Ancillary Services: Enhancing Revenue and Patient Care

Transcription

1 Ancillary Services: Enhancing Revenue and Patient Care Surviving the Perfect Storm Reed B. Hogan, II M.D VISION GIA to be the leader for GI care in Mississippi. FOCUS/OBJECTIVE Maintain independence one umbrella of services Comprehensive care model of consolidated services & ancillaries. Enhance best practices, protect income, market share, and to expand boundaries as the market drives expansion. Maximize size and depth of services Proactively position GIA to capitalize on opportunities / changes in the market. 1

2 31 MDs 3 Pediatric GI 3 Pathologists 8 Nurse practitioners 13 CRNAs (6 full time) 363 Employees 3 AECs 32,000 cases / yr Independent Practice 4 Best Doctors! This location Come across town For your CT and US Pick up prep here Get Endo here!! We valet park here for infusion!! No Here!! Transform Convenient, fragmented efficient, cost effective CONNECTED SILOs into EXPERIENCE CHANGE THE PARADIGM 2

3 31 MDs 3 Pediatric GI 3 Pathologists 8 Nurse practitioners 13 CRNAs (6 full time) 363 Employees 3 AECs 32,000 cases / yr Independent Practice Where are we now 3 AECs (Flowood, Madison, & Vicksburg) 8 Travel Locations (Magee, Hazlehurst, Carthage, Forest, Morton, Yazoo City, Kosciusko, Tupelo 31 physicians 32,643 endoscopy procedures on 27,544 patients 32,112 clinic visits. 363 total staff Gross Revenues of $75,126,900 21% growth /1 yr 9 3

4 10 A Perfect Storm

5 Go Viral GI Website Presence Ancillary Services 13 Ancillary Services Endoscopy Center Sedation Pathology Dietary / Weight Loss Sponsored Research Rx / Tx Development Diagnostics Scrub Shop In House Pharmacy Radiology / CT / US Infusion Clinical Blood Lab HyGieacare Specialty Service Lines Reference Labs Medical Linen Services 14 Always asking the question: when can we add Ancillary Services to help us grow, even in the middle of the storm? 15 5

6 Change your mindset 16 Endoscopy Center Value $ $ $ 17 Endoscopy Center Cases Cases Cases per Year Rooms MDs Per Per Room Month Year Per Year ,027 2, ,472 17,660 3, ,671 20,952 2, ,846 22,155 3, ** ,556 22,448 3, ,418 17,021 2, ,427 17,131 2, cases / room / year 18 6

7 Endoscopy Center 3000 cases / room / year 19 Patient From Pre op THE PATIENT DICTATES THE FLOW The Efficiency Triangle Labor intensive 16+ employee MD evaluation contacts per patient Patient ready to sedate Pre-op Eval Initiate Sedation 5 10 min Evaluation and discharge New patient in room 3 5 Minutes Dictation complete Dictation Form completion One room One MD Procedure Scope in scope out EGD 5 10 min Colon min Patient in recovery Discharge Patient!!!! Proprofol 20 Revenue Take Home Augmentation Message: Through Ancillary Services Endoscopy Center Study processes Maximize efficiency Fill the rooms, all day Do not overbuild Expect physician pushback 3000 cases / room / year 7

8 Pathology AncillarySer vices Ancillary Services 22 Pathology Value $ $ $ $ 23 Revenue Augmentation Through Ancillary Services Pathology Pathology Services Physician Owned Model GI Practice GI Lab GI Lab GI Lab Tissue Technical Diagnosis Signs out Acquisition ( TC) (PC ) report Great for larger practices, 4 6,000 specimens per year. Stark law Anti markup Rule restrictions apply Lab may be in separate building if leased full time. 8

