Objectives

�� Develop an understanding of the key factors affecting the Develop an understanding of the key factors affecting the

marketplace over the next 3 yearsmarketplace over the next 3 years

�� How those factors can influence the operation and growth How those factors can influence the operation and growth �� How those factors can influence the operation and growth How those factors can influence the operation and growth

of labs and pathology practicesof labs and pathology practices

�� Be aware of the strategic options available to labs and Be aware of the strategic options available to labs and

physician practicesphysician practices

Speaker Backgrounds

Ms. Ditmore and Mr. Prell have more than 30 years of combined Ms. Ditmore and Mr. Prell have more than 30 years of combined experience in the management of Pathology practices and experience in the management of Pathology practices and

laboratories. This experience has focused itself in not only the laboratories. This experience has focused itself in not only the day to day operation of these business, but also in the day to day operation of these business, but also in the

development of business strategy, integration of these development of business strategy, integration of these development of business strategy, integration of these development of business strategy, integration of these companies into the medical communities in which they companies into the medical communities in which they

operated, the expansion of services and implementation of operated, the expansion of services and implementation of approaches that increased revenue and efficiency. Currently approaches that increased revenue and efficiency. Currently

they jointly operate a practice management and billing services they jointly operate a practice management and billing services company in Southern California that focuses on pathology and company in Southern California that focuses on pathology and

laboratory services.laboratory services.

Healthcare Landscape EvolvingHealthcare Landscape Evolving

�� The healthcare environment has been evolving and The healthcare environment has been evolving and

uncertain since TEFRA in 1980s. uncertain since TEFRA in 1980s.

�� TodayToday –– the government, employers, consumers and current the government, employers, consumers and current �� TodayToday –– the government, employers, consumers and current the government, employers, consumers and current

economic factors are combining to “Remake the Healthcare economic factors are combining to “Remake the Healthcare

System”System”

Current EnvironmentCurrent Environment

�� U.S. Economy Further Driving Push Towards Reducing U.S. Economy Further Driving Push Towards Reducing

Healthcare CostsHealthcare Costs

�� U.S. Unemployment Rate 10%U.S. Unemployment Rate 10%�� U.S. Unemployment Rate 10%U.S. Unemployment Rate 10%

�� Uninsured currently estimated at 47 MillionUninsured currently estimated at 47 Million

�� Government Spending Cuts to Balance BudgetGovernment Spending Cuts to Balance Budget

�� 2010 Medicare Spending totaled $522 Billion2010 Medicare Spending totaled $522 Billion

�� Medicare spending increasing by over 9% per yearMedicare spending increasing by over 9% per year

Healthcare EnvironmentHealthcare Environment

�� Employers paying an average of 60% towards work force health Employers paying an average of 60% towards work force health coveragecoverage

�� Cost of coverage and who pays a major focus by large Cost of coverage and who pays a major focus by large employers and government employers and government employers and government employers and government

�� This high expense by Government, Employers and Patients This high expense by Government, Employers and Patients shifts focus to Valueshifts focus to Value

�� Merriam Webster Value: A numerical quantity that is assigned or is Merriam Webster Value: A numerical quantity that is assigned or is determined by calculation of measurement.determined by calculation of measurement.

�� Translates to payment based on specific measurements of Translates to payment based on specific measurements of outcomes that create “value” in the systemoutcomes that create “value” in the system

New Models and The Affordable New Models and The Affordable

Care ActCare Act

�� Turmoil in CongressTurmoil in Congress

�� Elections in 2012Elections in 2012

�� Implementation of Healthcare Reform unclear in many Implementation of Healthcare Reform unclear in many �� Implementation of Healthcare Reform unclear in many Implementation of Healthcare Reform unclear in many

areasareas

�� In addition to Insurance Coverage Changes (ie: preIn addition to Insurance Coverage Changes (ie: pre--existing existing

conditions, adult children age increase, etc.) other aspects conditions, adult children age increase, etc.) other aspects

are taking shape in Payment and Delivery Reformare taking shape in Payment and Delivery Reform

