February, 2011 JHD Group Statement of Qualifications
<ul><li>The JHD Group provides valued business services to large physician organizations  </li></ul><ul><li>The JHD Group ...
<ul><li>Our point of view emphasizes developing significant operational improvements in the short term and staging increas...
<ul><li>Our approach balances strategic management, operational integration and measuring results  </li></ul><ul><li>At th...
Our Track Record
<ul><li>Specific examples (cont’d)… </li></ul><ul><li>Community Health Network  </li></ul><ul><li>The Client:  Established...
<ul><li>Specific examples (cont’d)… </li></ul><ul><li>Manhattan’s Physician Group </li></ul><ul><li>The Client:  Manhattan...
<ul><li>Specific examples (cont’d)… </li></ul><ul><li>Yakima Valley Memorial Hospital </li></ul><ul><li>The Client :  Yaki...
<ul><li>Specific examples of where we have produced tangible results for our clients include: </li></ul><ul><li>Physician ...
<ul><li>Specific examples (cont’d)… </li></ul><ul><li>Ohio State University Medical Center </li></ul><ul><li>The Client : ...
<ul><li>Specific examples of where we have produced tangible results for our clients include: </li></ul><ul><li>El Camino ...
<ul><li>Specific examples (cont’d)… </li></ul><ul><li>Arlington Cancer Center </li></ul><ul><li>The Client : The Arlington...
<ul><li>Specific examples (cont’d)… </li></ul><ul><li>Monarch Health </li></ul><ul><li>The Client:  Monarch is a 1,700 phy...
<ul><li>Specific examples (cont’d)… </li></ul><ul><li>Carle Clinic: Medical Records </li></ul><ul><li>The Client:  The Car...
<ul><li>Specific examples (cont’d)… </li></ul><ul><li>UT Southwestern </li></ul><ul><li>The Client:  A large medical schoo...
<ul><li>Specific examples (cont’d)… </li></ul><ul><li>CSANT </li></ul><ul><li>The Client:  This client is a large group of...
<ul><li>Specific examples (cont’d)… </li></ul><ul><li>Southwest Physicians Associates </li></ul><ul><li>The Client:  A 1,4...
<ul><li>Specific examples (cont’d)… </li></ul><ul><li>Pinnacle Anesthesia Consultants </li></ul><ul><li>The Client:  Pinna...
<ul><li>Specific examples (cont’d)… </li></ul><ul><li>American Whole Health </li></ul><ul><li>The Client:  This client is ...
<ul><li>Specific examples (cont’d)… </li></ul><ul><li>Cole Managed Vision </li></ul><ul><li>The Client:  A $1.5 Billion pr...
<ul><li>Specific examples (cont’d)… </li></ul><ul><li>Cardiovascular Institute of the South </li></ul><ul><li>The Client: ...
<ul><li>Specific examples (cont’d)… </li></ul><ul><li>Carle Clinic: Supply Chain Evaluation </li></ul><ul><li>The Client: ...
<ul><li>Specific examples (cont’d)… </li></ul><ul><li>Touchstone Health Partnership </li></ul><ul><li>The Client:  Touchst...
<ul><li>Specific examples (cont’d)… </li></ul><ul><li>Children’s Medical Center of Dallas /  University of Texas Southwest...
<ul><li>Specific examples (cont’d)… </li></ul><ul><li>Bridgeport Hospital /Yale New Haven Health System </li></ul><ul><li>...
<ul><li>Specific examples (cont’d)… </li></ul><ul><li>Beth Israel Deaconess Medical Center /  Harvard Medical Faculty Phys...
<ul><li>Specific examples (cont’d)… </li></ul><ul><li>North Texas Hospital </li></ul><ul><li>The Client:   North Texas hos...
<ul><li>Specific examples (cont’d)… </li></ul><ul><li>St. Vincent Catholic Medical Centers </li></ul><ul><li>The Client:  ...
<ul><li>Specific examples (cont’d)… </li></ul><ul><li>Children’s Health Corporation of America </li></ul><ul><li>The Clien...
<ul><li>Specific examples (cont’d)… </li></ul><ul><li>Desert Medical Group/Oasis IPA </li></ul><ul><li>The Client:  Desert...
<ul><li>Specific examples (cont’d)… </li></ul><ul><li>Sequoia Physician’s Alliance </li></ul><ul><li>The Client:  Sequoia ...
Our Published Healthcare Articles
<ul><li>JHD Group is committed to advancing the conversation on a variety of important practice management topics… </li></...
Our People
<ul><li>Our professionals work in teams, providing for integrated solutions to complex issues. </li></ul><ul><li>For each ...
<ul><li>Each JHD Group professional has extensive healthcare experience mainly working with physician organizations. </li>...
<ul><li>Each JHD Group professional has extensive healthcare experience mainly working with physician organizations. </li>...
<ul><li>Each JHD Group professional (Cont’d)… </li></ul>Our People <ul><li>Juan Johnson: </li></ul><ul><li>Ms. Johnson has...
<ul><li>Each JHD Group professional (Cont’d)… </li></ul><ul><li>Allen C. Abramson, SPHR: </li></ul><ul><li>Mr. Abramson ha...
<ul><li>Each JHD Group professional (Cont’d)… </li></ul>Our People <ul><li>David Boucher: </li></ul><ul><li>Mr. Boucher ha...
<ul><li>Each JHD Group professional (Cont’d)… </li></ul>Our People <ul><li>Zachary B. Gerbarg, MD: </li></ul><ul><li>Zack ...
<ul><li>Each JHD Group professional (Cont’d)… </li></ul>Our People <ul><li>Sandra Hudak, MS, RN: </li></ul><ul><li>Ms. Hud...
<ul><li>Each JHD Group professional (Cont’d)… </li></ul>Our People <ul><li>Nikki R. Parham: </li></ul><ul><li>Ms. Parham h...
<ul><li>Each JHD Group professional (Cont’d)… </li></ul>Our People <ul><li>David Shute: </li></ul><ul><li>Mr. Shute specia...
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JHDG Qualifications

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JHDG Qualifications

  1. 1. February, 2011 JHD Group Statement of Qualifications
  2. 2. <ul><li>The JHD Group provides valued business services to large physician organizations </li></ul><ul><li>The JHD Group was founded in 1998 with the mission of assisting large Physician organizations to improve market position, operational and financial results as well as the use of business technology. We seek to go “at risk” for delivering measurable results and will guarantee that our work will provide tangible improvements </li></ul><ul><li>Our services fall into four broad categories: </li></ul><ul><ul><li>Clinical Integration through Electronic Medical Records which includes building the business case/case to act; selecting the right vendor; implementing the EMR; and realizing the benefits beyond electronic access to a patient record </li></ul></ul><ul><ul><li>Hospital – Physician Alignment including developing physician strategies; building owned physician capabilities; weaving a fabric of joint ventures, building an effective MSO, and using the “Stark Safe Harbor” EMR option to “Glue” community physicians to the hospital   </li></ul></ul><ul><ul><li>Physician Operations Improvement including revenue development, cost reduction, governance, market development (i.e. mergers), and physician management (i.e. compensation) </li></ul></ul><ul><ul><li>Practice Management where we provide the management team, market plan, methodologies, and controls to profitably manage and grow independent or hospital owned physician organizations </li></ul></ul><ul><li>We are highly experienced in working with private physician groups (single and multi-specialty), IPA’s (Independent Physician Associations), large Health Systems, Academic Medical Centers, Hospital Affiliated Multi-Specialty Health Networks, and MSO’s (Management Services Organizations) </li></ul>About the JHD Group <ul><li>Assessing current market positions </li></ul><ul><ul><li>Demographic Trends </li></ul></ul><ul><ul><li>Expansion Opportunities </li></ul></ul><ul><li>Developing agile and focused strategies </li></ul><ul><ul><li>Market Strategy </li></ul></ul><ul><ul><li>Network Development </li></ul></ul><ul><ul><li>Practice Expansion </li></ul></ul><ul><ul><li>Mergers & Acquisitions </li></ul></ul><ul><ul><li>Affiliation Transactions </li></ul></ul><ul><ul><li>Capital Sourcing </li></ul></ul><ul><ul><li>Governance </li></ul></ul><ul><li>Developing revenue </li></ul><ul><ul><li>Clinical Trials </li></ul></ul><ul><ul><li>Ancillary Services </li></ul></ul><ul><ul><li>Joint Ventures </li></ul></ul><ul><ul><li>Payer Contract Negotiation </li></ul></ul><ul><ul><li>Pricing/Fee Schedule </li></ul></ul><ul><ul><li>Revenue Capture </li></ul></ul><ul><li>Improving operational infrastructure effectiveness, cost efficiency and service </li></ul><ul><ul><li>Clinical Operations </li></ul></ul><ul><ul><li>Central Business Office </li></ul></ul><ul><ul><li>Managed Care Operations </li></ul></ul><ul><ul><li>Contract Administration </li></ul></ul><ul><ul><li>Physician Compensation / Incentives </li></ul></ul><ul><ul><li>Ancillary Operations </li></ul></ul><ul><ul><li>Compliance Management </li></ul></ul><ul><ul><li>Credentialing </li></ul></ul><ul><li>Developing clinical management tools </li></ul><ul><ul><li>Utilization Management </li></ul></ul><ul><ul><li>Case Management </li></ul></ul><ul><ul><li>Quality Management </li></ul></ul><ul><ul><li>Outcomes Reporting </li></ul></ul><ul><ul><li>Coding & Compliance </li></ul></ul><ul><ul><li>Disease Management </li></ul></ul><ul><ul><li>Medical Record </li></ul></ul><ul><li>Integrating information technology </li></ul><ul><ul><li>Internet Strategy </li></ul></ul><ul><ul><li>Solution Architects </li></ul></ul>Our services are built around skills and experience
  3. 3. <ul><li>Our point of view emphasizes developing significant operational improvements in the short term and staging increased market and knowledge leadership over the long term. </li></ul><ul><li>We use very experienced professionals, many of whom bring 20 – 30 years of experience to each client relationship. </li></ul><ul><li>We seek to work with clients who can “See over the wall”, have greater aspirations for profitability, and desire to have greater impact on their markets. </li></ul><ul><li>We prioritize operational excellence as the starting point, and focus on the high impact change levers where we can most dramatically address root problems, and improve results. </li></ul><ul><li>Once operational excellence has been achieved, the opportunities for market and knowledge leadership begin to open. </li></ul>About the JHD Group
  4. 4. <ul><li>Our approach balances strategic management, operational integration and measuring results </li></ul><ul><li>At the enterprise level, we focus on the macro levers which most affect a healthcare organization including: </li></ul><ul><ul><li>The market conditions, the provider’s goals within their market, and how these shape the key elements of its strategy </li></ul></ul><ul><ul><li>The operating organization, particularly the integration of people, process, and technology </li></ul></ul><ul><ul><li>The use of measures and outcomes to assure accountability and redirect as needed </li></ul></ul><ul><li>Within the enterprise, we focus on a limited number of high impact change levers such as: </li></ul><ul><ul><li>The positioning for market development </li></ul></ul><ul><ul><li>The organization’s culture and structure of accountability </li></ul></ul><ul><ul><li>The use of enabling technologies </li></ul></ul><ul><ul><li>The role of medical management and supporting tools </li></ul></ul><ul><ul><li>The effectiveness of the major business functions, such as: </li></ul></ul><ul><ul><ul><li>Managed care contracting </li></ul></ul></ul><ul><ul><ul><li>Revenue management </li></ul></ul></ul><ul><ul><ul><li>Cash flow management </li></ul></ul></ul><ul><ul><ul><li>Cost management </li></ul></ul></ul><ul><ul><ul><li>Transaction processing/Central Business Office </li></ul></ul></ul><ul><ul><li>Core processes across the organizational functions </li></ul></ul><ul><li>The expected result of this approach is a clear understanding as to how the financial and performance indicators will improve over time in terms of the “Business Case” for the organization. </li></ul>About the JHD Group
  5. 5. Our Track Record
