BusinessPlan_FinaFinallEdit

TRAJECTORY INFUSION
CENTER
Business Plan
Gerardo Flores, Conrad Virgo, Trinity Marquez, Amanda Romano,
Anh Ngoc Nguyen, Carly Knight

Trajectory Infusion Center
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Cancer Treatment Center: Infusion Center
Executive Summary
This is the business plan for a for-profit Infusion Center, with a special focus on ambulatory
infusion treatments for Cancer patients. This plan will include information on the profile of our
company, an industry and service overview, a competitive analysis, a service delivery plan and a
human resources plan, and various financial statements (Berkowitz, 2011). Our goal is to make
infusion therapy accessible and affordable to all of our patients. We have a highly trained staff of
nurses, physicians, and pharmacists ready to provide the best quality care for the wellbeing of
our patients. The Trajectory Infusion Center provides current methods of infusion therapy on an
outpatient level, and offers state-of-the-art equipment that may decrease or eliminate hospital
stays for our patients.
2. Marketing Highlights
The Trajectory Infusion Center provides a myriad of services, including infusion therapy, which
will eliminate the need for patients to visit hospitals and allow for a better outpatient experience.
Treatment at an infusion center is more cost effective than receiving the same treatment in a
hospital setting. We also save costs as a for-profit organization, as we are not required to provide
educational services to the community. Our infusion center is constantly seeking out newer and
more effective methods to prevent, treat, and diagnose multiple forms of cancer, as well as
supporting basic and clinical research of blood cell development and stem cells, amongst other
things.
3. Target Market Summary
Our target market is cancer patients who require chemotherapy treatment. We are located at
Signal Hill, California, which is the most central location to people who are patients at Long
Beach Memorial, Community Hospital, and Los Alamitos Medical. Having an ambulatory
service gives us an advantage over other organizations that are not willing to travel to their
patients to provide care. Cancer patients who require our treatment benefit greatly from our plan,
as we provide closer locations and lower rates than existing hospitals.
4. Competitive Analysis
There are other hospitals near our location who offer trajectory infusion for their patients that
operate under the same business hours. This can be viewed as competition to our business, as the
hospitals are large and have been thriving for many years, and have multiple investments that

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allow them to upgrade their technology and procedures to better suit their patients. Other
competitors may also offer chemotherapy, diagnostic radiology, radiation therapy, and surgery.
5. Key Marketing Strategies
The Trajectory Infusion Center will be implementing a number of key marketing strategies to
ensure our company’s success. Our internet based strategy includes creating an online website
that showcases the basic information and features of our Infusion Center, such as location,
contact information, and business hours, as well as placing advertisements on the internet. The
Infusion Center will also be developing contracts with a variety of nursing homes, hospitals, and
assisted living facilities (The Finance Resource, n.d.). Our Infusion Center must also be well
involved with the community to make ourselves more appealing to our target market. To do this
we can assist in local blood drives or sponsor a local sports team, or help out at other local
community events. Our marketing strategy must properly target our demographic by being active
online and in the community.
6. Operational Highlights
It is important that we protect our business against potential lawsuits in the form of insurance.
This includes insurance coverage for malpractice, liability, business, and workers compensation.
We are also required to have voluntary regulation so as to be recognized by the state. We must
have accreditation for our rendered services, meaning that we comply with the state and federal
government professional standards of practice, in order to be reimbursed by insurance carriers.
We must also adhere to other standards provided by JCAHO and OSHA.
7. Intermediary Concerns or Issues
Because our Infusion Center will be brand new to the community, our business will be largely
unknown. It is important that we market strongly to the target demographic surrounding our
community as well as appealing to those in the immediate area as well.
8. Management team Overview
Our highly trained staff of nurses, physicians, and pharmacists work collaboratively to evaluate
the needs of our patients and provide the best possible plan customized to our patient’s needs. It
is important that our staff is in fit condition to provide the best possible care to our patients.
Employees are given a competitive benefit package that includes health insurance and a 401K
plan. The employee wellness program helps maintain a healthy workforce for our company.
9. Financial Highlights