Payment ReformPayment Reform

�� Emphasis on Prevention and Cost ControlEmphasis on Prevention and Cost Control

�� NNo data supports quality increases in the P4P (PQRI) o data supports quality increases in the P4P (PQRI)

ProgramProgramProgramProgram

�� SoSo, the Affordable Care Act, through the controversial, the Affordable Care Act, through the controversial

Medicare Shared Savings Program approved for Medicare Shared Savings Program approved for ACOsACOs, ,

aims to create aims to create payments based on payments based on value focused on the value focused on the

patient and episode outcomes patient and episode outcomes

Payment Reform Payment Reform

Demonstration Projects Demonstration Projects

�� VVolunteer olunteer organizations are offered the opportunity to share in organizations are offered the opportunity to share in

savings while being held accountable for both savings while being held accountable for both Part A Part A and Part B and Part B

payments with any gains received to be allocated among the hospitals payments with any gains received to be allocated among the hospitals

and physicians of the and physicians of the ACOACO

�� Details Details such as mandatory valuesuch as mandatory value--based performance modifiers are to based performance modifiers are to

be applied to payments under the Medicare Physician Fee Schedulebe applied to payments under the Medicare Physician Fee Schedule

beginning beginning in in 2013 and to be released in 20122013 and to be released in 2012

�� August 25 Federal Register Details Four ModelsAugust 25 Federal Register Details Four Models

Mcare Demonstration ModelsMcare Demonstration Modelsfrom Federal Register August 25, 2011from Federal Register August 25, 2011

�� Model 1 Model 1 –– Bundled payment for Inpatient stays, paid on discount basis of up to 2%, Bundled payment for Inpatient stays, paid on discount basis of up to 2%, Pathology and other physician services will not be included Pathology and other physician services will not be included

�� Model 2/3 Model 2/3 –– Bundled payment for Inpatient stay and postBundled payment for Inpatient stay and post--episodic care for up to 90 episodic care for up to 90 days after discharge, pathology and other physician services will be included as days after discharge, pathology and other physician services will be included as Model 2/3 Model 2/3 –– Bundled payment for Inpatient stay and postBundled payment for Inpatient stay and post--episodic care for up to 90 episodic care for up to 90 days after discharge, pathology and other physician services will be included as days after discharge, pathology and other physician services will be included as well as lab and DME services, the target price will be a discount over historical well as lab and DME services, the target price will be a discount over historical payments from 2% to 3% depending on which post discharge care occurs payments from 2% to 3% depending on which post discharge care occurs

�� Model 4 Model 4 –– Bundled payment for ALL services including physician, hospital and Bundled payment for ALL services including physician, hospital and othersothers

Don’t Let AP Become a Don’t Let AP Become a

CommodityCommodity

�� Many IPAs and insurance companies treat clinical Many IPAs and insurance companies treat clinical

laboratory as a commodity and purchase based on lowest laboratory as a commodity and purchase based on lowest

bidbid

�� It is imperative that pathologists take proactive steps to It is imperative that pathologists take proactive steps to

ensure AP does not take that same path in a bundled ensure AP does not take that same path in a bundled

service payment approachservice payment approach

Delivery ReformDelivery Reform

�� Pushing Risk to Providers based on Prescribed and Measured Quality Pushing Risk to Providers based on Prescribed and Measured Quality OutcomesOutcomes

�� Medical Home Medical Home

�� A Director, primary care physician, manages delivery of specialist and A Director, primary care physician, manages delivery of specialist and ancillary care for a patientancillary care for a patientancillary care for a patientancillary care for a patient

�� A model from the 1960s being revisitedA model from the 1960s being revisited

�� Sustainable Healthcare Communities: ACO model that includes Sustainable Healthcare Communities: ACO model that includes