  6. 6. <ul><li>Specific examples (cont’d)… </li></ul><ul><li>Community Health Network </li></ul><ul><li>The Client: Established in 1956, Indianapolis-based Community Health Network is a leading not-for-profit health system offering convenient access to expert physicians, advanced treatments and leading-edge technology. </li></ul><ul><ul><li>Scope of JHD Group Work : CHNw ambulatory physician services had grown by uniting a number of different ambulatory entities, and therefore had wide variations in practices as well as challenges with multiple practice management systems. It was increasingly challenging to effectively manage payers and to bill and collect for services. </li></ul></ul><ul><ul><li>The JHD Group was engaged to design and implement an infrastructure with common technology, policies, practices, and processes (practice management) that would improve the ability to better manage payer accountability and optimize revenue collection cost effectively. </li></ul></ul><ul><li>Results: The client is currently meeting a very aggressive schedule to implement some 170 multispecialty practices on a common Practice Management system. In addition, a CBO has been structured and is being staffed, common policies and procedures have been deployed and training is ongoing for all revenue cycle related staff to significantly improve capabilities across the board. </li></ul>Our Track Record <ul><li>The Vancouver Clinic </li></ul><ul><li>The Client: The Vancouver Clinic is a large multi-specialty clinic located in Washington State. The group is a physician-owned and governed organization that has operated since 1936. </li></ul><ul><li>Scope of JHD Group Work: The JHD Group was engaged to facilitate a Practice Management/EHR selection and developed the deployment plan for the selected vendor: Epic. This work involved conversion from a MISYS Practice Management System and EHR with extensive modifications, improving the revenue cycle processes around the Practice Management implementation, and implementing the EHR to over 170 physicians in five locations. </li></ul><ul><li>Results: The entire project was managed on schedule and on budget including the contract negotiation and initial budgeting efforts. A full implementation plan for both EPM and EMR was delivered as well as a business case for positive EHR ROI. </li></ul>
  7. 7. <ul><li>Specific examples (cont’d)… </li></ul><ul><li>Manhattan’s Physician Group </li></ul><ul><li>The Client: Manhattan’s Physician Group is a five Medical Center multi-specialty group located in New York. </li></ul><ul><li>Scope of JHD Group Work: JHDG was engaged to restructure and manage this group over a three year period. The work involved separating the group out from a hospital system, re-organizing it into a multi-specialty configuration, negotiating new Union contracts and payer contracts including capitated agreements; organizing a network of sub-specialists; building from scratch a administrative infrastructure, developing a business and financial plan; and recruiting a management team. </li></ul><ul><li>Results: The group began operations in May 2006 without any interruption in service and is now on a program to merge in additional groups and grow market position. </li></ul>Our Track Record <ul><li>Sadler Clinic </li></ul><ul><li>The Client: Sadler Clinic is a large multi-specialty clinic of over 90 physicians in 27 specialties encompassing over 8 locations in the Montgomery County area north of Houston. </li></ul><ul><li>Scope of JHD Group Work: The JHD Group was engaged to develop the business case and implementation strategy to move Sadler Clinic to an integrated practice management and electronic medical records system across all locations. The work involved surveying all physicians, summarizing key requirements, conducting a rigorous selection process, and developing a Business and Implementation Plan. </li></ul><ul><li>Results: Within 120 days a vendor selection was completed and detailed plan was developed and presented to the MSO and PA boards recommending a selected vendor and the process to implement the entire product over 24 months following approval. </li></ul>
  8. 8. <ul><li>Specific examples (cont’d)… </li></ul><ul><li>Yakima Valley Memorial Hospital </li></ul><ul><li>The Client :  Yakima Valley Memorial Hospital is the largest acute care facility in its region that operates a variety of healthcare facilities and employs or provides practice management services to over 80 physicians in a wide range of practices and specialties. </li></ul><ul><li>Scope of JHD Group Work :  JHDG was engaged to develop a new vision for Yakima Valley Memorial Hospital’s physician enterprise.  During the course of the work we drove the selection of a new ambulatory EHR and PM system, developed a new approach to financial management of the practices, piloted a restructuring of revenue cycle management for the hospital-owned management services company, and developed management tools to support explicit goal setting and performance management. </li></ul><ul><li>Results :  New revenue cycle policies and procedures have begun to drive improved financial performance at the practices, with incremental monthly collections increases of more than $100K per month currently realized, and several hundred thousand per month more to be captured from further implementation of redesigned processes. </li></ul>Our Track Record <ul><li>Saint Joseph's / Mercy Care Services </li></ul><ul><li>The Client: Sponsored by the Sisters of Mercy and Saint Joseph’s Health System, Mercy Care Services was created in 1985 by volunteer nurses and physicians and grew from modest beginnings into a “medical home” that provides an efficient, integrated system of primary health care, dental services, education and social services through multiple locations in the Atlanta area. </li></ul><ul><li>Scope of JHD Group Work: The JHD Group was engaged to assess the operational improvement opportunities in both the Mercy Care Downtown and Mercy Care North clinics focusing on the patient and care delivery processes. The emphasis was to improve patient services, and to increase both the efficiency and effectiveness of the ambulatory operations prior to implementing an Electronic Medical Record (EMR). The work involved surveying staff and physician leadership; assessing data from finance and operations, documenting process flows, and developing recommendations for staffing and flow improvement. </li></ul><ul><li>Results: This work resulted in the identification of the major problem areas, and a detailed approach for restructuring the Department Clinic processes. </li></ul>
  9. 9. <ul><li>Specific examples of where we have produced tangible results for our clients include: </li></ul><ul><li>Physician Associates of the Greater </li></ul><ul><li>San Gabriel Valley  </li></ul><ul><li>The Client: Physician Associates of the Greater San Gabriel Valley is a network of over 800 independent physicians in private practice. </li></ul><ul><li>Scope of JHD Group Work: JHD Group was engaged to recommend and implement an Electronic Medical Record system across all Physician Associates practices. </li></ul><ul><li>Results: The JHD Group provided a detailed business plan for the adoption of an integrated practice management and electronic medical record system which included cash planning of investment over time, the strategic positioning opportunities, and the implementation roll-out plan. We then assisted with the implementation which included system set-up, training, and workflow redesign </li></ul>Our Track Record <ul><li>HIP/Staten Island Medical Group </li></ul><ul><li>The Client: A large New York City multi-specialty group practice operating out of multiple clinics in both a capitated and fee-for-service environment. </li></ul><ul><li>Scope of JHD Group Work: We were retained to manage a two year restructuring project with the goal of substantially improving the group’s market position, profitability, supporting infrastructure, and the tools to be used by the group to manage itself effectively. The scope of the work included market development, managed care contracting, medical/utilization management, infrastructure (i.e. accounting, financial reporting, billing, collection, etc.) development, clinic operations improvement, compliance, physician compensation, and staff development. </li></ul><ul><li>Results: In the first year of this program, financial controls were put in place, the management was restructured, medical/utilization management was upgraded, a marketing program was designed and implemented, urgent care treatment centers were opened, a managed care contracting strategy was developed and new contracts negotiated, revenue was increased by 8%, and costs were reduced by 10%. </li></ul>
  10. 10. <ul><li>Specific examples (cont’d)… </li></ul><ul><li>Ohio State University Medical Center </li></ul><ul><li>The Client : The Ohio State University Medical Center is a leading public university academic medical center located in Columbus Ohio. </li></ul><ul><li>Scope of JHD Group Work : The JHD Group was charged with developing a strategy and an accompanying feasibility study to determine how to clinically link referring physicians throughout the state of Ohio with the Ohio State University Medical Center using the electronic medical record in use at the system. </li></ul><ul><li>Results : The client expanded their view of the market and modified their going-in assumed approach to one of utilizing different tactics depending upon the needs in different practices and situations. </li></ul>Our Track Record <ul><li>The Center for Cancer and Blood Disorders and The Arlington Cancer Center </li></ul><ul><li>The Client : The Center for Cancer and Blood Disorders and Arlington Cancer Center are two large comprehensive cancer centers located in the Dallas Fort Worth area . </li></ul><ul><li>Scope of JHD Group Work : The JHD Group facilitated merger discussions between the groups beginning with a retreat to determine common interest. With the success of the retreat JHD was brought back to facilitate discussions and manage the due diligence and merger business case development. </li></ul><ul><li>Results : Legal documents were finalized and the physicians in both practices voted unanimously to merge. </li></ul>
  11. 11. <ul><li>Specific examples of where we have produced tangible results for our clients include: </li></ul><ul><li>El Camino Hospital </li></ul><ul><li>The Client:   El Camino Hospital is a 395 bed acute care facility located in Mountain View, California, the heart of Silicon Valley.  The medical staff consists of almost 1,000 physicians. </li></ul><ul><li>Scope of JHD Group Work:   The client posed two questions:  (1) How to assist their independent community physicians given the extreme competitive forces that they face, and (2) How to support their practices with electronic connectivity, including an electronic health record. </li></ul><ul><li>Results:    We drew on the results of a clinical interoperability readiness assessment (the “Blitz”) and a proprietary JHD Group survey of like hospitals to develop and implement a strategy for increasing clinical integration and loyalty between the community physicians and the hospital.  This strategy resulted in a cooperative to deploy an integrated EPM/EMR system to community physicians under the Stark Safe Harbor, a health information exchange, a GPO and a patient health record/patient portal. Additionally, an LLC was formed to provide management services to interested physicians, and the vehicle for a series of physician – hospital ambulatory care development joint ventures. </li></ul>Our Track Record Hill Physicians The Client: Hill Physicians is a large IPA in California supporting 2,600 primary care and specialty physicians. Through their eSolutions Group, Hill provides a number of technology solutions to the physicians including an ASP integrated EPM and EMR. Scope of JHD Group Work: The JHD Group was engage to assess Hill’s IT organization, IT support capability, and the methodology for implementing the integrated practice management and electronic medical record systems. As a part of this engagement, we provided re-designed their implementation methodology which included the design of supporting workflows, development of a training program, and directly supported implementations. As a part of this work we assisted with the revenue cycle management at selected practices. Results: The eSolutions organization was redesigned, supplemental staff were recruited and trained, a streamlined methodology for practice management and electronic medical record systems implementation was developed, and multiple practices were implemented.