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One of our main financial requirements is a startup loan to ensure that our business can sustain
itself for the first few months of practice. We can obtain a loan from CapitalOne healthcare
financing for $3,000,000 with a 4% interest rate for 20 years. As a for-profit organization, we
are subject to property tax and business tax, but Signal Hill has no utility tax. We will also have
expenses for labor costs, overhead, benefits, employee salary, and equipment.
A majority of our income will be from co-payments, insurance payments, and publicly funded
sources, such as Medicare and Medicaid (The Finance Resource, n.d.).
Company Profile
1. Type of Organization
This business is a limited liability company organization. With a specialty focused on
ambulatory infusion treatments for Cancer patients.
2. Name of Organization
3. Hours of Operation
Monday 8:00 a.m.-5:00 p.m.
Tuesday 08:00 a.m.-5:00 p.m.
Wednesday 8:00 a.m.-5:00 p.m.
Thursday 08:00 a.m.-5:00 p.m.
Friday 8:00 a.m.-5:00 p.m.
Saturday 09:00 am- 4:00 p.m.
Sunday closed.
4. Scope of Service Line
Trajectory Infusion Center primary focus is the treatment of cancer patients, along with other
types of infusion therapy to treat patients. The services offered by Trajectory Infusion Center

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include, chemotherapy, blood transfusions, immunoglobulin treatments, autoimmune disease
drug treatment, enzyme replacement therapy, as well as specialty intravenous fluids.
Our infusion center is equipped with registered nurses who have expertise with a wide range of
access sites, in order to provide the best treatment options for patients. The staff at Trajectory
Infusion Center are able to work with patients who have central venous devices such as port-a-
catheters, which is the best method of administering infusion therapy.
5. Clients Served
Trajectory Infusion Center mostly specializes in providing care to cancer patients that require
chemotherapy treatment. This is why most of the nurses at our infusion center are trained in
oncology. We also provide infusion treatments for patients suffering from other illnesses.
6. Location of Clinics
Our infusion center will be located in areas of need. We want to make sure that patients can go
for infusion treatment outside of the traditional environment such as a hospital. That is why we
decided having ambulatory centers would best serve our demographic. The location of our first
center will be in Signal Hill, California. This way patients from hospitals such as Long Beach
Memorial, Community Hospital, and Los Alamitos Medical will have a place to go for treatment.
Signal Hill is a well-developed community. It is centrally located and is easily accessible.
7. Description of Business
Trajectory Infusion Center brings to Signal Hill, California a cost saving alternative to infusion
treatment. Many healthcare providers might view using hospitals as a way of treating patients,
however with our ambulatory treatment facility costs are lowered because our primary focus is
providing infusion therapy. The goal of Trajectory Infusion Center is to meet the needs of our
patients in any way that is medically safe for them. Whether it is simple infusion treatment for a
wide range of illness, or long term infusion treatment. Our trained staff is knowledgeable, and is
dedicated to providing the best treatment outcome.
8. Profit Status (nonprofit or for profit)
Trajectory Infusion Center is a for profit institutions. We take a wide range of payment options
that include insurance as well as cash prices for our patients. Our aim is to make treatment
affordable and accessible.