�� Insurance CompaniesInsurance Companies

�� HospitalsHospitals

�� MMedical Foundationsedical Foundations

�� Medical Providers Medical Providers

Delivery Reform Delivery Reform

�� Hospitals Purchasing PracticesHospitals Purchasing Practices

�� Ex: Individual primary care practices and large subEx: Individual primary care practices and large sub--specialty specialty

groups such as oncology and radiologygroups such as oncology and radiology

�� Insurance Companies buying Medical Groups and PracticesInsurance Companies buying Medical Groups and Practices

�� Ex: United Healthcare in So. Cal purchased largest IPA in Ex: United Healthcare in So. Cal purchased largest IPA in

region as well as other smaller groupsregion as well as other smaller groups

Standardized DeliveryStandardized Delivery

�� Creating predictability in Cost and OutcomeCreating predictability in Cost and Outcome

�� Standardization created and measured through Electronic Standardization created and measured through Electronic

SystemsSystemsSystemsSystems

�� Government, Employers and Consumers are focused on Government, Employers and Consumers are focused on

moving healthcare into the electronic agemoving healthcare into the electronic age

Technology TrendsTechnology Trends

�� $787 Billion ARRA set aside $20 Billion for HITECH Act$787 Billion ARRA set aside $20 Billion for HITECH Act

�� Incentives for Adoption Incentives for Adoption -- $44k per physician for Certified EHR $44k per physician for Certified EHR

with Meaningful Use to be paid over 5 yearswith Meaningful Use to be paid over 5 years

�� Certification Certification -- Office of National Coordinator (ONC) defines Office of National Coordinator (ONC) defines �� Certification Certification -- Office of National Coordinator (ONC) defines Office of National Coordinator (ONC) defines

criteria for EHR certificationcriteria for EHR certification

�� Meaningful Use Meaningful Use –– Medicare/Caid Services (CMS) defines MU and Medicare/Caid Services (CMS) defines MU and

establishes incentivesestablishes incentives

�� Health Information Exchange FundingHealth Information Exchange Funding

Electronic Health Record Electronic Health Record

Adoption Adoption

�� EHR AdoptionEHR Adoption

�� Group Practice Journal reported in July 2011 that approximately ¼ of Group Practice Journal reported in July 2011 that approximately ¼ of US primary care physicians have adopted EHRUS primary care physicians have adopted EHR

�� EE--Prescribing Incentive provided for reimbursement for those who EPrescribing Incentive provided for reimbursement for those who E--�� EE--Prescribing Incentive provided for reimbursement for those who EPrescribing Incentive provided for reimbursement for those who E--prescribed by July 1, 2011, but also a penalty for not participating in 10 prescribed by July 1, 2011, but also a penalty for not participating in 10 ERxERx by this dateby this date

�� Letters in mail to physicians that did not comply that they will receive a 1% Letters in mail to physicians that did not comply that they will receive a 1% cutcut

�� Physician Incentive of up to up to 75% of eligible Physician Incentive of up to up to 75% of eligible McareMcare allowable up to allowable up to $44k over five years (First year 2011 = $18,000)$44k over five years (First year 2011 = $18,000)

�� Penalties for those who do not adopt EHR with Meaningful Use by 2015Penalties for those who do not adopt EHR with Meaningful Use by 2015

Meaningful UseMeaningful Use

�� Meaningful Use defined in Three CategoriesMeaningful Use defined in Three Categories

�� Use certified EMR in a meaningful wayUse certified EMR in a meaningful way

�� Use certified EMR technology for electronic exchange of health dataUse certified EMR technology for electronic exchange of health data

�� Use certified EMR to submit clinical quality dataUse certified EMR to submit clinical quality data

�� Stage I Stage I –– Now Now �� Stage I Stage I –– Now Now

�� Core Objectives, Menu (choice) Objectives and Clinical Quality MeasuresCore Objectives, Menu (choice) Objectives and Clinical Quality Measures