  12. 12. <ul><li>Specific examples (cont’d)… </li></ul><ul><li>Arlington Cancer Center </li></ul><ul><li>The Client : The Arlington Cancer Center is a multispecialty comprehensive cancer center serving patients from all over the world located in the Dallas Fort Worth area. </li></ul><ul><li>Scope of JHD Group Work : JHD provided interim management services as a result of staff departures. JHD led the effort to improve financial performance through a comprehensive expense reduction effort and the collection of old accounts receivable. </li></ul><ul><li>Results : The client collected $2,600,000 in old receivables and reduced staffing costs by 20% while recruiting two additional physicians. Through aggressive cash management JHD helped the practice remain solvent despite tight credit. </li></ul>Our Track Record <ul><li>Ohio Permanente </li></ul><ul><li>The Client :  The Ohio Permanente Medical Group (OPMG) is a multispecialty group located in the Northeast Ohio region serving over 140,000 Kaiser plan members with over 200 employed and contracted physicians. </li></ul><ul><li>Scope of JHD Group Work :  JHDG was engaged to develop a strategic plan with a particular focus on the recruitment and retention of physicians and the identification of market opportunities to reposition OPMG in the highly competitive and largely consolidated Northeast Ohio healthcare marketplace. </li></ul><ul><li>Results :  The work was performed during the Fall and Winter of 2008-2009.  The recommendations for new approaches to the recruitment of physicians (with a particular emphasis on Primary Care Physicians), as well as for a strategic initiative to help reposition the Group in the Northeast Ohio marketplace, were well received and embraced by the Board of Directors.  While the recruitment recommendations are currently being implemented, it is too soon measure their impact.  The recommendations for strategic repositioning of the Group require review and approvals from other organizations in the Kaiser “family”. </li></ul>
  13. 13. <ul><li>Specific examples (cont’d)… </li></ul><ul><li>Monarch Health </li></ul><ul><li>The Client: Monarch is a 1,700 physician IPA in southern California. </li></ul><ul><li>Scope of JHD Group Work: JHDG was retained to develop a business plan which would facilitate the rapid clinical integration necessary for Monarch to remain competitive as their market transitioned. The planning and analysis involved assessing alternative strategies, opportunities for partnership/collaboration with payers and hospitals, the role of an electronic Medical Record system, and how to best overcome internal and external hurdles in implementing a plan. </li></ul><ul><li>Results: The work resulted in a detailed analysis of alternative strategies along with related risks and opportunities as well as a payback analysis for an Electronic Medical Record system including the effect of CMS “Risk Adjusted” and “Pay-For-Performance”. </li></ul>Our Track Record <ul><li>Muir Medical Group, IPA  </li></ul><ul><li>The Client: Muir Medical Group, IPA is a network of over 700 independent physicians in the East Bay area of San Francisco. </li></ul><ul><li>Scope of JHD Group Work: The JHD Group was engaged to build a plan to offer its preferred practice management and electronic medical record system to its member practices to help achieve clinical integration across the IPA. JHD was retained to bring tangible results to a process that had already been underway. </li></ul><ul><li>Results: Over a year long period, JHD was able to provide specifics and structure to their plan and methodology which resulted in an accelerated implementation schedule. The JHD Group took the lead in operationalizing the new methodology and implementing the initial physician practices along with building and developing Muir’s newly formed internal department that would lead the project for the ongoing future. </li></ul>
  14. 14. <ul><li>Specific examples (cont’d)… </li></ul><ul><li>Carle Clinic: Medical Records </li></ul><ul><li>The Client: The Carle Clinic is a 270 physician multi-specialty practice with an associated foundation hospital located in Champaign/Urbana, Illinois. </li></ul><ul><li>Scope of JHD Group Work: In conjunction with Cejka and Company, the JHD Group provided an independent assessment of the health information management (HIM)/Medical Records function at Carle. The project focused on identifying the reengineering opportunities in the medical records process, the business and patient care case for change, and the considerations associated with implementation of an Electronic Medical Record. </li></ul><ul><li>Results: This analysis resulted in a commitment by the clinic and hospital organizations to overhaul the existing medical records organization and processes. </li></ul>Our Track Record <ul><li>Piedmont Health System </li></ul><ul><li>The Client: This client is a large integrated health systems located in Atlanta which includes an acute-care tertiary facility and a medical staff of more than 800 physicians. </li></ul><ul><li>Scope of JHD Group Work: The JHD Group was retained to assess the feasibility of implementing an Ambulatory Electronic Medical Record System (AEMRS) which integrates not only hospital records, but also hospital owned clinic operations, affiliated physician offices, and with a link to BCBS. This analysis addressed the business case for implementing an AEMRS, alternative approaches to funding, the major challenges including the required operational reengineering in physician offices, and the larger strategic considerations to the stakeholders. </li></ul><ul><li>Results: This project provided the analytical foundation for moving forward with the EMR implementation. </li></ul>
  15. 15. <ul><li>Specific examples (cont’d)… </li></ul><ul><li>UT Southwestern </li></ul><ul><li>The Client: A large medical school with over 850 physicians who teach, conduct research, and provide healthcare services to the community. </li></ul><ul><li>Scope of JHD Group Work: The project involved an assessment of the revenue cycle management process for the Department of Psychiatry which included all activities such as scheduling, insurance verification, coding, charge capture, claims scrubbing, billing, payment processing, denials management, collections, and cash control. The objective was to quickly identify weaknesses in the process and propose solutions which would allow the medical school to provide assurances that all collectable dollars were being collected. </li></ul><ul><li>Results: The project identified lost dollars and their causes and recommended a different approach to organizing the revenue management cycle. </li></ul>Our Track Record <ul><li>Triangle Orthopaedic Associates </li></ul><ul><li>The Client: A 22 physician, orthopedic group in Durham, North Carolina. </li></ul><ul><li>Scope of JHD Group Work: Our firm was engaged to manage the entire practice and “turnaround” the financial performance of the organization. For the purposes of our engagement, the focus was to dramatically improve physician income, reduce the indebtedness of the group, and stabilize the operations while reducing the overhead of the group. </li></ul><ul><li>Results: Over the period of a year, we deployed 11 senior staff who, in aggregate, worked in excess of 6,000 hours and succeeded in reducing the overhead rate by over 8%, generating sufficient excess cash to fund a previously unfunded $1.2 million requirement, increasing the collection rate 3% resulting in $1.5 million in incremental net revenue, and increasing physician income in the aggregate by over $1.2 million. </li></ul>
  16. 16. <ul><li>Specific examples (cont’d)… </li></ul><ul><li>CSANT </li></ul><ul><li>The Client: This client is a large group of Cardiologists and Cardiovascular Surgeons with multiple clinics in the Dallas Metroplex. </li></ul><ul><li>Scope of JHD Group Work: The JHD Group was engaged to manage this group of 50 cardiologists and cardiovascular surgeons under a five year incentive based contract with our compensation was directly related to improvements in physician income. During this relationship JHDG overhauled the billing and collection function reducing cost by 20 percent, replaced the practice management system, introduced CT scanning technology, developed a comprehensive reporting structure, recruited over six new physicians, and implemented a referral development program. </li></ul><ul><li>Results: Over the five year period of this assignment, the revenue cycle processes were upgraded, an operating/financial “Dashboard” was put into place, new managed care contracts were negotiated, an electronic medical record system was selected and initial implementations started, and a CT strategy was implemented. </li></ul>Our Track Record <ul><li>Mills-Peninsula Medical Group  </li></ul><ul><li>The Client: Mills-Peninsula Medical Group is a 380 physician IPA, affiliated with Mills-Peninsula Health Services, a Sutter Health affiliate, and is located in San Mateo county, south of San Francisco. </li></ul><ul><li>Scope of JHD Group Work: JHD Group was engaged to evaluate the organization’s strategy and develop an approach to achieve clinical integration. We subsequently recommended to MPMG’s board the implementation of a common Electronic Medical Record and Practice Management System linked to an operations improvement process in all the MPMG practices. Since that recommendation, a vendor has been selected and installed, the EMR and PMS have been implemented in multiple practices, and a number of operational improvements have been made enabling increased integration. </li></ul><ul><li>Results: This work resulted in a detailed business plan based on having an EMR to “glue” physicians to Mills, Mills was positioned to ensure clinical integration for care delivery purposes to begin PPO contracting. </li></ul>
  17. 17. <ul><li>Specific examples (cont’d)… </li></ul><ul><li>Southwest Physicians Associates </li></ul><ul><li>The Client: A 1,400 physician IPA located in the Dallas Metroplex. </li></ul><ul><li>Scope of JHD Group Work: The JHD Group provided market planning assistance which subsequently led to a substantial restructuring of the SPA organization. This restructure focused on separating the risk and non-risk business, and renegotiating the basis upon which the group operated going forward. </li></ul><ul><li>Results: Physician agreement on restructuring options and successful IPA operation after restructuring. </li></ul>Our Track Record <ul><li>Texas Radiology Associates </li></ul><ul><li>The Client: A large radiology group operating out of five hospitals. </li></ul><ul><li>Scope of JHD Group Work: We were engaged to assess the performance of the group’s outside billing and collection company, and to renegotiate the arrangement with the billing company. As a part of the required analysis, we assessed the collections effectiveness in terms of lost charges, “failure to collect”, and reporting of results. </li></ul><ul><li>Results: Our analysis provided the client with the data necessary to determine that the billing company was not performing, and assisted in setting the terms for a new billing company. </li></ul>Southwest Physicians Associates