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Industry Overview
1. Social Changes
We are in the business of helping patients that are going through one of the most difficult things
that one can. Not only are we aware of the need to help patients that come to our facility, we are
also dedicated to making a change overall. One of the things that Trajectory Infusion Center is
dedicated to is providing social change. We see an opportunity to do this in our community. We
realize that the needs to be more awareness placed on the fight against cancer. We are committed
to helping the community to do just that. Our organization will partner with various charities that
help with providing services to patients that are battling with cancers such as breast cancer, and
childhood leukemia. For example we plan to be a part of the Avon walk for breast cancer. The
community around the Signal Hill area is in desperate need of providing health related services
and counseling for those battling the disease. The Avon walk for breast cancer has managed to
raise and astounding 3.6 million dollars for local breast cancer organizations in the Long Beach
area. We at Trajectory Infusion Center are happy to be a part of this social change. Awareness
starts with taking action which is our motto. Our staff and patients join the walk which brings
approximately 1,700 participants over a weekend to raise money for this much needed health
crisis. We are dedicated to finding a cure.
2. Economic/reimbursement Changes
In order to make sure that we are meeting industry standards. Our institution is dedicated to
provide the best cost for patients. This means that we accept all forms of payment that are
provided. This includes payment from Medicare as well as private insurance plans. We work
with insurance plans to make sure that reimbursement is done appropriately. We use DRG
system to ensure that drugs that are given in our facility are coded properly. This not only
ensures the financial viability of our infusion center, but also eliminates charges that patients
might have due to improper billing.
3. Demographic Changes
First and foremost Trajectory Infusion Center is dedicated to being an equal opportunity
employer. Our staff are highly specialized in oncology. Furthermore we pride ourselves on
having a diverse staff. We believe that hard work should pay, this is why we have a competitive
benefits package for all our employees. This includes paid time off, health insurance, and 401K.
The health of our employees is also of importance to our organization. A healthy workforce is a
more productive workforce. At Trajectory we have an employee wellness program, this program
assists employees with various health concerns such as weight management, regular screening
for diabetes and high blood pressure. For employees to take advantage our wellness program,
they are rewarded by a reduction in the cost of health benefits. We use the Healthyroads system

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to help employees. Healthyroads provides population health programs nationally for health plans
and employer groups, serving more than 5 million individuals across the United States
(Healthyroads, 2016).
It also important to highlight the size population of the area Trajectory Infusion Center will be
located. There are 11,585 people living in the Signal Hill Area. Population under 20 years is
26.3%, 21 to 34 years is 22.1%, 35 to 44 years is 16.1%, 45 to 54 years is 14.9%, and 55 years
and over is at 20.3%. Based on these figures Signal Hill, California is an area that is ideal for
growth.
4. Health Care Delivery Changes
Trajectory Infusion Center is a patient centered organization that provides continuous quality
care for a patient over the necessary time needed. By providing in home and ambulatory care we
can offer quality care at a lower cost which allows patients who are in need the option to seek
help outside of a hospital setting. The patient centered organization helps us to assure that
patients get the indicated care when and where they need and want it in a culturally and
linguistically appropriate manner.
5. Regulatory/Political Changes
Trajectory Infusion Center is a third-party center. Therefore we are required to have voluntary
regulation in order for our services to be recognized by the state. Most insurance carriers will not
reimburse us for services rendered unless we have accreditation.
This accreditation means that we are compliant with the state and federal government in areas
such as professional standard of practice and the clinical manner in which we provide infusion
therapy.
We are accredited by the Healthcare Quality Association on Accreditation (HQAA). This means
that we have accreditation in areas such as IV compounding, Medical Practice, and third-party
billing.
6. Key Success Factors in your segment of the Industry
For our infusion center to have success in our market we need to make sure that we are running
our operation differently than our competitors. In order to do this patient satisfaction has to be
our top priority. We also need to make sure that we adhere to the standards of regulatory bodies
such as JCAHO and OSHA.
Some of the key strategies for success are:

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● Authorizations for all patients- This will reduce the hassle patients may encounter to
receive treatment.
● Access to labs services, infusion services and rapid times for lab results.
● There are no barriers to service- we specialize in providing infusion therapy, this is the
primary focus of our organization.
● We always have a physician on call in case any issues arise with patients.
● Trajectory Infusion Center Communicates with referring physician about and problems or
issues administering care to patients.
7. Barriers to entry in your segment of the industry
There are many barriers that can be found in any healthcare organization that is trying to conduct
business. Some of these barriers that we predict that Trajectory Infusion center will face are the
sources of referral for our infusion center. We are entering a market that is dominated by patients
being seen in the hospital setting for infusion treatment. In order to overcome this we have to
market our infusion services to doctors that treat patients for various cancers as well as patients
that need other forms of infusion.
Another barrier that will hinder our entry to this industry, is the recruitment and retention of our
clinical staff. It is important that the staff we attract are not only highly specialized in infusion
therapy, but they also need to be compensated by industry standards.
Brand recognition is another area that needs to be considered as a barrier. We have to make sure
that Trajectory Infusion Center has a brand that is easily recognized by patients and healthcare
providers.
8. Barriers to exit in your segment of the industry
The exit barrier for our segment of the industry are low. This means that there are not a lot of
infusion centers that are exiting our industry. This is good for the healthcare industry. There will
not be much turnover, hence the longevity of Trajectory Infusion Center is good. This is due to
the rising amount of patients that require infusion therapy.
Service Overview
1. What is the proposed new service proposal’s unique features/benefits?
It offers the latest technology and new antibiotic therapies. The latest technological
improvements have led to improved vascular access devices, equipment, and infusion to ensure a
safer and more reliable experience. Trajectory infusion center allows for accessibility for all
patients with little to no hassle to receive treatment. Patients will be able to have easy access to
labs services, infusion services and rapid times for lab results. There are no barriers to service.

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2. What values does it provide to key target markets?
For outpatient candidates, the Infusion Center is the most convenient alternative to an inpatient
stay. It recognizes and caters to the schedules of its patients. The center offers flexible
appointments and is able to administer treatments promptly and efficiently to lessen the time
patients will need to be absent from their daily obligations such as school or work
3. What are the benefits of this new service proposal?
Infusion therapy eliminates the necessity of a hospital visit and allows for a better outpatient
experience. This method of cancer treatment is cost efficient, high quality, and promotes patient
morale. Because the patient agrees to the plan of care, there would be no increased risk for
therapy to be administered as an outpatient.
4. How is this new service positioned against existing services by others?
As far as outpatient services are concerned, infusion center therapy is much more cost effective
than the same treatment administered in a hospital setting. Trajectory provides ambulatory
services in a comfortable environment which enhances the patient experience comparatively to
other forms of cancer treatments for a more feasible price
5. What are you doing differently?
Highly trained and knowledgeable staff comprised of nurses, physicians, and pharmacists
provide the best individualized customer service. They collaboratively work together to evaluate
needs of the patient and produce a customized plan of comprehensive care. This reflects our
mission of placing the highest priority on the patient experience and level of comfort as the
epicenter of the healing process.
Competitive Analysis
1. Describe your competition’s services
Bioscrip infusion services include: ACHC accreditation for all BioScrip services, Specially
trained Infusion Pharmacists, National Nursing Coverage with experienced nurses who
specialize in IV infusions, Clinical Dietitian support for parenteral and enteral nutrition, Clinical
Respiratory Care Services, Home Medical Equipment delivered and set up, USP 797 compliant
sterile product compounding facilities, Infusion medications, supplies and pumps to meet all
clinical requirements, Written policy and protocols for the safe administration of infused drugs,
Free-Standing Ambulatory Infusion Centers, Externally qualified Centers of Excellence in the
core infusion therapies, Expertise in clinical trial management and execution
2. What is their point of differentiation

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They offer a large quantity of services that are not encompassed in other infusion centers and
their professional support program includes 24/7/365 access to Clinical Pharmacists, Dietitians,
and Infusion Nurses.
3. What real value do they deliver to the customer that others do not
Bioscrip provides a wide array of products, services and condition-specific clinical management
programs tailored to improve the care of individuals with complex health conditions. At the
user’s discretion, they can choose where their care takes place: in their home, physician office,
ambulatory infusion center, skilled nursing facility or other alternate sites of care.
4. Describe their customer profile
Their customer profile is primarily geared toward the wealthy older population of cancer
patients. This can be inferred by the fact that they provide highly innovative technology with the
comfort of an outpatient experience that would not be accessible to all budgets. In addition, there
is no mention of pediatric services which leads us to determine their marketing is not geared
toward children, but adults instead.
5. Detail the pricing strategy
It is not possible to determine exactly how Bioscrip sets their prices because that information is
not accessible online. They accept insurance including Medicare and Medicaid which
demonstrates the concept that contracts are made based on the reimbursements they receive.
They offer worry-free financial services by providing patients with a dedicated BioScrip
manager to handle insurance coverage and reimbursement, and design customized Pro Forma
financial modeling or payment terms.
6. What is their marketing/advertising approach
BioScrip’s mission statement “Our mission is to enhance the lives of those we care for each day”
demonstrates their intention of portraying to potential users that their company operates with a
commitment to bring cost-effective care that is customer focused and individually specialized.
Furthermore, they emphasize the fact they are dynamic in providing care in a variety of locations
including homecare or an alternate-site setting. In addition, BioScrip utilizes the fact that they
provide infusion and home care services from over 70 locations across 28 states as a marketing
strategy.
7. Why do customers/referral sources buy or use them
They provide 24-hour Emergency Service, take all types of insurance including Medicare and
medical, and provide a large quantity of services, all with the benefits of an outpatient
experience.