9 Pathology GIA Pathology Ancillary Dashboard 2016 Estimate Annual % of Jan June Annualized Projected Actual Revenue Actual Estimate Increase Revenue 3,494, % 1,716,850 3,433,700 $ $ $ Salaries & Benefits $ 464,945 13% $ 236,962 $ 473,924 Clinical Expenses 1,144,442 33% 414, ,619 $ 1,609,387 46% $ 651,271 $ 1,302,543 13% Net income (loss) $ 1,885,319 53% $ 1,065,579 $ 2,131,157 $245, Sedation Value $ $ $ 26 Revenue Augmentation Through Ancillary Services Sedation Sedation Services The Sedation Company Help you provide optimal care for your patient. Rapid turnover Take care of scheduling Hiring and Firing Joint venture if you would like a piece of the action. 9

10 Revenue Augmentation Through Ancillary Services Sedation Sedation Company Model JOINT VENTURE GI Physician Performs Procedure Sedation Company Contracts Sedation Company s Anesthesia Provider Sedates Both Providers Bill &Collect fees Infusion Ancillary Services 29 Infusion 2 Chairs 3 Chairs 30 10

11 IBD Center of Excellence Infusion 31 Dietary / Weight Loss Anci llary Serv Ancillary Services ices Ancillary Services 32 Dietary / Weight Loss Value $ 33 11

12 Diagnostic Center Smart pill, Pill Cam, Bravo, Motility, Fibroscan Ancillary Ancillary Services Ancill Services ary Servic es 34 Diagnostic Center Smart pill, Pill Cam, Bravo, Motility, Fibroscan Value $ 35 Diagnostic Center Smart pill, Pill Cam, Bravo, Motility, Fibroscan 36 12

13 Radiology / CT / US Value $ $ 37 Radiology / CT / US Radiology / CT / US ACTION STEPS 2018: 2 ND CT tech 12 > 20 cases/d Staff Education cost and convienence 39 13

14 Sponsored Research Value $ $ 40 In Office Pharmaceutical Dispensing Value $ $ 41 In Office Pharmaceutical Dispensing 42 14

15 In Office Pharmaceutical Dispensing 43 Pharmaceutical and Device Development Value $ $ $ $ $ 44 Clinical Blood Lab Value $ $ 45 15

16 Revenue Augmentation Through Ancillary Services Clinical Blood Lab Clinical Blood Lab ACTION STEPS 2018: For send out tests: patient billing New studies: stool analysis 47 In Office Pharmaceutical HyGIeaCare Dispensing Value $ $ 48 16

17 In Office Pharmaceutical HyGIeaCare Dispensing Value $ $ 49 Medical Linen Services Value $ 50 Scrub / Accessory Retail 51 17

18 Complex Medical Reference Lab $ Value $ $ $ $ $ 52 Complex Medical Reference Lab 53 The Nash Project Telemedicine NASH / Fatty liver Home Clinic Setting National Registry Commercial Research Ancillary Services 54 18

19 50,000 45,000 40,000 35,000 30,000 25,000 20,000 15,000 10,000 5,000 0 Revenue Augmentation Through Ancillary Services The Nash Project Among patients who biopsied, there is a 5:1 screening vs. trial inclusion ratio, requiring large patient pools to support the current & upcoming PH3 NASH trials. Over the , ~ 130,000 NASH patients will need to be biopsied in order to support Phase 3 trial accruals. Additional screening will be needed to support compounds in Phase 2 programs (over 23 active trials) NASH PH3 Trial Accruals (based on patients who receive biopsies) 12.5K screened 2,000 10,500 17K screened 3,900 13,100 47K screened 9,400 37,600 8,900 35, Pts. Excluded Pts. Entering trials Cumulatie Pts in trials 44.5K screened Nash Project What Our Program Is: Health management Lifestyle coaching Progress monitoring Patient education Motivation Accountability Complimentary to the services of the physician Pathway to engage with NAFLD remotely Prelude to a more traditional telehealth platform What Our Program Is NOT: Complex clinical protocols Replacing the role of the nurse or physician Medical treatment in the traditional sense

20 Complex Medical Reference Lab Expensive, outside our box. Stakeholders would rather own restaurant. 58 Complex Questions Medical Reference? Lab Expensive, outside our box. Stakeholders would rather own restaurant. 59 An Experiment Be on the lookout for this ad 20