  18. 18. <ul><li>Specific examples (cont’d)… </li></ul><ul><li>Pinnacle Anesthesia Consultants </li></ul><ul><li>The Client: Pinnacle is a 200 physician anesthesia practice operating in the Dallas Metroplex. </li></ul><ul><li>Scope of JHD Group Work: We were initially engaged to provide an efficiency and effectiveness evaluation, and were subsequently retained under a four year management contract. Under this contract, the JHD Group was responsible in managing all of the non-clinical operations of Pinnacle including, but not limited to, managed care contracting, billing and collections, accounting and finance, human resources, information systems, physician recruiting, compliance, scheduling, and market development. Our arrangement with Pinnacle followed a partnership model where we worked closely with the physicians in developing strategy and policy, and were entirely at risk for the results. </li></ul><ul><li>Results: Over a 5 year period, on a doctor adjusted basis, revenue increased 13%, overhead costs reduced to pre-1999 levels, and expenses reduced by 25 basis points (0.25%) per year. The organization and governance was also stabilized. </li></ul>Our Track Record <ul><li>Adventist Health System </li></ul><ul><li>The Client: Adventist Health System organizations provide 36 hospitals totaling more than 6,000 licensed beds, care for nearly 4 million patients each year in inpatient, outpatient and emergency room visits, and employ almost 43,000 members. </li></ul><ul><li>Scope of JHD Group Work: JHDG was initially engaged to review and validate AHS’ existing plan to implement an electronic medical solution to its employed physician base. Additionally, JHDG was engaged to conduct a study and assimilate a business plan for AHS to offer electronic medical record solutions through its regional hospital base to community physicians. </li></ul><ul><li>Results: Our recommendations resulted in streamlining the approach to EMR planning and implementation across Adventists. Additionally, the sites involved in the practice management and revenue cycle management were successfully improved. </li></ul><ul><li>C ONSULTANTS </li></ul><ul><li>A NESTHESIA </li></ul><ul><li>P INNACLE </li></ul>
  19. 19. <ul><li>Specific examples (cont’d)… </li></ul><ul><li>American Whole Health </li></ul><ul><li>The Client: This client is an alternative medicine PPMC with approximately 70 physicians, headquartered outside Washington D.C., with operations in several states. The clinical practice involves primary care services integrated with alternative medicine specialists. </li></ul><ul><li>Scope of JHD Group Work: The JHD Group was initially retained to provide an assessment of business operations. We subsequently provided an Interim Chief Operating Officer and were retained to fix broad aspects of the operation. This assignment involved improving the billing and collections operation, facilitating the development of a common vision and mission with the physicians, restructuring the physician compensation methodology, overhauling the finance and accounting functions, reengineering overhead and reducing costs, establishing performance monitoring tools, re-staffing many support functions, and developing a business plan for restructuring the business. </li></ul><ul><li>Results: The business was restructured, and negative cash flow was reduced by $750,000 per month. </li></ul>Our Track Record <ul><li>ProMedCo Management Company </li></ul><ul><li>The Client: ProMedCo was a large PPMC which managed multi-specialty physician practices located across the country and had over $400 million in annual revenues. </li></ul><ul><li>Scope of JHD Group Work: The JHD Group provided assistance to ProMedCo on a number of assignments, most related to pre-acquisition due diligence on multi-specialty physician groups, post merger integration of the groups, and interim staffing. This work involved assessment of the practice management aspects of potential acquisitions, conducting operational due diligence, and managing a multi-specialty practice for an interim period. The interim management assignments involved market planning, physician recruitment, operations streamlining, and stabilizing clinic operations during the post-merger integration process. </li></ul><ul><li>Results: Each assignment resulted in a detailed documentation of the risks and opportunities associated with each acquisition and the successful integration after acquisition. </li></ul>
  20. 20. <ul><li>Specific examples (cont’d)… </li></ul><ul><li>Cole Managed Vision </li></ul><ul><li>The Client: A $1.5 Billion provider of eye glasses and optometric services. </li></ul><ul><li>Scope of JHD Group Work: Approximately $250 million of Cole’s business was serviced through managed care contracts, and the company was in need of a redesigned managed care infrastructure. The JHD Group provided a comprehensive assessment of existing issues, initiated and managed a process to identify and implement “Quick Wins”, and designed a new infrastructure specifically focusing on improving financial results and service. </li></ul><ul><li>Results: Substantial increased cash flow, streamlined managed care processes, and designed improved managed care infrastructure. </li></ul>Our Track Record <ul><li>Professional Anesthesia Consultants </li></ul><ul><li>The Client: Professional Anesthesia Consultants is a provider of office based anesthesia services in the Philadelphia/Southern New Jersey markets. </li></ul><ul><li>Scope of JHD Group Work: The JHD Group assessed issues around the billing and collection processes, the effectiveness of the supporting billing and collections service, and the impact of these issues on cash flow. After this assessment was completed, we were asked to redesign the supporting processes from scheduling through payment posting, train the anesthesiologists in effective case documentation, renegotiate the arrangement with the billing company, and ensure collection of old accounts. </li></ul><ul><li>Results: Cash receipts and organizational efficiency were dramatically improved. </li></ul>
  21. 21. <ul><li>Specific examples (cont’d)… </li></ul><ul><li>Cardiovascular Institute of the South </li></ul><ul><li>The Client: A large medical and surgical group practice providing cardiology and cardiothoracic surgery over a number of hospitals in Louisiana. </li></ul><ul><li>Scope of JHD Group Work: The JHD Group assisted CIS in its strategic and market planning by developing a market assessment, providing a benchmark analysis, and framing the strategic issues to be addressed in developing CIS. </li></ul><ul><li>Results: This project resulted in a strategic analysis customized for CIS which formed the foundation for resolution of a number of basic issues. </li></ul>Our Track Record <ul><li>Lovelace Physician Group </li></ul><ul><li>The Client: A 270 physician, multi-specialty clinic in Albuquerque, New Mexico. </li></ul><ul><li>Scope of Work: Our firm was engaged to conduct a comprehensive organizational assessment that evaluated all aspects of the group’s core processes, infrastructure, and practice operations. </li></ul><ul><li>Results: We completed the assessment and identified over $30M in organizational improvement opportunities and developed a structured plan to harvest these gains within 2-3 years. Additionally, we were successful in implementing an “authority responsibility” matrix that clarified the role and responsibility of the physician group practice board in the context of their relationship with the hospital management company that actually owns the integrated (physician – hospital) organization . </li></ul>
  22. 22. <ul><li>Specific examples (cont’d)… </li></ul><ul><li>Carle Clinic: Supply Chain Evaluation </li></ul><ul><li>The Client: A 270 physician multi-specialty practice with an internal supply chain which currently handles approximately $20 million in supplies, injectibles and other soft goods. </li></ul><ul><li>Scope of JHD Group Work: JHDG identified areas for improvement related to systems, policies, procedures and controls. This work involved assessing the approach to vendor contracting, purchasing, inventory management, pricing, supplies billing, and cost accounting. </li></ul><ul><li>Results: The project identified lost dollars and their causes and recommended an approach to organizing the supply chain management process. </li></ul>Our Track Record <ul><li>The Permanente Company </li></ul><ul><li>The Client: This client is the physician management arm of the Kaiser Permanente Foundation, located in Oakland, California. </li></ul><ul><li>Scope of JHD Group Work: The JHD Group was retained to provide interim clinical management for a large multi-specialty clinic located in Tampa. This assignment involved transitioning two clinics into a single operation. Our work included selecting new information systems; assessing staffing and compensation, including, physician compensation; reengineering patient flow; and implementing controls over pharmacy utilization. </li></ul><ul><li>Results: The clinic consolidation and integration was completed on schedule with minimum disruption of patient service. </li></ul>
  23. 23. <ul><li>Specific examples (cont’d)… </li></ul><ul><li>Touchstone Health Partnership </li></ul><ul><li>The Client: Touchstone is a medical management centric IPA located in New York City. </li></ul><ul><li>Scope of JHD Group Work: Our assignment for this client involved conducting a comprehensive assessment of a 60 physician multi-specialty group in a very short period of time. Over a two week period, we addressed two basic questions : </li></ul><ul><li>What are the strengths, weaknesses, opportunities, and threats related to the Medical Group’s market position and operation? </li></ul><ul><li>What changes need to be made for the group to increase competitiveness and prosper? </li></ul><ul><li>Our assessment focused on the group’s market position, the level of overhead costs, the outcomes and productivity of the group’s physicians, the effectiveness of the supporting infrastructure, and the ability of the organization and its culture to adapt. </li></ul><ul><li>Results: The resulting report, which was fully accepted by the group, was used as the basis for proposing a full delegation of capitation risks and practice management under a long term contract. </li></ul>Our Track Record <ul><li>Cardiovascular Provider Resources (CPR) </li></ul><ul><li>The Client: CPR is a large cardiology practice with over 50 physicians operating out of several clinics in the Dallas metropolitan area. </li></ul><ul><li>Scope of JHD Group Work: The JHD Group was retained to provide broad turnaround support to CPR and to assist in the transition from a PPMC to a physician owned practice. This work involved developing a market plan, improving the effectiveness of the billing and collection functions, implementing management and control tools in managed care operations, reengineering the clinic operational processes, providing interim management for the central billing office, improving the accounting and finance function, and initiating the chief operating officer role. </li></ul><ul><li>In addition to the turnaround assignment, we assisted in the negotiations of a Heart Hospital joint venture and assessed the prospects for a cardiac centric internet venture. </li></ul><ul><li>Results: Increased cash flow 20%, reduced cost of operation, increased reliability of the infrastructure, and stabilized the management and governance process. </li></ul>
