2 Business Optimization & Advisory Services In today s environment, it takes more than clinical expertise to maintain a successful oncology practice. Now more than ever practice leaders must possess keen foresight in a diverse set of areas, including revenue cycle management, inventory management, business operations, technology integration and financial reporting. We believe that the most effective, efficient, affordable and accessible care is provided by independent, community oncologists. We understand that you re facing extreme legislative and reimbursement pressures that make it increasingly difficult to stay above water this is not an indictment of your staff or your procedures it s a reality of the current market dynamics.
3 Our Process We can help improve your profitability with our proven experts and best practices Discovery Phase Our team of dedicated consultants, comprised of individuals who have years of direct, professional experience in oncology practice administration, human resources, drug procurement, technical instruction and technology implementation, will initially collect and review your practice data to rapidly build our understanding of your unique situation. Assessment Phase Our team will then visit your practice, meet with your personnel and study your processes in an effort to get a complete view of your operational performance in the areas mentioned previously. We will conduct interviews and small group sessions to identify areas for improvement to get a better understanding of existing roadblocks. Implementation Phase After the analysis is complete, we will work with your team to share our comprehensive findings, including recommendations for improving efficiencies and where you may be able to find increased revenue. Our consultants will confirm your areas of strength and lay out a plan of action for you to attack any areas of deficiency. The report will detail the anticipated financial impact of recommended solutions, the potential for revenue recovery and any possible reduction in overhead costs. You can then determine whether you d like to continue working with us to implement solutions, or if you d prefer to move forward on your own.
4 Our Expertise We work with your practice leadership and management team in the areas of: Practice Business Optimization Phase 1: Practice 360 Consulting Service (Assessment) Compare your business operations, inventory management and revenue cycle management with proven best practices collected from across the nation. Then work with our established industry experts to receive practical improvement methodologies that you can implement. Phase 2: Practice Transformation Services (Implementation) Our team works with practice management to assist in implementation of recommendations and process redesigns received from your Practice 360 Consulting Service for an improved overall business performance. Practice Management Optimization Services Managed Care Contracting Services Contract negotiation support and guidance on the financial, strategic and administrative aspects of payer agreements aimed at optimizing your reimbursements. RCM/PM Software Implementation Services Revenue cycle assessment & review of practice management system functionality & employee knowledge. These greater insights will uncover ways to maximize the automation of your systems where appropriate. E&M Coding Optimization Services Through E & M coding and documentation audits, we enable your practice to optimize revenue & mitigate risk by simplifying the various complexities of coding. Patient Scheduling Services Onsite evaluation of schedule processes and patient facilities combined with staff interviews allow our consultants to create the optimal patient scheduling procedures for your practice, so that you can maximize patient intake and volumes. Human Resources Evaluation Services Evaluation of current HR policies, guidelines and functions to determine compliance and potential liability to your practice. Risk Management Evaluation Services Our practice optimization experts look at current risk management and safety programs to determine if the minimum requirements are being met and what processes you need to put in place to ensure you are appropriately covered.