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8. What are the opportunities or threats to your organization
Due to the fact Bioscrip has been a thriving company for years, they are well established and
have the capabilities to expand their services and provide a larger variety of services at a cost
efficient price. They also provide a 24-hour emergency services which is marketable to potential
patients.
Place
1. Where will the service be delivered?
Our home infusion center is located in Signal Hill, California however since the goal of our
infusion center is to cater to the patients who wish to receive treatment outside of the traditional
hospital setting our services will be delivered in the immediate areas we are surrounded by. By
providing ambulatory services we can easily attain access to patients who are not wanting or
willing to receive treatment in a hospital setting.
2. What are the costs associated with this manner of distribution?
The Trajectory Infusion Center we are associated with offers cost friendly services that are
provided by experienced and educated staff. Patients that are not covered by health insurance are
typically paying $5,000-$10,000. This cost includes a drug administration fee, drug cost and
facility fee. The total cost depends on the type of cancer, the individual case, drug regimen used,
and the method used to administer the drug. For patients who are covered by health insurance
chemotherapy is covered by most insurance plans therefor they are usually paying an out-of-
pocket fee that consists of doctor visit, lab and prescription drug copays or coinsurance.
3. What is the marketing importance/advantage of this location?
Having our organization based out of Signal Hill we are able to reach out to a mix of strong,
diverse neighborhoods that are contained within the city. Long Beach has maintained a strong
sense of community, which is where our passion to provide services to patients who are
struggling comes into play (lbadvantage.org). Being surrounded by such a diverse community
allows us to partner with multiple charities so we are able to create a name for our organization
and give back to other organizations who are looking to provide quality care to the community.
Having a marketing team that contributes to the success of charities and various organizations
around us allows us to receive the support we need to keep our organization going.
Some of these outside organizations include:
 Avon walk for breast cancer
 Assistance League of Long Beach
 Long Beach Ronald McDonald House
 The Nonprofit Partnership, etc.

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With Signal Hill and the surrounding communities being so diverse when marketing for our
organization we must ensure that the ads are representing the various ethnicities and age groups
adequately.
4. Does the location provide any competitive advantages?
Being located in Signal Hill provides easy access to all patients who are located within our
community or who are or have received treatment from any of the local hospitals such as Long
Beach Memorial, Community Hospital, and Los Alamitos Medical Center. Having an
ambulatory service gives us an advantage over other organizations that are not willing to travel
to their patients to provide care.
5. Are there exit issues with this distribution strategy?
The scope of Trajectory Infusion Center is to provide cost efficient, quality care to a significant
portion of the population. By offering in home and ambulatory services we are easily accessible
to patients who wish to receive treatment outside of a hospital setting no matter what portion of
the population they fit into.
Pricing
1. Labor costs of FTEs
According the the HR plan the labor salary cost is $950,000 dollars a year which means it costs
$2,603 to have our infusion center run per day. These labor cost includes our full-time
employees benefits and expenses. Employee’s benefits include a 401k plan, and insurance for
health, life, vision, and dental.
Labor costs of FTEs
Employees Salary Per Year Total Salary
Nuclear Medicine Technician 2 $85,000 $170,000
Physician 1 $150,000 $150,000
Pharmacist 1 $100,000 $100,000
Medical Assistant 2 $35,000 $70,000
Infusion Nurses 2 $80,000 $160,000
Health care Administrators 1 $65,000 $65,000
Counselors 1 $65,000 $65,000