  24. 24. <ul><li>Specific examples (cont’d)… </li></ul><ul><li>Children’s Medical Center of Dallas / University of Texas Southwestern at Dallas </li></ul><ul><li>The Client: Children's is a 348 – bed hospital exclusively devoted to meeting the needs of children from birth to age 18. The hospital also has more than 50 outpatient clinics and a state-of-the-art emergency center designed specifically for children. </li></ul><ul><li>Scope of JHD Group Work: Our firm was engaged to stabilize the division of pediatric radiology in a manner that maintained the viability and stability of the program and service for both Children’s and UTSW. Part of this study involved determining the market compensation, performance expectations and expected impact of relative physician under - supply of pediatric radiologists over the foreseeable future. </li></ul><ul><li>Results: The leadership at both UTSW and Children’s is using our recommendations to effectively stabilize the division of pediatric radiology. </li></ul>Our Track Record <ul><li>UCSF Medical Center </li></ul><ul><li>The Client: The UCSF Medical Center is a major academic medical center located in San Francisco. </li></ul><ul><li>Scope of JHD Group Work: The JHD Group was engaged to assess the operational improvement opportunities in the Orthopedic and Pediatric Specialty Departments related to improving service to patients and increasing the efficiency and effectiveness of the ambulatory operation. The work involved surveying patients, referring physicians, staff and physician leadership; assessing data from finance and operations, and observing clinic operations. </li></ul><ul><li>Results: This work resulted in the identification of the major problem areas, and a detailed approach for restructuring the Department Clinic processes. </li></ul>
  25. 25. <ul><li>Specific examples (cont’d)… </li></ul><ul><li>Bridgeport Hospital /Yale New Haven Health System </li></ul><ul><li>The Client:   This client is a 425 bed community hospital that is affiliated with the Yale New Haven Health System. </li></ul><ul><li>Scope of JHD Group Work:   The JHD Group was engaged to investigate the initial feasibility and most appropriate approach to effectively merge four (4) community general surgery practices into a sustainable model that included an academic department of surgery. </li></ul><ul><li>Results:   Upon evaluating the strategic, financial, cultural, and operational factors for the hospital, each of the four (4) community based practices, and the academic department of surgery, we presented a workplan that would create a financially sustainable, merged practice model with 18 months of operations. </li></ul>Our Track Record <ul><li>Methodist Sports Medicine Center </li></ul><ul><li>The Client: Methodist Sports Medicine Center is a large sports medicine orthopaedic group located in Indianapolis, Indiana. </li></ul><ul><li>Scope of JHD Group Work: Our affiliation was structured as a management relationship in which JHD Group was charged with coordinating / managing all of the strategic and operational aspects of the practice in order to increase physician income. The scope of the work included maximizing the return from various ancillary services (ambulatory surgery center, radiology, physical therapy, etc.); clinic staffing, patient service, and physician support; coding, billing and collections, managed care contracting, and market growth and positioning. </li></ul><ul><li>Results: In the first four months of our work, this group saw a financial improvement of greater than $700,000. Additionally, the group substantially improved its market position and added new physicians, increasing the scope and presence of the group. </li></ul>
  26. 26. <ul><li>Specific examples (cont’d)… </li></ul><ul><li>Beth Israel Deaconess Medical Center / Harvard Medical Faculty Physicians </li></ul><ul><li>The Client:   The Division of General Medicine and Primary Care of the Harvard Medical Faculty Physicians (in collaboration with Beth Israel Deaconess Medical Center) includes almost 50 faculty involved in market leading research, resident medical education, and patient care. </li></ul><ul><li>Scope of JHD Group Work:   This project involved re-designing the faculty compensation model in a manner that effectively transitioned the group away from a pure salary-based model to a performance-based plan with market competitive metrics. The goal of the division chairperson was to link faculty income with their contribution for all work performed (i.e. teaching, research, patient care). </li></ul><ul><li>Results:   This work resulted in an approach that values faculty work effort equivalently irrespective of seniority. The fundamental unit of measurement for clinical effort is “work RVUs”; with non-clinical work for teaching measured with internally derived “educational RVUs”. Additionally, the compensation system allows individual faculty income to float (up and down) within a reasonable band. </li></ul>Our Track Record <ul><li>HealthPartners Medical Group </li></ul><ul><li>The Client: HealthPartners Medical Group is a 400 physician multi-specialty group in Minneapolis, Minnesota that is integrated with a 600,000 member healthplan and hospital network. </li></ul><ul><li>Scope of JHD Group Work: JHD Group was retained to provide strategic and operational planning for the oncology service line. We forecasted the expected impact of broader trends of oncology service delivery and reimbursement, and determined how it would impact HealthPartner’s market position and organizational structure. We identified and quantified improvement opportunities in workflow, supporting infrastructure, staffing, and revenue cycle management. We also provided a detailed recommendation regarding the resources and required changes to facilitate a successful transition from hospital-based to freestanding status of the cancer program. </li></ul><ul><li>Results: Our operational analysis highlighted greater than $1.2M in improvement opportunities. Further, our strategic recommendation included developing an integrated clinical approach to the service line that effectively repositioned HealthPartner’s oncology program to compete more effectively for patients. </li></ul>
  27. 27. <ul><li>Specific examples (cont’d)… </li></ul><ul><li>North Texas Hospital </li></ul><ul><li>The Client: North Texas hospital located in Denton, Texas is owned and operated by local physicians in partnership with Cirrus Health. The 102,530 square foot campus houses a medical office building, an imaging center and a hospital with 6 operating suites, 6 procedure rooms, 22 PACU beds and 16 overnight rooms. </li></ul><ul><li>Scope of JHD Group Work: JHD performed an assessment of operations including: revenue cycle (patient access, coding, billing, AR management); information systems; medical records management; managed care contracting; long term strategic planning; cost effectiveness and quality of management; and governance and decision making. </li></ul><ul><li>Results: JHD Group used a structured methodology to assess the operations in terms of Staffing, Revenue Cycle, Human Resources, Credentialing, Governance, Managed care contracting, Facility utilization, Market development, Management control and reporting, Financial Results and in particular the revenue trends, profitability, and their components. </li></ul>Our Track Record <ul><li>Hoag Hospital </li></ul><ul><li>The Client: Hoag Hospital is a 511 licensed bed hospital (413 available) located in Newport Beach, California. Hoag Hospital is centrally located in Orange County, which is bordered by Los Angeles, Riverside, and San Diego counties. Hoag has Centers of Excellence in Heart, Women’s, Orthopedics, Cancer and Neurosciences. Hoag Hospital currently has joint venture arrangements in Imaging and Surgical Services. de range of patient services to the Orange County community. </li></ul><ul><li>Scope of JHD Group Work: JHD Group was engaged to formulate a strategy for clinical integration of the Hoag community that would tie-in the infrastructure of their MSO, Hoag Practice Management, Inc., Greater Newport Physicians IPA, and other community physicians. We led a planning process that will take Hoag’s Clinical Integration abilities to the next level. We are currently engaged to lead Phase I of their implementation. </li></ul><ul><li>Results: The work resulted in “unstagnating” roles and responsibilities between affiliated entities and moving forward with their EMR implementation with a larger scope and a greater sense of urgency. </li></ul>
  28. 28. <ul><li>Specific examples (cont’d)… </li></ul><ul><li>St. Vincent Catholic Medical Centers </li></ul><ul><li>The Client:   SVCMC is a large multi-hospital system in the greater New York city area. </li></ul><ul><li>Scope of JHD Group Work:   The JHD Group was engaged to lead in the restructuring of how over 800 physicians are managed and compensated. This work involves inventorying all of the physicians capabilities and arrangements; assessing capacity utilization and productivity, evaluating compensation methodologies arrangements; and developing an approach for rationalizing the physician capacity and assuring that the SVCMC system has the tools to manage physician cost. </li></ul><ul><li>Results:   This project resulted in a plan for substantial reorganization of the physician services, reduction in the cost of physician services, and improvements in ambulatory revenue cycle management. </li></ul>Our Track Record <ul><li>CAC Florida Medical Centers </li></ul><ul><li>The Client:   CAC Florida Medical Centers is a 45-physician medical group that supports a 25,000 member Medicare HMO in Miami, Florida and operates ten strategically located, full service, multi-specialty medical centers. </li></ul><ul><li>Scope of JHD Group Work:   This project involved redesigning the physician compensation model in a manner that effectively transitioned the group away from a panel-based model to a productivity-based plan with equivalent incentives for patient access and coding. The goal of group leadership was to use the compensation plan change as a tool to support a cultural change in the physician practice, thereby introducing a variable compensation component that linked income with performance and market competitive incomes. </li></ul><ul><li>Results:   Our work with this client resulted in CAC adopting our revised compensation plan methodology with a market-based salary, plus quarterly incentive that focused on productivity, quality, and patient satisfaction. Our plan also included a similar recommendation for site medical directors and other physician leaders. </li></ul>
  29. 29. <ul><li>Specific examples (cont’d)… </li></ul><ul><li>Children’s Health Corporation of America </li></ul><ul><li>The Client: An association of the nations largest Children’s hospitals. </li></ul><ul><li>Scope of the Work:   The JHD Group was asked to identify best practices in pediatric radiology for the six largest Children’s hospitals.  We used the CHCA PACT database to profile performance at each of the institutions and visited each to identify the unique characteristics that could benefit the others.  We also evaluated the accuracy and utility of the PACT database, the collection of data utilized by CHCA members to compare performance. </li></ul><ul><li>Results:   We identified best practices in multiple categories including Radiologist Services, Information Management, Sedation Practices, Patient Flow, and Business Approach.  We compared each modality for cost and utilization along with administration, information technology and nursing clearly identifying key differences among the hospitals.  We identified cost reduction opportunities for both labor and non-labor.  We made recommendations to improvements in the PACT database.  Finally we made recommendations for implementation for CHCA and at each site which are being implemented by the institutions. </li></ul>Our Track Record <ul><li>Kingsbrook Jewish Medical Center </li></ul><ul><li>The Client: Kingsbrook Jewish Medical Center is an independent, inner-city, not-for-profit community teaching hospital serving an ethnically diverse, socio-economically disadvantaged population in north central Brooklyn, N.Y.  In addition to a small, full time physician leadership team, Kingsbrook employs and/or contracts with more than 100 of its medical staff on full- or part-time bases to provide for the professional medical needs of its community. </li></ul><ul><li>Scope of JHD Group Work: JHD has been working with Kingsbrook over the past several months to rationalize its employment and contractual relationships with its physician employees and contractors, and to develop job descriptions, fair market compensation valuations, time and performance management tools, and to identify potential compliance issues arising from their employment and/or contracting arrangements. </li></ul><ul><li>Results: Our work provided Kingsbrook with both a toolkit and a framework for defining and managing their future physician relationships, as well as a guide to resolving/restructuring the wide range of historical relationships which challenge current management systems and capabilities. </li></ul>