�� ERx, Vaccination Records Submission Electronically, Hemoglobin A1CERx, Vaccination Records Submission Electronically, Hemoglobin A1C

�� Stage II Stage II –– 2013 (same time as ICD2013 (same time as ICD--10……)10……)

�� Discussion around requirements for crossDiscussion around requirements for cross--system communicationsystem communication

�� Stage III Stage III –– 2015 2015 -- Undefined Undefined

Health Information ExchangesHealth Information Exchanges

�� HIE early adopters faced challenges and mostly failureHIE early adopters faced challenges and mostly failure

�� HIEs successful in some areas with larger hospital and clinic HIEs successful in some areas with larger hospital and clinic systemssystems

�� HIE Extension Centers in California through HIE Extension Centers in California through CalHIPSOCalHIPSO are are �� HIE Extension Centers in California through HIE Extension Centers in California through CalHIPSOCalHIPSO are are working to promote HIE with federal fundingworking to promote HIE with federal funding

�� HIE experts argue that Stage II essentially requires functioning HIE experts argue that Stage II essentially requires functioning HIE HIE �� Ex: MD review of Rx data on % patients from other institutions (Ex: MD review of Rx data on % patients from other institutions (ieie: :

hospital visit outside system)hospital visit outside system)

�� HIE Challenge is financial sustainabilityHIE Challenge is financial sustainability

Technology ResponsesTechnology Responses

�� EHR Interface a MustEHR Interface a Must

�� Larger AP Labs may use internal IT staff and Interface Engine Larger AP Labs may use internal IT staff and Interface Engine Product (ex: Corepoint)Product (ex: Corepoint)

�� Smaller AP Labs may use Interface Provider (ex: Lifepoint, Smaller AP Labs may use Interface Provider (ex: Lifepoint, �� Smaller AP Labs may use Interface Provider (ex: Lifepoint, Smaller AP Labs may use Interface Provider (ex: Lifepoint, Halfpenny)Halfpenny)

�� Some Partner with Hospital where HIS builds Interface which Some Partner with Hospital where HIS builds Interface which contains APcontains AP

�� HIE HIE

�� Be at the TableBe at the Table

�� Have relationship with hospital CIO and/or COOHave relationship with hospital CIO and/or COO

Reimbursement TodayReimbursement Today

�� Declining Reimbursement in the Near TermDeclining Reimbursement in the Near Term

�� Part B Lab Spending totaled $8.4 Billion in 2010Part B Lab Spending totaled $8.4 Billion in 2010

�� Part B Lab Spending represents 1.6% of overall Medicare Spending Part B Lab Spending represents 1.6% of overall Medicare Spending and increasing at a rate of approximately 6% annuallyand increasing at a rate of approximately 6% annually

�� MED PAC proposed cuts of 9% to laboratories and Super MED PAC proposed cuts of 9% to laboratories and Super Committee on Deficit Reduction is looking at a variety of Committee on Deficit Reduction is looking at a variety of Committee on Deficit Reduction is looking at a variety of Committee on Deficit Reduction is looking at a variety of scenarios including lab coscenarios including lab co--payspays

�� TC Grandfather set to expire in 2011TC Grandfather set to expire in 2011

�� Additional Challenges in ReimbursementAdditional Challenges in Reimbursement

�� ICDICD--10 January 1, 201310 January 1, 2013

�� Laboratory PreLaboratory Pre--Authorization a New Trend?Authorization a New Trend?