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Managers 2 $60,000 $120,000
Janitor 2 $25,000 $50,000
Medical Biller 1 $15/hour
Total 15 - $950,000
At our organization our infusion nurses typically work 40 hours per week leading to an average
salary of $80,000 per year. Using the LeanTaaS ROI Calculator in order to improve our
operations if we have 30 infusion chairs, $300 reimbursement per treatment, 70 treatments per
weekday, 8 nurses, on average 20% overtime, $80,000 salary per year per nurse, and a 10%
growth in projected patient volumes per year implementing improvements will create a 20%
higher patient volumes, $546,000 increase in revenue, $128,000 reduced labor costs leading to a
total savings of $674,000 (businesswire.com).
2. Overhead
According to Health Affairs, administrative overhead is expected to reach a quarter of a trillion
dollars by 2022 (Himmelstein & Woolhandler, 2015). Since our facility is new and our services
will be costly for most patients to pay out-of-pocket, we will see most of our overhead costs go
toward administration and insurance billing. This will take a large amount of financing especially
if our facility is getting patients from different health insurance plans. To keep overhead low we
will staff half of our nurses on a per-diem model. According to Bryan Soronson, this keeps costs
low since we only use nurses when we need them (Versel, 2005).
3. Margin
There are two main margin ratios we need to focus on when we consider our businesses
profitability. These two ratios are the total margin and the operating margin ratio. These will help
us see if our organization is making sufficient money to stay in business. Since we are a for-
profit organization, we need to make a profit to please our shareholders and stakeholders. Across
the healthcare industry margins tend to be low. They can run anywhere from 0% to just 15%.
According to Modern Healthcare, “the average operating margin in 2013 was 3.1%, down from
3.6% in 2012” (Kutscher, 2014). To make our facility profitable in the long run we need to run a
total margin of 5% and an operating margin above average at 4%. This will ensure that we meet
our financial obligations and succeed at giving our patients the best care.
4. Low, medium, high (relative to competing service providers)
Part of our mission is to provide cost saving treatments so we are considered to be a low cost
organization. The cost of running an organization such as Trajectory Infusion Center, has many

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factors to consider. We have to look at how much it will cost for insurance for our clinical
personal. Our infusion center will consist of primarily oncology nurses. The average cost for
malpractice insurance for nurses in California is approximately $90 per year. This covers liability
from $1million to $6million per year. This cost is assumed by our infusion center because, we
want to make sure that our nurses and patients are protected from injury caused at our infusion
center.
The cost of malpractice insurance for nurses in California is roughly the same for other states
such as Arizona and Texas.
Service Delivery Plan
1. Service delivery methodology
Trajectory Infusion Center offers clinical trials, patient care, and research. We offer a full range
of specialty that diagnose and treat most forms of cancer: chemotherapy, blood transfusions,
immunoglobulin, antibiotic therapy, and other intravenous fluids.
2. Clinical protocols and description of best practices
The infusion center works with patients and physicians, by educating them on the best course of
action for treatment. Patients get to have treatment in a comfortable environment. We find that
due to the extensive time it takes for treatment, it is best for our patients to have access to
amenities such as television and internet access. This makes the length of infusion treatments
more bearable, and provides less hindrances to our patient’s lives.
3. Cost analysis (direct and indirect overhead)
Direct Cost:
 Medical materials and supplies
 Employee salaries and wages
 Advertising
Indirect Cost:
 Building and equipment depreciation
 Utilities (gas, rent, electric, water)
 Malpractice insurance

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5. FTE requirements
According to the Internal Revenue Service (IRS), a full-time employee is determined by 40
hours of service per week, or 130 hours of service a month.