  30. 30. <ul><li>Specific examples (cont’d)… </li></ul><ul><li>Desert Medical Group/Oasis IPA </li></ul><ul><li>The Client: Desert Medical Group is a 20 physician staff model group located in Palm Springs, California. Oasis IPA is a 200 physician IPA also located in Palm Springs. </li></ul><ul><li>Scope of JHD Group Work: JHDG was engaged to develop a business and action plan that would allow the medical group and the IPA to effectively implement the NextGen electronic medical record and practice management system in their region. Challenges that were faced included how to effectively implement these systems in regional practices where the average physician group size is approximately 1.5 physicians. </li></ul><ul><li>Results: We completed the design phase of the action plan that will allow Oasis to effectively build on its current infrastructure to efficiently and cost-effectively be able to “ramp-up” its clinical integration capability. </li></ul>Our Track Record <ul><li>North American Medical Management - California </li></ul><ul><li>The Client: North American Medical Management – California is a 2,500 physician network located throughout California. </li></ul><ul><li>Scope of JHD Group Work: JHDG was retained by North American Medical Management – California to develop an operating model that would best meet the needs of NAMM – CA and its affiliates. This included surveying the interests of key physicians to provide an assessment of the value of the existing relationship, the goals of the practices and to identify ventures of common interest. </li></ul><ul><li>Results: The engagement provided a concrete assessment of the value of the relationship and raised a number of mutually beneficial interests. </li></ul>
  31. 31. <ul><li>Specific examples (cont’d)… </li></ul><ul><li>Sequoia Physician’s Alliance </li></ul><ul><li>The Client: Sequoia Physician’s Alliance is a confederation of 40 physicians in Redwood City, California. </li></ul><ul><li>Scope of JHD Group Work: JHDG was retained to develop the confederation into a business unit of Mills Peninsula Medical Group. This included executing participating physician agreements, processing credentialing applications, developing and staffing a working governance structure including an operating Board and committees, and implementing a compensation plan. </li></ul><ul><li>Results: The engagement provided a plan to reorganize physician relationships. </li></ul>Our Track Record
  32. 32. Our Published Healthcare Articles
  33. 33. <ul><li>JHD Group is committed to advancing the conversation on a variety of important practice management topics… </li></ul>Our Published Healthcare Articles Date Publication Topic Feb-11 DOTmed Business News Practice Management: Revenue Cycle and EMRs – It’s not just about billing and collections anymore Nov-10 DOTmed Business News Practice consolidation – it’s picking up speed Nov-09 Group Practice Journal Exploring Meaningful Use: Results of an EHR Survey by AMGA and JHD Group Nov-08 Trustee Magazine Trends and Strategic Planning: Implications for the Board Nov-07 Trustee Magazine Bonding with Physicians: Hospitals and IT Donations Sep-07 Group Practice Journal Nine Strategies for Successful EHR Adoption Jul-07 American Hospital Association - Center for Healthcare Governance (Monograph) Hospital-Physician Clinical Integration May-07 Physician Executive Effectively Integrating Your EMR Initiative May-05 American Hospital Association - Center for Healthcare Governance (Monograph) Exploring Hospital-Physician Business Relationships Aug-04 The Doctor's Office Discounts for Deserving Patients Aug-04 Group Practice Journal A Model Where Results Count Jul-04 Physician Compensation Report Evaluating Comp Plan May Lead to Limited Change May-04 The Doctor's Office Accurate Place-of-Service Codes Reduce Chances of OIG Scrutiny Apr-04 The Doctor's Office Requirements to Avoid Overbilling Allegations
  34. 34. Our People
  35. 35. <ul><li>Our professionals work in teams, providing for integrated solutions to complex issues. </li></ul><ul><li>For each client assignment, we build a team drawn from full time JHD Group staff, a network of specialists, and organizations with specific capabilities required for a particular assignment. The competency listing below provides an indication of the type of available skills. </li></ul>Our People <ul><li>Our teams can range in size from 1 or 2 up to 8 to 10, depending on the client’s requirements. These teams can be mobilized very quickly, and produce tangible results in days. </li></ul><ul><li>The biographical summaries which follow are representative of the people we assign to projects. </li></ul>The competencies of our people… <ul><li>Practice Operations </li></ul><ul><ul><li>Registration </li></ul></ul><ul><ul><li>Benefit verification </li></ul></ul><ul><ul><li>Scheduling </li></ul></ul><ul><ul><li>Medical Records </li></ul></ul><ul><li>Central Billing Office </li></ul><ul><ul><li>Revenue Recapture </li></ul></ul><ul><ul><li>Third-Party Billing </li></ul></ul><ul><ul><li>AR/Collections </li></ul></ul><ul><ul><li>CPT4 and ICD9 Coding </li></ul></ul><ul><ul><li>Compliance </li></ul></ul><ul><li>Information Technology </li></ul><ul><ul><li>Legacy Systems </li></ul></ul><ul><ul><li>Internet Solutions </li></ul></ul><ul><ul><li>Hardware Architecture </li></ul></ul><ul><ul><li>Communications </li></ul></ul><ul><ul><li>Systems Integration </li></ul></ul><ul><ul><li>Network Design </li></ul></ul><ul><li>Finance and accounting </li></ul><ul><ul><li>Treasury Function </li></ul></ul><ul><ul><li>Accounting and Financial Reporting </li></ul></ul><ul><ul><li>Capital Formation </li></ul></ul><ul><li>Physician Compensation </li></ul><ul><ul><li>Productivity and benchmarking assessments </li></ul></ul><ul><ul><li>Physician compensation methodologies/plans </li></ul></ul><ul><ul><li>Physician retention </li></ul></ul><ul><li>Managed Care Administration </li></ul><ul><ul><li>Payer Contracting </li></ul></ul><ul><ul><li>Provider Contracting </li></ul></ul><ul><ul><li>Network Operations </li></ul></ul><ul><ul><li>Claims Processing </li></ul></ul><ul><ul><li>Credentialing   </li></ul></ul><ul><ul><li>Capitation Management </li></ul></ul><ul><li>Governance </li></ul><ul><ul><li>Board Structure </li></ul></ul><ul><ul><li>Management Structure </li></ul></ul><ul><ul><li>Committee Process </li></ul></ul><ul><li>Change Management </li></ul><ul><ul><li>Organization and Individual change process </li></ul></ul><ul><ul><li>Cultural change </li></ul></ul><ul><li>Market Development </li></ul><ul><ul><li>Market Strategy </li></ul></ul><ul><ul><li>Mergers and practice consolidations </li></ul></ul><ul><ul><li>Health Plan Contracting </li></ul></ul><ul><ul><li>Hospital/Physician Integration </li></ul></ul><ul><ul><li>Population Management </li></ul></ul><ul><li>Medical Management </li></ul><ul><ul><li>Utilization Management </li></ul></ul><ul><ul><li>Quality Management </li></ul></ul><ul><ul><li>NCQA Standards </li></ul></ul><ul><ul><li>Case & Disease Mgmt. </li></ul></ul><ul><li>Facilities </li></ul><ul><ul><li>Planning and Design </li></ul></ul><ul><ul><li>Operations </li></ul></ul>
  36. 36. <ul><li>Each JHD Group professional has extensive healthcare experience mainly working with physician organizations. </li></ul><ul><li>John H. (Hank) Duffy: </li></ul><ul><li>Mr. Duffy, the founder of the JHD Group, has 33 years of experience, with 27 years in Management Consulting and Business Management. Before establishing the firm, Mr. Duffy was the National Director and COO of American Practice Management, Inc. (APM, Inc.), and the National Managing Partner for Coopers & Lybrand’s Healthcare Consulting business. </li></ul><ul><li>His direct experience includes hospital and physician organization strategic planning, mergers, and operations improvement. In this regard he has led the reengineering of large academic medical centers, facilitated the merger of multiple hospital systems, managed the operation of large physician groups, designed the managed care infrastructure for specialty providers, led turnaround programs for multiple physician organizations, and led clinical and operational integration through the implementation of Practice Management and Electronic Medical Record Systems. </li></ul><ul><li>Mr. Duffy has an MBA Degree from the University of North Florida, a BS Degree in Business Administration/Management from Georgetown University, a Certificate of Public Accounting, and a Certificate of Management Accounting. </li></ul>Our People <ul><li>Rachaell Miner: </li></ul><ul><li>Ms. Miner has over 12 years of experience in health care billing and reimbursement. As a billing supervisor she was responsible for recruitment, hiring, training and evaluation of personnel. Her department oversight included the resolution of billing and reimbursement issues for insurance, and both state and federally funded programs; tracking and analysis of payer denials; development and implementation of training modules for clinic staff on payer reimbursement, covered services, patient eligibility and ICD-9 coding; expertise in payer regulations and reimbursement policy. </li></ul><ul><li>Prior to joining the JHD Group, Ms. Miner worked as a team leader on the planning and implementation of NextGen EPM for a large non-profit health care organization; participating in file build; designing training materials and implementing a training plan. </li></ul><ul><li>Ms. Miner has a BA in Business Administration from San Jose State University. </li></ul>Clifford F. Gallagher: Mr. Gallagher has over 9 years of experience in data acquisition and analysis, organizational planning, physician operations improvement, revenue cycle management, and healthcare information technology specializing in practice management and electronic medical records systems. In this role he has worked with large scale physician groups, IPA’s, and healthcare organizations to redesign their central operations and billing models, implementation of large scale enterprise based practice management and electronic health records systems, develop merger analysis methodologies for new client growth and acquisitions, and assessing physician performance to streamline clinical operations and enhance their revenue cycle. Prior to joining the JHD Group, Mr. Gallagher worked as an Senior Solutions Architect for Physician Services Department at Perot Systems and as an Operations Manager at CBIZ Medical Management Professionals, a large physician management firm. Mr. Gallagher’s educational background includes a BS in Biochemistry and Molecular Biology from Trinity University, and a Masters of Science in Health Care Administration from Trinity University.
