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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 firstname.lastname@example.org ( tel ) 610.374.4404 ext. 111. OBJECTIVES.
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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).