�� Laboratory Economics Reported on New Laboratory Benefit Laboratory Economics Reported on New Laboratory Benefit Management Firm: Beacon LBSManagement Firm: Beacon LBS

Laboratory Competitive Laboratory Competitive

EnvironmentEnvironment

•• Growth rate has slowed Growth rate has slowed

�� Annual rate of 10% growth for AP and specialized testing is now Annual rate of 10% growth for AP and specialized testing is now

under 5%under 5%

•• Exclusive MegaExclusive Mega--Insurance and MegaInsurance and Mega--Lab ArrangementsLab ArrangementsExclusive MegaExclusive Mega--Insurance and MegaInsurance and Mega--Lab ArrangementsLab Arrangements

�� UHC/Labcorp and Aetna/QuestUHC/Labcorp and Aetna/Quest

•• National Specialized Laboratories seeking AP Outreach casesNational Specialized Laboratories seeking AP Outreach cases

�� CarisCaris, , BostwickBostwick, Genoptix, Genoptix

•• Insourcing of AP Insourcing of AP -- TC and PCTC and PC

�� Laboratory Economics reported in March 2011 that 15 of 20 Urology Laboratory Economics reported in March 2011 that 15 of 20 Urology

Groups 5+ InsourcedGroups 5+ Insourced

Responding to the EnvironmentResponding to the Environment

�� Promote the PracticePromote the Practice

�� PayorPayor ContractingContracting

�� Work with SpecialistsWork with Specialists�� Work with SpecialistsWork with Specialists

�� Partnering with other LaboratoriesPartnering with other Laboratories

Promote the PracticePromote the Practice

�� Market AP Group ExpertiseMarket AP Group Expertise

�� Urology, Hematology, GI, DermUrology, Hematology, GI, Derm

�� Partner with other AP groups that have that subPartner with other AP groups that have that sub--specialty specialty

expertiseexpertiseexpertiseexpertise

�� Partner with Specialized laboratories for TC/PC split of Partner with Specialized laboratories for TC/PC split of

specialized testing (ex: FISH testing)specialized testing (ex: FISH testing)

�� Combine sales effortsCombine sales efforts

Payor ContractingPayor Contracting

�� Anatomic Pathology Anatomic Pathology PayorPayor ContractingContracting

�� Leverage AP Hospital Agreement for Outreach Work with Leverage AP Hospital Agreement for Outreach Work with

Commercial Commercial PayorsPayors

�� Seek AP Outreach Carve Out or Partner with regional Clinical Seek AP Outreach Carve Out or Partner with regional Clinical �� Seek AP Outreach Carve Out or Partner with regional Clinical Seek AP Outreach Carve Out or Partner with regional Clinical

Laboratory provider for AP Outreach carve outLaboratory provider for AP Outreach carve out

�� Provide HEDIS Data from LISProvide HEDIS Data from LIS

�� Have a plan if your group provides tests that fall into required Have a plan if your group provides tests that fall into required

HEDIS criteriaHEDIS criteria

Work with SpecialistsWork with Specialists

�� Respond to Respond to InsourcingInsourcingof Anatomic Pathology by other of Anatomic Pathology by other SpecialistsSpecialists

�� EHR Contribution ConsiderationEHR Contribution Consideration

�� Partner with Hospital Partner with Hospital �� Partner with Hospital Partner with Hospital

�� Histology Lab Director or Consultant RoleHistology Lab Director or Consultant Role

�� Collect a Fee for this ServiceCollect a Fee for this Service

�� Better to keep PC, even if TC LostBetter to keep PC, even if TC Lost

�� Best to Bill Directly for PCBest to Bill Directly for PC

�� Talk with These Specialists RoutinelyTalk with These Specialists Routinely

�� Keep them Engaged with You as their ResourceKeep them Engaged with You as their Resource

Safety in NumbersSafety in Numbers

�� Partnering with a CP or AP Lab Partner: Partnering with a CP or AP Lab Partner:

�� Another Anatomic Pathology Group in the Region or Regional Another Anatomic Pathology Group in the Region or Regional

