years 2019 and 2020. The following are the four reporting categories and their weights:

  1. Quality (60%) – The practice selects at least 6 measurement criteria to report on from a choice of over 300. Some are general categories and some are for specialty practices. For example, a cardiologist may report on measurements for controlling high blood pressure among all their patients. Quality is the only category that must be reported on for the entire year.
  2. Advancing Care Information (25%) – ACI includes all the measurements that were a part of Meaningful Use. It measures how the practice promoted patient engagement (patient portal) and exchanged information using EHR technology.
  3. Improvement Activities (15%) – The primary focus on Improvement Activities will be on care coordination, which is the ability to work seamlessly with other providers. Additionally, providers will have a list of over 900 categories and 9 sub-categories to report on.
  4. Cost (no mandated reporting in 2018) – This information will be based on data from Medicare claims received.

MIPS reporting options for 2018 

  • Option 1 – Submit “some data”- Quality is the only data that must be reported for the entire year. Enough data for 15 points must be reported.
  • Option 2 – Quality full year – Submit Quality full year, Advancing Care Information and Improvement Activities for 90 days.
  • Option 3 – All categories full year- Cost not reported in 2018

A practice can pick any of the options they choose, most likely it will be driven by their understanding of the program and the resources they assign to it.

More will be revealed on MACRA, MIPS and the best practices for reporting in the coming months. Due to the consequences of failing to report, and the urgency of a short preparation period, many healthcare organizations will need assistance with reporting. MIPS has much greater consequences than Meaningful Use.

First, all information submitted for reporting will be public. We will see reported information on CMS websites allowing you to compare providers, like we look at online reviews for traditional business today. Secondly, MIPS does more than just reward compliant practices, it also penalizes non-compliant ones. Meaningful Use was initiated as an experiment to some extent. MIPS seems to be making the transition to a regulation that is here to stay. Healthcare organizations will either need to get on board or face serious consequences.

Given the importance of MIPS to the healthcare industry, and the continued flow of information to this day, we will provide another update to this before year-end. Please look for a deeper dive on MIPS information including components not covered here, like how the points system works and Alternate Payment Methods (APM), that will become more important in the years to come.

*Medicare Part B is the portion of Medicare that pays for ambulatory services such as doctor office visits and prescriptions. Part A applies to hospital stays.


To meet and learn more about how MIPS reporting can affect your organization contact me at
 (513) 227-4131 or

What’s a Managed Service Provider (MSP)?



Most organizations, big and small, have gone through this exercise with Information Technology, as well as other services. “Should I hire a dedicated person, assign it to someone in the organization as an additional responsibility or outsource”? What’s a Managed Service Provider (MSP)?  When posing this question for IT services; size matters! In this exercise, we will assume there are from between 20 to 100 IT users in the organization considering an MSP.

Size Matters

When a company I consult with is near the lower end of this user count many times they will tell me that an employee’s relative; brother, sister or husband does their IT work. I call this type of IT provider a trunker, as their office and tools are in the trunk of their car. A trunker can be a smart way to go, receiving a prompt and personalized service response. However; it is important the trunker has a way to stay current with technology. Also, at least one employee of the organization be aware of all he or she does and documents all passwords and major tasks.

 I’ve seen the same level of service can be achieved with an IT MSP as the organization outgrows the trunker. The MSP will typically have an upfront cost to inspect and become familiar with the IT infrastructure. Then there will be a recurring charge, monthly or quarterly, for help-desk support that is either handled remotely or on the customers site. With few exceptions, organizations of 100 employees or less, are serviced satisfactorily with a remote agreement. When an issue calls for onsite service they will pay the predetermined labor rate. Another factor that is determined up front are Service Level Agreements (SLA’s). SLA’s will define how quickly the MSP will respond. As it was with the trunker mentioned before it’s up to the organization to keep track of the IT provider and their tasks. This can be made easier by the fact that an MSP, because it will engage multiple technicians for one customer, needs to document everything for their own benefit.

Why Use an MSP for My Business?

The MSP is the system I see work most often. So let me answer my original question. Why outsource my I.T?!

1)   Consistency and predictability of service. Based on the MSP’s reputation and the SLA’s provided most organizations experience responsive and high continuity of service. When the agreement ends, they can expect a smooth transition to the new vendor or person. I have witnessed many times when the trunker provider relationship ends poorly. The organization can be put in a position of having no documentation and not even knowing the passwords to access their systems.

2)   Transparency. Most MSP’s, as a part of their service, offer dashboards showing real-time status of devises on the network. Many even offer your business remote access to monitor your network. This is a major cost reduction based the cost to host or maintain monitoring yourself.

3)   Expertise. There is knowledge in numbers. Although you may only see or speak with one person as the face of your IT partner, you’re working with a team with vast experience and knowledge. The technical staff of an MSP will always have greater level of experience and a better knowledge of the trends in technology. This is particularly true in regulated organizations such as in healthcare and financial businesses.

Contact us for a free analysis of your business and what will serve it best.

Jim Conwell     (513) 227-4131