  37. 37. <ul><li>Each JHD Group professional has extensive healthcare experience mainly working with physician organizations. </li></ul>Our People <ul><li>David M. Willamson: </li></ul><ul><li>Mr. Williamson has over 17 years of experience most recently focused on practice management and electronic medical record implementation planning and management. He is specifically experienced in the NextGen products including set-up, training, go-live management, template development, HL-7 interfaces, and project management in both hospital and group environments. </li></ul><ul><li>Prior to his practice management/EMR experience, Mr. Williamson served in a technical training and development role for a large insurance company where he developed and delivered curriculum, created and maintained programs for e-commerce training, troubleshot software and usability problems, developed company-wide computer based training, and taught project management. Additionally he served in a number of customer support related roles, managed support functions, </li></ul><ul><li>Mr. Williamson attended the Graceland University and Columbia College majoring in Information Systems. </li></ul><ul><li>Drew D. Nietert: </li></ul><ul><li>Mr. Nietert has over 20 years of experience in Information Technology including maintenance and operation of desktops, laptops, remote sites, and servers; implementation of IT strategy & budgets; security maintenance and implementation; application upgrades, phone systems, and network development/management. He is Microsoft certified and is experienced in Microsoft Windows server products. </li></ul><ul><li>Mr. Nietert has participated in the implementation of NextGen’s Enterprise Practice Management and Electronic Health Records systems in multiple large IPAs, primarily focusing in the enterprise set-up and training. He has worked with vendors to add functionality to the EPM/EHR system through tablets, PDA’s, Voice recognition and medical equipment interfaces. He also has experience in creating and managing IT shops from the ground up including hiring of staff, help desk setup, process implementation and revisal, policies and procedures and integrating these shops with others to form cohesive teams. </li></ul><ul><li>Mr. Nietert has participated and lead more than a dozen large scale selection projects that involved board members, CEO’s, CIO’s, CFO’s and other leaders. He has lead groups in the creation of complete policy and procedures for large physician groups as well as served on HIMSS committees. </li></ul><ul><li>Mr. Nietert has a Bachelor’s Degree from Dallas Christian College. </li></ul>Karen L. Wagner, RN, BSN, CCM: Ms. Wagner has over 25 years of experience in healthcare management, with an emphasis on physician operations improvement, EMRs, and Medical Management. She has worked with healthcare providers, insurers, facilities and other MSOs to improve clinical and operational processes with specific experience in practice management; physician/ hospital relationships; developing clinical quality programs; implementing medical management and utilization management guidelines; implementation and use of EMRs; strategizing clinical policies and procedures; developing clinical data analysis and outcomes based performance improvement programs; and developing disease management and case management programs. During her tenure at JHD Group, she has also been a critical contributor to the CQI and Practice Management process and held executive level positions inclusive of Deputy Executive Director and Chief Clinical Information Officer. Prior to joining the JHD Group, Ms. Wagner was a Director of Clinical Services at Continuum Health’s MSO. She has held a product consulting role with a medical software company, as well as roles within insurance carriers on the national level. Ms. Wagner has a Bachelor of Science in Nursing from Bloomfield College and is an RN and Certified Case Manager.
  38. 38. <ul><li>Each JHD Group professional (Cont’d)… </li></ul>Our People <ul><li>Juan Johnson: </li></ul><ul><li>Ms. Johnson has over 8 years experience in the healthcare industry focusing on Systems Administration, Software Implementation and Training, Technical Writing, and Electronic Medical Records Template Development. She has worked with healthcare providers including hospitals, physician groups, and Information Technology sectors, participating in the development of several complex interfaces. </li></ul><ul><li>Her expertise includes physician practice management and ancillary service development within large MSO’s and Physician Networks. </li></ul><ul><li>Prior to joining the JHD Group, Ms. Johnson was the Systems Administrator for the Musculoskeletal Institute of La. consisting of five divisions including a Surgery Hospital; the Project Lead at Willis Knighton Health Systems , implementing medical software and software solutions over a variety of specialties. </li></ul><ul><li>Ms. Johnson obtained her education at Grambling State University majoring in Computer Science with a concentration in Software Engineering. </li></ul>Lee Libby: Ms. Libby has over 15 years of experience in operations, organization transformation, strategic marketing and allied health care.  Her experience includes design and execution of change management programs, technical communication initiatives, knowledge management systems, curriculum design, training and publication content generation. She has a history of success in structuring and executing organization change initiatives as well as delivering complex, critical communications and marketing programs for Fortune 500 corporations and smaller, privately owned entities. Prior to joining the JHD Group, Ms. Libby was a Senior Communications Consultant for EDS and an Associate Consultant in the Organization Transformation practice of A. T. Kearney, a global operations strategy consulting firm and has worked as a Radiology Technologist for a major regional healthcare system.   Ms. Libby has a Masters in Business and Technical Communications from Iowa State University, a Bachelor’s degree in English with a minor in Chemistry and an A.S. in Radiologic Technology from The University of New Mexico. Erin Kunysz: Mrs. Kunysz has 5.5 years of experience in healthcare information technology with a primary focus on implementation of electronic health record systems.  She has worked with a variety of clients including large multi-specialty outpatient clinics and hospital organizations spanning 25+ hospital sites.  She has extensive expertise in designing, building, training, and supporting clinical implementations to ensure seamless integration within the entire healthcare system.    Her most recent engagement at JHD Group was the clinical integration of a large multispecialty clinic where she was involved in vendor selection process, practice management implementation and electronic medical record implementation. Prior to joining JHD Group, Mrs. Kunysz was a Solution Delivery Consultant at a large healthcare software company specializing in the hospital laboratory module.   She also worked at a large healthcare system as an Application Analyst implementing and supporting electronic medical record solution for an 800 + physician group with multiple enterprises and practices. Mrs. Kunysz has a Bachelor’s of Science in Management from Purdue University with minors in Management Information Systems and Finance.
  39. 39. <ul><li>Each JHD Group professional (Cont’d)… </li></ul><ul><li>Allen C. Abramson, SPHR: </li></ul><ul><li>Mr. Abramson has more than 30 years of experience in human resources, with 25 years in the healthcare industry. He has been the Chief Human Resources Officer for two major academic medical centers and has served as interim head of human resources for several other large hospitals and health systems. Mr. Abramson also has extensive human resources consulting experience, including, heading the Human Resources Practice for CSC Healthcare, formerly American Practice Management, Inc. (APM, Inc.) for three years. He has been a member of the faculties of: The School of Public Health of Columbia University, Lehman College of the City University of New York, Austin Peay University, and Hannemann University Graduate School. </li></ul><ul><li>Mr. Abramson has an MA Degree in Personnel from Columbia University and a BA Degree in History from Indiana University. He has a lifetime accreditation as a Specialist in Human Resources from the Society for Human Resources Management. </li></ul>Our People <ul><li>Kelvin Drawdy, </li></ul><ul><li>Mr. Drawdy, is a Financial Operations Consultant.  He has more than 25 years of experience in hospital and health system business office functions and physician practice management.  </li></ul><ul><li>Kelvin’s expertise includes development and implementation of front-end and back office revenue cycle services, resulting in improved collections, cash flow, and compliance with government and commercial payer requirements.  </li></ul><ul><li>Prior to his work with The JHD Group, Kelvin served, among other positions, as Revenue Cycle Services Director for Perot Systems’ Physician Services Division and Vice President of Business Office Operations for Healthcare Financial Advisors.  </li></ul><ul><li>On an interim basis, he has led the turnaround of the revenue cycle for major physician groups – including one with more than 35 physician providers and two with 200+ physician providers.  He has extensive working knowledge of major practice management and EHR systems.  </li></ul><ul><li>He is a frequent contributor to articles pertaining to relevant issues which impact physician practices today and has a BS in Accounting from Georgia College. </li></ul><ul><li>  </li></ul><ul><li>Danna K. Campbell, BSN, MBA, CPA: </li></ul><ul><li>Ms. Campbell has over 25 years of experience in healthcare consulting and management.  She has worked with large teaching hospitals, for profit and not-for-profit hospitals with beds ranging from 200 – 1600 and large physician practices.  </li></ul><ul><li>Her experience includes performance improvement management (staffing analysis, productivity, protocol management, clinical delivery models), revenue cycle management (Interim management, implementation of billing/collections software, charge entry analysis, aging and denial management, development and analysis of RFP’s  for software selection), mergers and acquisitions, hospital/physician affiliations and co-management  and strategic planning for large physician practices and hospital acquisitions. She has also served in interim management roles, including CEO, CFO and COO for both hospital-based and privately owned physician practices. </li></ul><ul><li>   Ms. Campbell was Chief Executive Officer at a multi-specialty physician consulting firm; Partner in a large national healthcare consulting firm and various staff nursing and nursing management roles in a large teaching hospital. </li></ul><ul><li>  Ms. Campbell has a Masters in Business Administration from University of Houston, Bachelor’s of Science in Nursing from The University of Texas and is also a Certified Public Accountant in the state of Texas. </li></ul><ul><li>  </li></ul>
  40. 40. <ul><li>Each JHD Group professional (Cont’d)… </li></ul>Our People <ul><li>David Boucher: </li></ul><ul><li>Mr. Boucher has 35 years of healthcare and physician practice management experience. He also has 12 years of management consulting expertise. Mr. Boucher specializes in the areas of practice management consultations, strategic and revenue positioning for healthcare organizations, feasibility studies for new programs, and managed care contracting. </li></ul><ul><li>In 1999, he formed Boucher & Associates, a management consulting firm based in New York that specializes in providing consulting services to medical group practices and hospital employed physician groups. He was also the Executive Director for two large medical group practices, the Bassett Medical Group, a 175 physician group, and the Guthrie Clinic, a 225 physician multi-specialty group practice. </li></ul><ul><li>Mr. Boucher has a M.S. Industrial Administration degree, and B.S. Industrial Engineering degree from Purdue University. </li></ul><ul><li>Jacob Asher, MD: </li></ul><ul><li>Dr. Asher brings significant physician managerial expertise to our team. He has had leadership and management responsibilities at both the strategic and operational levels of a large group practice. At the operational level, Dr. Asher promoted innovation, coordinated patient-centered care in a multi-specialty setting, and designed more efficient workflows for delivery of common services. </li></ul><ul><li>Prior to joining JHD, he served on The Permanente Medical Group Board of Directors where he was a member of the compensation committee and the retirement benefits subcommittee. He was Chief of Otolaryngology for a period of 3 years, and served as Vice-Chair of the Northern California Permanente Chiefs of Otolaryngology. </li></ul><ul><li>Dr. Asher is a Board Certified Otolaryngologist. He graduated from Brown University and Boston University School of Medicine. He completed residencies at Boston University and the University of California, San Francisco. </li></ul><ul><li>Scott Bourne: </li></ul><ul><li>Mr. Bourne has focused his practice exclusively on the challenges facing academic medicine. He has been a principal at APM Management Consultants, Senior Director for AHC strategy at the University Hospital Consortium, a senior consultant at A.T. Kearney and company, and has consulted individually to deans, hospital CEO’s and prominent academic consortia and institutions. </li></ul><ul><li>In addition to leading complex and high-level strategy and operations improvement engagements, Mr. Bourne has extensive experience facilitating faculty led initiatives targeting many of the day-to-day operational and resource issues unique to academic medicine; achieving educational excellence and competitive outcomes in the preclinical years; balancing clinical training program growth with rigorous quality and compliance management; coordinating talent and institutional assets to build research prowess and scale within a meticulous compliance framework; and addressing faculty retention and advancement issues systematically. </li></ul><ul><li>Mr. Bourne has presented research findings and engagement reviews to several prominent academic and clinical organizations including the AHC, the AAMC, UHC, and several others. </li></ul>
