Dear Colleague,
Teri U. Guidi, MBA, FAAMA President and CEO
Thank you so much for your interest in the Oncology Management Consulting Group’s services and qualifications. Our experience is both broad and deep, and includes work in virtually all settings where oncology care is delivered. The accompanying case studies represent just a small glimpse into some of the projects in which our expert consulting staff has been involved, providing examples of numerous types of clients and a variety of work scope samples. Some engagements are tightly focused on a particular issue while others incorporate several work areas and multiple deliverables. We take great pride in supporting the provider community, across all clinical and operational disciplines, making it possible for our clients to maximize their performance. Our focus has always been on ensuring the success of oncology providers. Because we tailor every engagement to each client’s specific needs, there are innumerable other cases that we are unable to publish due to space constraints. If you don’t see one that precisely illustrates our expertise relative to your circumstances, we would be most happy to discuss your particular situation and outline how our consulting professionals can support your success. We look forward to speaking with you and to assisting you and your oncology team in the future. Very best regards,
Teri U. Guidi
Teri U. Guidi, MBA, FAAMA President and CEO
“Oncology Management Consulting Group exhibits the most outstanding qualities I expect of a professional consulting firm. Their oncology knowledge is simply unsurpassed by any in the industry! They provide innovative, viable solutions to ever-increasing complex problems and challenges…they work closely with clients - as team members! Their genuine collaboration with staff, skilled guidance and apparent depth of experience and expertise truly impress me! I would recommend them highly to any colleague. “
– Matt Sherer, MBA, MHA
Administrative Director John B Amos Cancer Center Columbus Regional Healthcare System, Columbus, GA
Case Study #1 Physician Practice and Community Hospital in the Mid-Atlantic Challenge: Align programmatic and financial interests A large, multi-site medical oncology practice was planning to move one of their offices into the hospital’s new outpatient center. The practice and the hospital hoped to avoid duplicating services and sought ways to more efficiently provide chemo-infusion to the community. The Oncology Management Consulting Group was invited to work with both sides in order to develop a more closely aligned relationship. • Interviews with key stakeholders to assess readiness; identify common interests and goals, and to articulate potential dealbreakers • Facilitate multiple working sessions with the planning group to negotiate the deal points • Complete analysis and projections of service volumes, costs, reimbursement under multiple ownership scenarios to quantify the value of various models • Definition of multiple contractual relationship options for integrated delivery of outpatient infusion services: ownership, governance, management control, etc.
Case Study #2 Large Multi-specialty Physician Group Affiliated with the Health System, California Challenge: Improve operational efficiency and safety for the medical oncology practice and infusion suite Multi-specialty group with a small medical oncology section asks for expert assessment and recommendations regarding staffing, flow, processes, and a review of coding and billing for chemotherapy and physician professional services. • Observations and in-depth interviews to identify areas for improvement • Analysis of staffing mix and productivity. • Comprehensive review of charts for appropriate documentation and coding • Complete review of billing and collections • On-site interim leadership to institute multiple operational and safety recommendations: staff roles, productivity measures, training needs, etc. • Identification of over $600,000 in missed reimbursement annually
Case Study #3 Community Hospital and Health System in Mississippi Challenge: Conduct a complete review of the revenue cycle for infusion and radiation therapy services Community hospital with employed medical oncologists invited the Oncology Management Consulting Group to assess all phases of the revenue cycle for the infusion center and the radiation oncology center to ensure appropriate documentation, coding, billing, and collections. • Review charts for compliant documentation • Review charge masters for completeness and reasonableness of charge amounts • Review claims and EOBs • Identified over $2 million in missed annual infusion revenue and approximately $1.5 million in missed annual radiation charges
Case Study #4 Prominent Academic Health System in Pennsylvania. Challenge: Create a Consistent Strategic Direction Across All Sites Multi-site, major academic health system in Pennsylvania engages OMC Group’s assistance with strategic planning across the organization including a top-level assessment to review and evaluate a professional affiliation with a renowned NCI designated cancer center. A highly charged political environment necessitates deliberate care and sensitivity to confidentiality issues • Interviews and investigation to surface sensitive political issues and other critical concerns related to the NCI center affiliation, in particular its value, the potential for additional value, the potential impact of discontinuing the relationship, and opinions regarding other options and desired benefits • Comprehensive review of key data elements (tumor registry, financial and market data) to understand current and potential market position. • Opinions and recommendations for future strategic direction for the multiple inpatient and outpatient sites, to guide individual institutional programs while building a consistent strategy across the system