Clinical LaboratoryClinical Laboratory

�� CoCo--marketing withmarketing with Logistics Logistics AAssistance ssistance (courier, client services, (courier, client services,

interfaces)interfaces) to Maintain/Gain to Maintain/Gain AAdditional dditional OOutreachutreachinterfaces)interfaces) to Maintain/Gain to Maintain/Gain AAdditional dditional OOutreachutreach

�� Working withWorking with Regional Regional LLab ab for TC processing, sofor TC processing, so HospitalHospital--based based

GGroup may roup may EExpand xpand intointo Outreach Outreach EEnvironmentnvironment

�� Consider selling part or Consider selling part or all all of AP Outreach Business to Larger of AP Outreach Business to Larger

PartnerPartner

�� Speak with specialized attorney or laboratory banker/brokerSpeak with specialized attorney or laboratory banker/broker

Looking InwardLooking Inward

�� Maximize ReimbursementMaximize Reimbursement

�� Reduce ExpensesReduce Expenses

Billing and Revenue Cycle Billing and Revenue Cycle

ManagementManagement�� Analyze CollectionsAnalyze Collections

�� TTop five CPTs Government and Commercial Payorsop five CPTs Government and Commercial Payors

�� Review Matrix QuarterlyReview Matrix Quarterly

�� Are you collecting for Breast and Colon P4P?Are you collecting for Breast and Colon P4P?

�� Track collections Track collections per per requisition to spot overall collection trendsrequisition to spot overall collection trends

�� Monthly Monthly is ideal, but quarterly is sufficient. This will show you if collections start to is ideal, but quarterly is sufficient. This will show you if collections start to slip in your billing slip in your billing department. Increased patient department. Increased patient responsibility write responsibility write offs? A large offs? A large slip in your billing slip in your billing department. Increased patient department. Increased patient responsibility write responsibility write offs? A large offs? A large PayorPayorhas suddenly adjusted has suddenly adjusted reimbursement? Claims reimbursement? Claims have not been worked have not been worked appropriately?appropriately?

�� Denials and Write OffsDenials and Write Offs

�� Review Top Five Denial CategoriesReview Top Five Denial Categories

�� Review Write Off $ totals in each categoryReview Write Off $ totals in each category

�� Days Days inin A/R by Payor A/R by Payor

�� Over 120 Over 120 days should not exceed 20%days should not exceed 20%

�� Clean Data for ClaimClean Data for Claim

�� Eligibility Checking prior to Claims SubmissionEligibility Checking prior to Claims Submission

�� Claims Analysis prior to Submission (EDI providers most often doing competent job in Claims Analysis prior to Submission (EDI providers most often doing competent job in this area)this area)

Is Your Billing Manager Ready?Is Your Billing Manager Ready?

�� HITECH Act HITECH Act -- Claims Submission with new 5010 StandardClaims Submission with new 5010 Standard

�� Jan 1, 2012 all fee for service providers must submit claims to Jan 1, 2012 all fee for service providers must submit claims to

MCare in this formatMCare in this format

�� Testing is usually done by the billing information system Testing is usually done by the billing information system �� Testing is usually done by the billing information system Testing is usually done by the billing information system

provider in conjunction with the medical group or billing provider in conjunction with the medical group or billing

companycompany

�� Testing should be done already or immediately with your Testing should be done already or immediately with your

Medicare Administrative Contractor (Ex: Palmetto). ASK THIS Medicare Administrative Contractor (Ex: Palmetto). ASK THIS

QUESTIONQUESTION

ICDICD--9 vs ICD9 vs ICD--1010

�� Five to Seven CharactersFive to Seven Characters

�� 13,000 to 68,000 codes13,000 to 68,000 codes

�� ICDICD--10 includes laterality (ie: Right vs Left)10 includes laterality (ie: Right vs Left)

�� 5010 Standard Accommodates5010 Standard Accommodates�� 5010 Standard Accommodates5010 Standard Accommodates

�� Ask if your billing manager has a plan for training and Ask if your billing manager has a plan for training and implementation in 2012implementation in 2012