  41. 41. <ul><li>Each JHD Group professional (Cont’d)… </li></ul>Our People <ul><li>Zachary B. Gerbarg, MD: </li></ul><ul><li>Zack Gerbarg, MD is a principal and co-founder of Eagle Medical Management, LLC, a healthcare management consulting firm. Dr. Gerbarg has over twenty years of experience in medical leadership including senior level positions responsible for strategic planning, operations, staff development, practice management and medical policy. For over four years, he served as the COO for a 240 physician multi-specialty group practice while having responsibility for over 1,600 employees and 180,000 globally capitated lives. He has managed budgets in excess of $150 million and has served on the Board of Directors for two healthcare organizations. </li></ul><ul><li>Throughout his career, Dr. Gerbarg has been involved in hiring, selecting, supervising, assessing and coaching physician leaders at all levels. He has also had direct responsibility for utilization management, quality improvement, physician recruiting, urgent care and outpatient surgery. </li></ul><ul><li>Dr. Gerbarg is a graduate of Cornell University and Albany Medical College. He is Board Certified in Internal Medicine. </li></ul><ul><li>Jess L. Boyer, MD: </li></ul><ul><li>Dr. Boyer is a principal and co-founder of Eagle Medical Management, LLC, a healthcare management consulting firm. Dr. Boyar has over twenty years of medical management experience including eight years in which he has held either CEO or Chief Medical Officer positions in both the for-profit and not-for-profit sectors. He has operated group practices, IPA’s and mixed models. He has managed groups as large as 240 physicians with budgets of $300 million and IPA’s as large as 250,000 members. </li></ul><ul><li>Over the course of his medical management career, his responsibilities have included utilization management, quality management, medical office operations management, finance including claims and billing, strategic planning, mergers and acquisitions and sales and marketing. </li></ul><ul><li>Dr. Boyar received his education and training at University of California, San Diego and is Board Certified in Pediatrics and Pediatric Nephrology. </li></ul><ul><li>Becky J. Harrison, CHCO, MCS-P: </li></ul><ul><li>Ms. Harrison has more than 20 years of experience in physician practice management, rural healthcare operations, and central business office management. Her experience includes working with hospitals, physician practices, MSOs, and ambulatory care facilities. More specifically, she has assisted with operational and regulatory assessments, financial analysis, medical facility design, practitioner recruitment, managed care contract negotiations, and federal grant submission for ambulatory care facilities. She routinely assisted with the improvement of physician medical records management, and coding and compliance issues. </li></ul><ul><li>Ms. Harrison is a Certified Healthcare Compliance Officer and a Medical Compliance Specialist. She served as an expert witness for the Texas Senate Sub-Committee on Rural Health Affairs, and has been a speaker for the Texas Department of Health regarding Rural Health Clinic regulations, certification and operational issues. </li></ul>
  42. 42. <ul><li>Each JHD Group professional (Cont’d)… </li></ul>Our People <ul><li>Sandra Hudak, MS, RN: </li></ul><ul><li>Ms. Hudak has over 25 years of healthcare experience in clinical care, information system design, and clinical system implementation projects. For over ten years her focus has been in clinical informatics including EMR System implementation and integrating systems into operational improvements for acute care, physician practices, and long term care providers. </li></ul><ul><li>Her project experience includes evaluating EMR vendors and clinical systems implementations. In this regard, she has been responsible for managing the project plan, clinical content definition, template development, and workflow redesign. </li></ul><ul><li>Ms. Hudak’s previous experiences include Director of Product Development for an Internet-based health care technology business focused on physician practice clinical system and Manager Information Planning at Helix Health System where she developed and managed clinical system implementations and system selection projects. </li></ul><ul><li>Ms Hudak received her BSN and MS in Nursing Informatics from the University of Maryland School of Nursing. </li></ul><ul><li>Kevin N. Hnatusko: </li></ul><ul><li>Mr. Hnatusko has 20 years of experience in healthcare with expertise in physician practice management, managed care operations and financial management. He has managed large academic practices including back office, clinical delivery networks and front-end operations, and is experienced in the areas of practice acquisition, hospitalist programs, and financial management. </li></ul><ul><li>Mr. Hnatusko served as President and CEO for the startup and operation of a physician practice management company where he lead the financial turnaround of an employed physician group, re-contracted with providers to align financial incentives with increased productivity, transitioned providers to private practice from employed status, and implemented a system-wide information system providing clinical and administrative linkages between the acute care setting and physician offices using an ASP model. Mr. Hnatusko was also previously employed by North American Medical Management as the Executive Director for a large PHO/IPA in Chicago. </li></ul><ul><li>Mr. Hnatusko holds an MBA from Loyola University and a BA Degree in Business Administration from St. Xavier College. </li></ul><ul><li>Kent Madsen: </li></ul><ul><li>Mr. Madsen has over 20 years of experience in outpatient facility and physician business service organization management and consulting. Functional experience includes purchasing, facilities management, multiple facility building projects, business service line development, human resources, IT management, sales/marketing and web application development. </li></ul><ul><li>Mr. Madsen most recently built and led Triium, a physician business service organization serving 170 independent physician practices that included approximately 4000 physicians with average annual revenue growth of 30%+. He successfully developed business lines that included a group purchasing organization, cooperative insurance products, risk pool management, training/education business services and consulting resource group. </li></ul><ul><li>Mr. Madsen’s education includes a Bachelors of Science Degree in Finance from California State University, Sacramento and an MBA Degree in Operations from the Carlson School of Management at the University of Minnesota, Twin Cities. </li></ul>
  43. 43. <ul><li>Each JHD Group professional (Cont’d)… </li></ul>Our People <ul><li>Nikki R. Parham: </li></ul><ul><li>Ms. Parham has over 20 years in healthcare experience with an emphasis in physician management, billing and collection, and revenue cycle management. She has assessed and improved the revenue cycle operations for multiple hospitals and physician organizations with the work involving improvements in patient access, medical coding, and business office/patient accounting functions, denial management, and state and Federal regulatory Compliance. She has developed centralized and decentralized business office models for major healthcare providers, implemented up-front cash collection procedures and backlog elimination plans for billing, collections, denial management, correspondence, and remittance posting. In addition she has provided interim manager and director services for physician practices and hospital systems including all practice administration responsibilities. </li></ul><ul><li>Prior to joining the JHD Group, Ms. Parham served with PricewaterhouseCoopers and Arthur Anderson as a Senior Manager. </li></ul><ul><li>Ms. Parham has a Bachelor of Business Administration from Texas Tech University. </li></ul><ul><li>Jeff Pannell: </li></ul><ul><li>Mr. Pannell has over 25 years of executive management experience working within the healthcare profession. His expertise, prior to joining JHD Group, includes working in consulting services specializing in emergency department group performance. He held the position of Regional COO of Emcare, and was EVP of DFW Hospital Council where he was instrumental in growing both businesses, and increasing company revenues. He developed physician compensation models and production reports which became the benchmark for emergency physicians. </li></ul><ul><li>Mr. Pannell is a certified mediator and holds a Doctor of Pharmacy degree from UT Health Science Center and a Bachelor of Science Pharmacy degree from the University of Texas. He also graduated with High Honors. </li></ul><ul><li>Andrew Romanyk: </li></ul><ul><li>Mr. Romanyk has over 15 years of experience working in healthcare, as well as 11 years of management consulting expertise. Mr. Romanyk specializes in the areas of strategic and financial planning, operations improvement / reengineering, and managing. In 1995, he formed Romanyk Consulting Corporation, based in Flower Mound, Texas, which provides both healthcare and non-healthcare clientele with operational cost efficiency measures, reengineering and process improvement, organizational structure assessments, performance metrics, and benchmarking. He also worked as a Senior Consultant in healthcare with Deloitte & Touche, and was a Director at two Texas based medical centers. </li></ul><ul><li>Mr. Romanyk has an Industrial Engineering Masters Degree from the University of Texas, and a Mechanical Engineering Bachelors Degree from the University of Texas at Austin. In addition to these credentials, he is also a Certified Healthcare Executive from the American College of Health Care Executives. </li></ul>
  44. 44. <ul><li>Each JHD Group professional (Cont’d)… </li></ul>Our People <ul><li>David Shute: </li></ul><ul><li>Mr. Shute specializes in helping organizations address their most difficult challenges, especially in the realms of mission, vision, strategy, and strategic plans. As an executive and as a consultant, he has focused on physicians, academic health centers, and systems. In addition, he has served both a number of not-for-profit, mission-driven enterprises, and building on his term as the CEO of a venture-backed physician software company, a dozen early stage companies. </li></ul><ul><li>Mr. Shute has held executive positions at Cleveland Clinic, where he served as Director of Special Projects, and at NextMED Systems, where he served as President and CEO. </li></ul><ul><li>He was a consultant with McKinsey & Company, where he co-led the firm’s Midwestern healthcare strategy. He also co-led the Midwestern strategy practice of CSC’s Healthcare Group (formerly APM Management Consultants), and has run his own independent consultancy with clients ranging from Medtronic to Cedars-Sinai Health System to a number of technology-focused early stage companies. </li></ul><ul><li>He holds an MA and MBA from the University of Virginia, and a BA from the University of Chicago. </li></ul><ul><li>Meyer Samet, CPA: </li></ul><ul><li>Mr. Samet has 15 years of executive and controller management experience working in healthcare and medical consulting, with an emphasis on start-up, growth, turnaround, and crisis environments. He is Founder and President of Samet Consulting in Macon, Georgia where he conducted due diligence for Promedco Management Company, forensic accounting for Phycor a multi-specialty medical group, and worked with several other multi-specialty practices and hospitals on improving their financial performance. He has also served as Controller for Information Systems of America, and Assistant Controller for the Coca-Cola Company. </li></ul><ul><li>Mr. Samet holds a Bachelor of Science, Business Administration degree from East Carolina University and majored in Accounting. </li></ul>
  45. 45. JHD Group © 2010 All rights reserved. Reproduction by any means – including photocopy, fax or electronic delivery – is a violation of federal copyright law. San Francisco 533 Airport Boulevard Suite 400 Burlingame, CA 94010 Dallas Corporate Headquarters 5055 Keller Springs Road Suite 240 Addison, TX 75001 Office: 972.220.0474 Fax: 972.220.0487 New York 1212 6 th Avenue Suite 803 New York, NY 10036

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