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6. Space requirements
Trajectory Infusion Center will be 4500ft². We have diagnostic and treatment function which
requires a laboratory; other functions dealing hospitality care includes food service and
housekeeping. A simple method of computing space requirement for hospitals is on the basis of
beds the hospital will have. According to Kunders, the normal space that is occupied by the bed
itself and access is about 100 ft² while laboratory test space requires at least 900 to 1200 ft².
Human Resources Plan
Organizational structure/staffing plan
1. Clinical (full-time vs. part-time)
 Nuclear medicine technician (2 Full-time)
 Physician (1 Full-time)
 Pharmacist (1 Full-time)
 Medical Assistant (2 Full-time and 1 part-time)
 Nurses (RN, LVN, LPN) (2 Full-time)
 Physician’s assistant (1 Full-time)
2. Non-clinical (full-time vs. part-time)
 Healthcare Administrators (1 Full-time)
 Counselors (1 Full-time)
 Managers (1 Full-time and 1 part-time)
 Janitor (2 Full-time)
 Medical biller (1 full-time)
 Social services (contracted)
Compensation
1. Rate
 Nuclear medicine technician ($85,000 annual salary)
 Physician ($150,000 annual salary)
 Pharmacist ($100,000 annual salary)
 Medical Assistant ($35,000 annual salary)
 Infusion Nurses ($80,000 annual salary)
 Healthcare Administrators ($65,000 annual salary)
 Counselors ($65,000 annual salary)
 Managers ($60,000 annual salary)
 Janitor ($25,000 annual salary)
 Medical biller ($15 hourly)

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Depending on the occupation, rates will be varied according to professionals and years of
experience. According to the American Medical Association, most technicians and therapist
starting salaries range from $45,000 to $55,000 annually; nurse practitioners and physician’s
assistant start from $100,000 annually. Specialty physicians’ salaries will depend on years of
practice but the median starting range is from $150,000 annually.
2. Benefits
Benefits at our Trajectory Infusion Center will only be available to all regular and probationary
employees working 40 per week. Medical insurance coverage begins on first day of
employment.
o Medical insurance
o Dental Insurance
o Paid Time Off
 Paid time off will be for holidays, vacation, illness, family need or personal business.
 Time is accrued each pay period based on length of service, employment status, and FTE.
3. Job descriptions (detailed listings)
 Nuclear medicine technician ($85,000 annual salary)
-Operate emission tomography diagnostic equipment and effective communicate
with patients
 Physician ($150,000 annual salary)
-Evaluating the need of medicinal therapy and prescribing the relevant medicines
 Pharmacist ($100,000 annual salary)
-Prepare medications and review physician’s orders
 Medical Assistant ($35,000 annual salary)
-Make sure administrative and clinical duties are running smoothly
 Infusion Nurses ($80,000 annual salary)
-Prepare radioactive drugs and administer to patients
 Healthcare Administrators ($65,000 annual salary)
-Organize and coordinate medical and health services in relation to policies
 Counselors ($65,000 annual salary)
-Assess with patient of care and treatment plans
 Managers ($60,000 annual salary)
-Recruit, hire and evaluate assistant administrators, and clinical staffs
 Janitor ($25,000 annual salary)
-Perform heavy cleaning duties
 Medical biller ($15 hourly)
-Verify patient’s insurance and answer common billing questions
-Work closely with patients to support them through difficult times

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4. Roles and responsibilities
 Nuclear medicine technician
 Administer radiopharmaceuticals and medications for patient imaging and
therapeutic procedures
 Physician
 Monitor response when necessary to revise the therapeutic plan
 Pharmacist
 Ensure of safe procurement, adequate storage and dispensing of medicines
 Medical Assistant
 Verify patient information and prepare them for examinations
 Infusion Nurses
 Assess patient health by performing physical examinations; obtaining, updating,
and studying medical histories
 Healthcare Administrators
 Act as liaisons among governing boards, medical staff and department heads.
 Counselors
 Instruct and counsel patients by describing therapeutic regimens; promoting
wellness and healthy lifestyle
 Managers
 Making sure practice is running smoothly and the facility is running efficiently
 Janitor
 Keep facility and work space clean and sanitized
 Medical biller
 Compile data and submit claims to insurance companies and bill patients
 Social services
 Liaising with other agencies about assessments