�� Educate your referring providers on tests with Medical Educate your referring providers on tests with Medical Necessity Limitations/ABNNecessity Limitations/ABN�� Sales staff may create materials for distributionSales staff may create materials for distribution

�� Laboratory LIS should assist in ABN adjustment and generation Laboratory LIS should assist in ABN adjustment and generation

Accessioning for CollectionsAccessioning for Collections

�� Accessioning properly on the front end maximizes Accessioning properly on the front end maximizes

collections and reduces costs internallycollections and reduces costs internally

�� Consider routine training for Accessioning staff in Consider routine training for Accessioning staff in �� Consider routine training for Accessioning staff in Consider routine training for Accessioning staff in

insurance mix and insurance data/card details insurance mix and insurance data/card details

Lean ThinkingLean Thinking

�� Educate YourselfEducate Yourself

�� Consider an outside consultant for training to the staff rather Consider an outside consultant for training to the staff rather

than a complete LEAN overhaulthan a complete LEAN overhaul

�� Incorporate Tools into Lab VocabularyIncorporate Tools into Lab Vocabulary

�� Value Added vs NonValue Added vs Non--Value Added ActivitiesValue Added Activities

�� Root Cause Root Cause -- Five Whys?Five Whys?

�� Load BalancingLoad Balancing

�� Kanban Kanban –– Visual AidsVisual Aids

Operational EfficienciesOperational Efficiencies

�� Automation in Anatomic Pathology Automation in Anatomic Pathology

�� Bar Coded cassettes and slides Bar Coded cassettes and slides

�� REAL time improves quality/patient safety and decreases FTEsREAL time improves quality/patient safety and decreases FTEs

�� Automated LIS functions through Voice Control and Voice RecognitionAutomated LIS functions through Voice Control and Voice Recognition

�� Templates or Free Dictation Templates or Free Dictation �� Templates or Free Dictation Templates or Free Dictation

�� Both reduce FTEs if done in a lean fashion where single piece versus Both reduce FTEs if done in a lean fashion where single piece versus batch flow is implementedbatch flow is implemented

�� Slide ImagingSlide Imaging

�� Reduces Delivery/Courier TimeReduces Delivery/Courier Time

�� Used well in AP outreach organizations for IHC and special studiesUsed well in AP outreach organizations for IHC and special studies

�� Facilitates IntraFacilitates Intra--department Reviewdepartment Review

StrategyStrategy

�� Be at the TableBe at the Table

�� Assume Medical Staff Leadership Positions within the HospitalAssume Medical Staff Leadership Positions within the Hospital

�� Participate on Hospital Committees and BoardsParticipate on Hospital Committees and Boards

�� Be VisibleBe Visible�� Be VisibleBe Visible

�� To Referring Physicians, Medical Groups/IPAs and Insurance CompaniesTo Referring Physicians, Medical Groups/IPAs and Insurance Companies

�� Attend Attend client visits with your reps or attend educational talks locally client visits with your reps or attend educational talks locally provided to other specialtiesprovided to other specialties

�� Ex: Ex: An HPV Diagnostics An HPV Diagnostics talk given to your GYN clients. Attend a GI or GU drug talk given to your GYN clients. Attend a GI or GU drug talk given to those talk given to those specialistsspecialists

�� Relationships will be the best tool in this uncertain and evolving new Relationships will be the best tool in this uncertain and evolving new healthcare paradigmhealthcare paradigm

StrategyStrategy

Understanding market forces as well as revenue and cost Understanding market forces as well as revenue and cost

management strategies are critical. However, that will not management strategies are critical. However, that will not

be enough in the age of reform.be enough in the age of reform.

Questions?Questions?

Joel@medicorp1.comJoel@medicorp1.comJoel@medicorp1.comJoel@medicorp1.com

Jolie@medicorp1.comJolie@medicorp1.com