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POSITIONING YOUR PRACTICE FOR SUCCESS / SURVIVAL: MEETING THE CHALLENGE. Bob Orzechowski , MBA, SPHR Chief Operating Officer Berks Hematology Oncology Associates, Ltd . West Reading, PA email@example.com ( tel ) 610.374.4404 ext. 111. OBJECTIVES.
Bob Orzechowski, MBA, SPHR
Chief Operating Officer
Berks Hematology Oncology Associates, Ltd.
West Reading, PA
(tel) 610.374.4404 ext. 111
After This Session You Should Be Able To:
Identify the Primary Business Management Challenges in a Private [Hem-Onc] Medical Practice
Identify Potential Tools & Interventions to Address Those Challenges
Recognize Linkages (interrelationships) Between the Various Components of the Business, the Necessity & their impact on the enterprise
“The soul of practicing medicine is a solemn social contract under which patients surrender themselves to us and trust us to do what is best for them.”
US – “right vs wrong”
THEM – “win vs lose”
1. DEVELOPING A CONCEPT OF THE ORGANIZATION AND FORMING A VISION OF WHERE THE FIRMSHOULD BE HEADED (THE MISSION: defines purpose & direction, determines priorities, reflects values)
2. TRANSLATING THE MISSION INTO SPECIFIC LONG-RANGE AND THEN SHORTER-RANGE PERFORMANCE OBJECTIVES
3. CRAFTING A STRATEGY: (Where does the organization want to be?)
4. IMPLEMENTING A STRATEGY: (How can the organization get to where it wants to be?)
5. EVALUATING PERFORMANCE AND INITIATING CORRECTIVE ACTION: (How will the organization know when it has arrived?)
BHOA's mission is to provide the highest quality health care in our sub-specialties of medical oncology and hematology.
BHOA values honesty, integrity and respectful behavior in all our dealings with each other, patients and all other stakeholders.
42 years of caring
5 physicians & 4 Physician Assistants
EMR in 2004; continuous investment in IT
Pharmacy & inventory mgmnt systems
Practice Mgmnt. & analytics software
IT Infrastructure – intranet, cable modems, DSL, hardware, supportive perihperals
inbound / outbound digitized faxing
all in-office, lab & hospital interfaces
1990 – 2004: 7,800 sq. ft. & 17 chairs
2005: 32,000 sq. ft. & 37 chairs & beds
700 + Payers or plans
7% non-risk bearing local PPO
7% MA & Uninsured – We See Everyone
Clinical Trials Program
In-House (“retail”) Pharmacy
No Hospital “Turfing” Option
14 FTE RNs - in infusion suite
2003-05: from 55 FTEs to 65 FTEs
2006 - 07 TURNOVER = .05, or ½ %
2008 T/O = 1%
2009 T/O = 10%
2010 T/O = 1%
DRO = 22 - 30 days
Gross revenue up 5% - CY09 –CY10
Net revenue even
Drug costs up 10%
Payroll ratio decreasing from10% to 8%
Most other non-drug costs decreasing
BASIC USMC MODEL FOR LEADERSHIP
Sense of Mission – Important, Urgent
Aligned Values – Ours & Yours
No Peacetime – Caring Never Stops
Excellence, not Perfection
Constant Learning & Training; Invest in People
Adequately Equipped; Low & Hi-tech
Autonomy & Accountability
“LADIES & GENTLEMEN WORKING WITH LADIES & GENTLEMEN”
Respect - Involved, Listened to
No “ Witch Hunts”:
Flexibility & Accommodation
Empowered - Autonomy & Discretion
Constant training, & info flow
Coupled with Accountability
Reliance & Trust - To do the Right Thing
Recognition & Celebrations
1. Quality Care - complexity. It is increasingly difficult to provide guideline based care profitably: Increasing options & variables for treatment
Oral oncolytics and medication management
Aging population, Chronic conditions
Fragmented or limited information exchange among stakeholders
Technology – the medical science, labs, EMR, data & information flow, infrastructure design / re-design
Leadership, Management & Organization
9% -non-Dr. (non-Provider) payroll
1.0% -Health Insurance
.9% -Payroll taxes
Higher administrative (indirect)costs
Sound Strategic Management is Critical for Continued Success.
Know and Understand Your People, Numbers & Your Processes.
Applied Knowledge is Power - Use what you learn, and always be learning
Understand Both the Economics for Your Business And for the Human Factors
Take Responsibility for Your Business & Yourself
Physician – owner compensation will continue to experience downward pressure.
Productivity & efficiency improvements are possible.
Employees will be the source of such improvements.
Managers & leaders will be integral to the business’ success as clinical & technological demands on providers increase.
If you keep doing what you’re doing, you’ll keep getting what you have (or even less).