5 Practice Growth Advisory Services Mergers & Acquisitions Evaluation Services Evaluation of potential practices considering merging/acquisition is the first step for practices looking to grow their footprint or merge with another office. We ensure that all relevant information about your unique market is available to you so that you can determine if a merger or acquisition makes sense for you. Start-Up Services (New Practice or Addition of Oncology Service Line) Thorough evaluation of planned services for a new or expanding practice. We then assess success based on plans and make recommendations for optimal performance. Construction and Renovation Advisory Services Whether you re building a dispensing pharmacy, adding a hot lab, or expanding your infusion suite, office expansion and redesign is not to be taken lightly. Regulatory measures regarding space parameters exist, and you do not want to do anything that will disrupt patient flow. Our experts will offer their guidance in determining what is right for your practice, and ensure all guidelines are being met. Our business optimization team is ready to help you find additional value in your practice today. Since no two practices operate the same way or face the same challenges, the time-line for completion of the Discovery and Assessment Phase will vary, as we are doing customized work and making thoughtful recommendations specific to the needs of your practice. Please allow us to help you continue your mission to serve your patients. For more information on how our business optimization team can help you or to schedule a consultation, please
6 Our Satisfied Clients The business optimization team visited our practice for 2 days. In such a short time, they were able to produce a concise, comprehensive report that provided valuable analysis for our management team. They were able to uncover issues and make recommendations that were effective in improving our operational efficiency. I would strongly recommend having the team study any issues you may not have time to investigate or to provide your practice with an analysis of potential areas for improvement. -Bob Phelan, CEO at Cancer Specialists, LLC The business optimization team performed a comprehensive practice management evaluation focused overall practice improvement with an emphasis on work-flow and technological management. The team provided key insight to better measure, monitor, and improve our financial and clinical performance. Since our initial meeting that was less than 6 months ago, we have fully transitioned from a paper-based chemotherapy coding system to a fully automated enterprise billing system. -Benjamin J. Ikard, OU Cancer Center Project Manager They gave me a whole new perspective on my practice. From inventory management to all aspects of accounts receivable, they improved my practice. This will now be an annual event for us as we realize that having another set of eyes review our systems has made us so much stronger. -Jeff Vacirca, MD at North Shore Hematology Oncology Associates (NSHOA)
7 Our Work Managing Ghost Inventory A Large Practice in the West This practice kept ghost inventory in an effort to save time during heavy treatment days but was unaware of the significant cash flow issues this could cause. We performed consultative work to quantify the effects of this practice on their bottom line, and, after seeing the findings, in a 4 month period ghost inventory was reduced from $483, to $1, Savings continue to rise for this practice, which has significantly improved cash flow. Improving Inventory Management A Large Practice in the Midwest After completing a consultative assessment, the business optimization team identified significant issues with the accuracy of this practice s charge capturing processes and their ability to maintain appropriate inventory. After a successful training program and significant changes in processes, the practice has realized a reduction in inventory of $997, Facing an Uncertain Future A Large Practice in the Midwest While facing financial issues that had an inevitable negative impact on the future of the practice, a large group tasked our Business Optimization Consultants to assess the practice, develop an implementation plan and establish goals to ensure future financial success. Our team worked cohesively with practice management and employees to improve efficiency, improve staffing ratios and increase reimbursement. Results included staff savings over $2 million annually, inventory reduction of $1 million, increased reimbursement by $8 million annually, decreased denial rates from 52% to 8%, decreased time to payment from 44 days to 17 days and decreased days in AR from 47 days to 31 days. Common Findings: Revenue Cycle Management In our work across multiple practices, we ve identified several trends that negatively impact revenue cycle. We often find: $1 million in primary payer claims greater than 45 days in unpaid status $500,000 in secondary payer claims greater than 75 days in unpaid status $985,000 in claims greater than 60 days that had been previously denied and were awaiting resolution $260,000 in credit balances greater than 60 days 36 percent average denial rate, not including duplicate claims Depending on the opportunities found, we customize our recommendations to reduce unpaid claims, reduce denials and work the claims denied to each practice. Common Findings: Business Operations In our work across numerous practices, some common findings that have great potential for practice savings and increased revenue were identified: Staffing: Many practices were overstaffed in nursing, laboratory operations, front desk and business office personnel. Potential reductions could lead to savings of over $500,000. Human resources: Some practices don t have basic policies in place to protect against liability such as required annual training for HIPAA, compensation review and increase policy, annual reviews, etc. Clinical operations: Physicians schedule reviews showed that due to limitations in their schedules, it was very hard to find room for new patients and follow-up for existing patients. This had led to decreased growth as well as decreased practice income. Based on our findings, we are able to provide individualized recommendations to benefit the practice and potentially increase their revenue.
8 Our Team John Dodd John Dodd has 39 years of experience in logistics management and 25 years of experience in HR management. He is the former Vice President of HR and Director of Procurement Management at Florida Cancer Specialists, where he was directly responsible for streamlining drug ordering. John has experience with risk management and facilities management. He earned a BS in Human Resources from Park University and an Associated Degree in logistics management and personnel management. Kristy McGowan Kristy McGowan is a former practice administrator for a large oncology practice. With expertise in revenue cycle management, practice operational management, profitability, quality assurance, managed care contracting, she also has an extensive background in government and 3rd party payer reimbursement. She is a former faculty member of Certified Careers Institute and a certified coder through American Academy of Professional Coders. Kristy earned a BA in Healthcare Administration, University of Utah.