Case Study #5 Large Teaching Health System in Eastern United States Challenge: Formulate a strategic and facility plan for two cancer center campuses to support continued growth and coordination with academic partner Facing unprecedented growth in volumes, and working with the academic partner towards NCI-designation, this center required a full assessment of capacity, projected growth in demand, and facility expansion planning. In addition, strategies to sustain market dominance and to continually support NCI-designation efforts were needed. • Thorough data analysis: demand and market share, service volumes, expense/revenue/downstream contribution margins • Extensive interviews with stakeholders: administration, clinicians, referring physicians, community members, etc. • Task force work to articulate and prioritize strategic initiatives • Business pro-formas to quantify potential implications (expense, revenue, etc.) of initiatives • Space programming and planning in collaboration with architects
Case Study #6 Community Hospital in a Highly Competitive Metropolitan Area Near Washington DC Challenge: Articulate a competitive strategy to reduce fragmentation of services and physician loyalties OMC was invited to assist a community hospital faced with multiple competing community, academic and NCI-designated Cancer Centers in developing a strategy to maximize physician loyalty and articulating a competitive strategy to attain market dominance in subspecialty services: • Analysis of hospital financial position for oncology services to prioritize subspecialties for focused development (recruitment, specialty services, technology expansion) • Market share analysis leading to identification of target niche program opportunities • Confidential interviews identifying physician drivers to key services and programs • Recommendations to reallocate prime office suites to key practices and drive higher levels of referral and utilization loyalties • Capitalize on unique sub-specialty niche of staff physicians
Case Study #7 Large Regional Health System in North Carolina Challenge: Multi-dimensional business development engagement An intricate and wide-ranging engagement for a large regional health system in North Carolina. This health system is experiencing rapid growth in a competitive market and myriad challenges regarding the merger of two competing private practices. A number of politically charged situations and unique integration challenges have led to a particularly complex and delicate project. An acrossthe-board review included • Financial feasibility analysis of costs and expected revenues for a proposed radiation joint venture • Comprehensive system wide strategic planning for clinical and supportive services and programs • Complete program planning for the new facility • Development of new hospital/physician relationship models for two disciplines • A detailed assessment of outreach market opportunities
Case Study #8 Mid-sized Community Hospital in the New York City Vicinity Challenge: Multi-dimensional business development engagement Mid-sized community hospital in a competitive market outside New York City requires support with facility development, construction and strategic direction for a proposed cancer center. An existing affiliation with an NCI designated cancer center was also to be reassessed. The new center will house physician-owned radiation, “time-share” suites for medical oncology, hospital-based infusion and several other cancer program components. This complex, multi-faceted engagement exposed rather delicate, politically sensitive situations requiring precise management and negotiations. Responsibilities included: • Re-evaluating the value and terms of an academic affiliation with an NCI center • Developing strategy for succession planning in key practices and improvement of hospital/physician relationships. • Facilitating detailed and substantially sensitive negotiations for medical oncology “time-shares” with multiple competing practices • Leading a task force to develop a comprehensive strategic plan • Developing policies, procedures and budget for the new infusion center • Successful preparation for an American College of Surgeons survey • Developing and negotiating the Medical Director contract
Case Study #9 Large Multi-specialty Physician Group and Community Hospital in the Pacific Northwest Challenge: Achieve alignment of the two entities and define future strategic direction A large multi-specialty private physician clinic and the community hospital they serve, engage OMC to assist in determining and selecting among the options for programmatic and financial alignment for outpatient cancer-related services. Considerable attention is necessary to overcome long-standing tensions and formulate joint strategy for growth: • Interviews and review of financials to qualify and quantify the current state for both entities • Leadership summit leading to agreements regarding delineation of control, distribution of revenue • Task Force sessions result in shared vision, strategic programmatic priorities and marketing plans including development of a joint venture facility and a joint approach to entry into a new market
Case Study #10 NCI Designated Center in the Southwest Challenge: Review multiple sub-specialty outpatient clinics for operational flow and efficiencies In order to ensure optimal throughput, utilization of capacity, and clarity of information flow, this NCI-designated Cancer Center requested OMC’s assistance in evaluating the operational aspects of several tumor-specific outpatient clinics and the infusion area. • OMC conducted in-depth interviews with line staff and involved physicians to learn the expectations and assumptions of the participants • Real-time observations of operations on-site revealed significant “disconnects” between management’s assumptions and functional realities • Recommendations included revision of job descriptions and development of consistent policies and procedures to maximize efficiency and to enable increased staffing crosscoverage