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Balance Sheet and Income Statement
Cash Flow Statement
Annual Cash Flow Statement
Revenue $1,500,000
Salary
Full-time Employees $650,000
Part-time Employees $300,000
Total: $950,000
Utilities
Electricity $2,000
Internet & Phone $4,500
Water & Trash $1,000
Total: $7,500
Expenses
Medical Supplies $15,000
Office Supplies $3,000
Repairs & Maintenance $3,000
Total: $21,000
Start-up Cost
Remodeling ($140/ft²) $200,000
Large Equipment $100,000
Small Equipment $75,000
Total: $375,000
Advertising (Educational) Expenses
Online Ads $1,000
Newspaper Ads $1,500
Magazine Ads $1,000
Total $3,500
*Preliminary Numbers
1. Billings
One of the most important processes to ensure consistent cash flow is billing. Billing accurately
and on-time is crucial to any businesses success. This is done to make sure that we are being
reimbursed for our services. According to one article, “with uncollected medical bills running as
high as 50 percent nationwide, collections must also be made priority at the time of visit”
(Ehrhardt, 2012, p. 1). This makes consistent billing crucial to the success of our infusion clinic.

19
We will utilize the weekly cycle billing schedule to optimize our cash flow. According to
Ehrhardt, this allows monies to be collected throughout the month and not just one day out of the
month (Ehrhardt, 2012, p. 16).
2. Loans
Considering we are already cash strapped and the fact that our practice will be in the red for the
first couple of months, we will consider taking a loan to start our business. There are a plethora
of creditors on the market. Most of these creditors lend money to nursing homes, acute care
hospitals, and even pharmaceutical companies. We will obtain a loan from CaptialOne healthcare
financing for $3,000,000. This will cover our start-up expenses and the first few months of
operation. Our loan will have a 4% interest rate for 20 years. Our total cost for this loan will be
$6,573,369.43 with $3,573,369.43 coming from the interest expense.
3. Expenses paid
Since we are a for-profit organization, we will be subject to several taxes. The first one is
property tax. This tax is currently 1.114851% in Signal Hill. If our total property value is
$1,000,000 and the building is valued at $2,000,000, our total tax will be $33,445.53 per year.
There are no utility taxes in Signal Hill and the business tax rate is one of the lowest in the
county. We will also have an interest expense on the loan we borrowed which will be in total
around $3,500,000. Other expenses will be the labor costs, overhead, and benefits.
4. Start-up costs
Start-up costs can hit a medical practice hard, especially when they are low on available cash.
According to one article, start-up costs for an infusion center can range from $10,000 to $15,000
(Staff, 2012). This estimate is just for equipment, however. There are other fixed costs like space
rental, staff salaries, and health benefits (Staff, 2012). These numbers could vary but if we have 2
physicians, 2 nurses, and a receptionist and a biller, we can be looking at around $75,000 to
$100,000 just for the first month in terms of salaries. In total, the start-up cost for our infusion
center would be around $200,000, including everything from capital to salaries.
5. Promotional (educational) expenses
Since we are a for-profit organization, we do not need to give educational services to the
community. This cuts out the community benefit reporting that many organizations need to
produce. In place of this we will consider running a promotion to draw people to our business.
One promotional expense could be free screenings for first time customers. Screenings are cheap
and they let us connect with the patient when they use the facility. This will entice people to use
our services and continue to come back. We can also put these promotional expenses as tax
deductible in our IRS forms.
6. Insurance

20
We will need to insure our facility against any lawsuits. This is the first insurance we need for
our practice. Malpractice insurance in California could range anywhere from $24,000 to $34,000.
There are also many other forms of insurance we need to purchase. We would need liability
insurance, business insurance, and workers comp insurance. In total we could be paying around
$100,000 to $150,000 on insurance alone.

21
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