The Complete Guide to Time Study for Public Health

Public health departments play a crucial role in delivering essential services to communities, often juggling multiple funding sources to sustain their programs. One of the most powerful tools for ensuring full reimbursement and compliance is a time study—a structured method for tracking how staff allocate their time to different activities. Time studies help departments justify funding claims, optimize resource allocation, and meet federal and state compliance requirements.

Whether you're navigating Medicaid Administrative Claiming (MAC/MAA), Federal Financial Participation (FFP), Targeted Case Management (TCM), or Maternal, Child, and Adolescent Health (MCAH) funding, an accurate and well-documented time study can significantly impact your department’s financial sustainability.

This guide covers everything you need to know about time studies—from how they work to best practices for maximizing funding.

What is a Time Study and Why Does It Matter?

A time study is a method of measuring and documenting the time employees spend on various work activities. In public health, time studies are essential for cost allocation, ensuring that staff salaries are appropriately charged to eligible funding sources like Medicaid or grant programs.

Without a time study, departments risk:

• Losing federal funding by underreporting Medicaid-related activities
• ‍Non-compliance with federal and state funding regulations
• ‍Budget inefficiencies from misallocating staff costs

By conducting a structured time study, your department can maximize reimbursement while maintaining compliance with the complex requirements of federal and state funding programs.

Types of Time Studies: Continuous vs. Random Moment Time Study (RMTS)

There are two primary time study methodologies used by public health agencies:

1. Continuous Time Study

In a continuous time study, employees track their activities throughout the day for a set period (e.g., one month per quarter). This method is precise and provides a detailed record of work activities, but it can be time-consuming for staff.

📌 Best for: Smaller programs, departments with highly variable tasks, or programs requiring granular reporting.

2. Random Moment Time Study (RMTS)

RMTS is a sampling method where employees are randomly selected at specific moments to record what they are doing at that exact time. The results are then extrapolated to estimate overall time allocation. RMTS is widely used in Medicaid Administrative Claiming (MAC/MAA) because it reduces administrative burden while still meeting compliance requirements.

📌 Best for: Large public health departments, Medicaid reimbursement programs, and agencies looking for a low-maintenance time study method.

Understanding Time Studies for Key Public Health Funding Programs

Time studies are required for many public health funding streams. Here’s how they apply to some of the most common programs:

Medicaid Administrative Claiming (MAC/MAA)

MAC/MAA allows public health agencies to claim federal reimbursement (typically 50%) for administrative activities that support the Medicaid program, such as:

• Assisting individuals with Medicaid applications
• Conducting Medicaid outreach and referral activities
• Planning or coordinating Medicaid services

Time studies help determine how much staff time is dedicated to Medicaid-related administrative work, ensuring agencies receive the correct federal reimbursement. Many MAC programs use RMTS to streamline reporting.

Federal Financial Participation (FFP) Time Study

FFP provides Medicaid reimbursement for certain activities performed by public health staff, but not all activities are reimbursed at the same rate.

• Standard FFP (50%) applies to most Medicaid administrative tasks
• ‍Enhanced FFP (75%) is available for Skilled Professional Medical Personnel (SPMP) performing specific programmatic functions
• ‍90% FFP is available for Medicaid eligibility systems, modernization projects, and certain health IT initiatives

A time study ensures that departments properly allocate staff time between different reimbursement categories, maximizing their federal match.

Targeted Case Management (TCM) Time Study

TCM is a Medicaid program that funds case management services for targeted populations, such as pregnant women, children with special health needs, or individuals with chronic illnesses.

• TCM is reimbursed on an encounter basis, not by time proportion
• A time study is used to determine which activities performed during an encounter are Medicaid-eligible

TCM time studies help agencies document client interactions, care coordination, and eligibility screenings, ensuring Medicaid funding is accurately claimed.

Maternal, Child, and Adolescent Health (MCAH) & Title V

Many MCAH programs receive funding through Medicaid and Title V grants. However, Title V funding is block grant-based and not reimbursed via time studies. Instead, time studies help separate Medicaid-eligible activities from those covered by Title V funds, ensuring proper cost allocation and preventing duplication of federal funds.

By implementing a structured time study, departments can leverage Medicaid funding where applicable while ensuring compliance with MCAH and Title V program guidelines.

Best Practices for Conducting an Effective Time Study

✅ Train Staff Regularly: Ensure employees understand how to categorize activities correctly. Errors in coding can lead to under- or over-claiming, both of which pose compliance risks.

✅ Use Standardized Activity Codes: Align activity codes with Medicaid, TCM, MAC, and MCAH definitions to ensure eligibility and reduce audit risks.

✅ Ensure Time Tracking is Complete: Whether using continuous tracking or RMTS, ensure that all time spent on public health activities is properly accounted for under the chosen methodology.

✅ Monitor Compliance and Participation Rates: All time study methodologies require minimum participation levels. RMTS requires an 85-90% response rate, while continuous time studies require complete and accurate daily reporting.

✅ Maintain Strong Documentation: Keep detailed records of completed time studies, training logs, and methodology documentation—these are crucial if audited.

✅ Leverage Technology for Efficiency: Digital time study tools reduce errors, simplify reporting, and improve compliance.

How Persimmony Supports Public Health Departments

At Persimmony, we pride ourselves on offering time study software that is customizable, yet simple to use, which can be used for any type of time study reporting requirement.

• Persimmony’s data collection and reporting tools help agencies conduct time studies efficiently.
• ‍Robust reporting features allow agencies to monitor staff compliance and track trends in time allocation.
• ‍Web-based software enables staff to log time from any location—whether in the field or at a desk.
• Program agnostic means we can run any variation and every flavor of time study.

Final Thoughts

A well-executed time study is the key to unlocking maximum funding for public health programs. Ready to take control of your time studies? Visit Persimmony’s Resource Center for expert insights, best practices, and tools to streamline your process.