Case Study #11 Community Hospital in Central Plains Challenge: Demand analysis and multi-year pro-forma for radiation therapy Prior to investing significant capital funds, this community hospital requested OMC’s assistance in evaluating options to develop radiation oncology capabilities: • Research and assessment of local/regional competition for radiation therapy services • Market demand analysis: population, incidence rates and estimated cases • Projections for radiation therapy service utilization (professional and technical) • Projections for operating expenses: staffing, supplies, marketing, contracts, occupancy, etc. • Expense projections for major and minor capital equipment: clinical machinery, computer hard/software, furniture, etc. • Five-year financial pro-forma under multiple volume scenarios
Case Study #12 Non-profit Health System and Private Medical Oncology Group in Upper Mid-West Challenge: Develop physician employment and compensation contracts for healthsystem owned private medical oncology practices. A health system and a private medical oncology group engaged OMC to facilitate the acquisition of the practice by the system’s for-profit arm, with particular focus on developing physician employment agreements acceptable to all parties including reasonable and appropriate performance incentives to ensure alignment of program and financial interests for the physicians and hospitals. • Confidential interviews with all physicians and key health system executives • Review of physician income and expenses • Draft of proposed contractual terms – program control, productivity expectations, benefit structure, etc. • Benchmarks and options for performance measures and incentive structure: clinical productivity, service quality, operational efficiency, etc. • Develop a calculation model for financial results for physicians and health system
Client List Oncology Management Consulting Group has assisted many premier cancer centers, community hospitals, clinics and oncology practices throughout the U.S. Assistance has been far-reaching and varied and has encompassed all aspects of oncology services. The following represents a partial list of clients that we have supported: Akron General Medical Center Akron, OH
Alamance Regional Medical Center Burlington, NC
New Mexico Oncology Hematology Albuquerque, NM
St. Luke’s Hospital Cedar Rapids, IA
Univ. of New Mexico Albuquerque, NM
Summit Health Chambersburg, PA
St. John’s Health Anderson, IN
Charleston Area Medical Center Charleston, WV
Provena Mercy Medical Center Aurora, IL
Riverbend Medical Group Chicopee, MA
Shivers Cancer Foundation Austin, TX
North Cypress Medical Center Cypress, TX
‘Specially for Children Austin, TX
Univ. of Colorado Cancer Center Denver, CO
Battle Creek Health System Battle Creek, MI
Morehead Memorial Hospital Eden, NC
Bay Regional Medical Center Bay City, MI
Elmhurst Memorial Hospital Elmhurst, IL
Bend Memorial Clinic Bend, OR
The Regional Cancer Center Erie, PA
Cascade Healthcare Community Bend, OR
Cook Children’s Health Care System Fort Worth, TX
Suburban Hospital and Health System Bethesda, MD
Univ. of Texas Medical Branch Galveston, TX
Mountain States Tumor Institute Boise, ID
Jennifer Cadiz, MD Harris, NY
St. Joseph’s Hospital Buckhannon, WV
Holyoke Medical Center Holyoke, MA
Client List (continued) Wayne Memorial Hospital Honesdale, PA
BlueRidge HealthCare Morganton, NC
St. Vincent’s Health System Indianapolis, IN
Cardinal Health Nashville, TN
Memorial Hospital and Health Care Center Jasper, IN
Merck & Co Whitehouse Station, NJ
Dartmouth/Hitchcock Cheshire Medical Keene, NH Baptist Hospital of East Tennessee Knoxville, TN Lafayette Hematology-Oncology Lafayette, LA Our Lady of Lourdes Lafayette, LA Lewistown Hospital Lewistown, PA
Ortho-Biotech Inc Bridgewater, NJ Claxton-Hepburn Medical Center Ogdensburg, NY Ottumwa Regional Medical Center Ottumwa, IA Lourdes Hospital Paducah, KY Parma General Hospital Parma, OH Singing River Hospital System Pascagoula, MS
Univ. of Louisville – Brown Cancer Center Louisville, KY
St. Joseph’s Hospital Paterson, NJ
University Medical Center Lubbock, TX
MNAP Oncology Center Philadelphia, PA
Centra Health Lynchburg, VA
Temple University Medical Center Philadelphia, PA
Virtua Health Marlton, NJ
Office of Frederic Price. MD Pittsburgh, PA
Sutter Gould Medical Group Modesto, CA
Buxmont Oncology Hematology Associates Quakertown, PA
Montgomery Cancer Center Montgomery, AL
Rapid City Regional Hospital Rapid City, SD
Client List (continued) Renown Health Reno, NV
Medical Offices of Dr. Rocco Caruso Stony Brook, NY
SouthLake Clinic Renton, WA
Capital Regional Medical Center Tallahassee, FL
William Beaumont Hospitals Royal Oak, MI
North Mississippi Hematology & Oncology Tupelo, MS
Cancer Therapy and Research Center San Antonio, TX ICU Medical Inc. San Clemente, CA Central Coast Medical Oncology Santa Maria, CA Adirondack Medical Center Saranac Lake, NY Anderson Cancer Institute Savannah, GA Dendreon Corp. Seattle, WA Grandview Hospital Sellersville, PA Summit Healthcare Show Low, AZ Michiana Hematology-Oncology South Bend, IN Genentech, Inc. South San Francisco, CA Trinity Health Steubenville, OH
DCH Health System Tuscaloosa, AL Ventura County Medical Center Ventura, CA Precision Radiotherapy Center Warren, OH ProHealth Care Waukesha, WI Forsyth Regional Cancer Center Winston-Salem NC Franciscan Skemp/ Mayo Health System LaCrosse, WI San Antonio Community Hospital Upland, CA Sutter Medical Foundation Sacramento, CA Riverside Medical Center Kankakee, IL Martin Memorial Health System Stuart, FL