OMC GROUP… Outstanding experts, Outstanding results!

• Financial and Market Analyses

• New Center Development

• Hospital/Physician Integration

• Strategic Planning

• Operational Assessments

• Revenue Cycle Reviews

• Implementation and Interim Leadership

• Performance and Financial Benchmarking

Oncology Management Consulting Group215-766-1280 • www.oncologymgmt.com

solutions@oncologymgmt.com

CASE STUDIESCLIENT LIST

CASE STUDIESCLIENT LIST

Dear Colleague,Thank you so much for your interest in the Oncology Management Consulting Group’s services and qualifications. Our experience is both broad and deep, and includes work in virtually all settings where oncology care is delivered. The accompanying case studies represent just a small glimpse into some of the projects in which our expert consulting staff has been involved, providing examples of numerous types of clients and a variety of work scope samples. Some engagements are tightly focused on a particular issue while others incorporate several work areas and multiple deliverables. We take great pride in supporting the provider community, across all clinical and operational disciplines, making it possible for our clients to maximize their performance. Our focus has always been on ensuring the success of oncology providers. Because we tailor every engagement to each client’s specific needs, there are innumerable other cases that we are unable to publish due to space constraints. If you don’t see one that precisely illustrates our expertise relative to your circumstances, we would be most happy to discuss your particular situation and outline how our consulting professionals can support your success. We look forward to speaking with you and to assisting you and your oncology team in the future. Very best regards,Teri U. GuidiTeri U. Guidi, MBA, FAAMAPresident and CEO

Teri U. Guidi, MBA, FAAMA

President and CEO

“Oncology Management Consulting Group exhibits the most outstanding qualities I expect of a professional consulting firm. Their oncology knowledge is simply unsurpassed by any in the industry! They provide innovative, viable solutions to ever-increasing complex problems and challenges…they work closely with clients - as team members! Their genuine collaboration with staff, skilled guidance and apparent depth of experience and expertise truly impress me! I would recommend them highly to any colleague.“

– Matt Sherer, MBA, MHA Administrative Director John B Amos Cancer Center Columbus Regional Healthcare System

A large, multi-site medical oncology practice was planning to move one of their offices into the hospital’s new outpatient center. The practice and the hospital hoped to avoid duplicating services and sought ways to more efficiently provide chemo-infusion to the community. The Oncology Management

CASE STUDY #1Physician Practice and

Community Hospital in the Mid-Atlantic

Challenge: Align programmatic and financial interests

Consulting Group was invited to work with both sides in order to develop a more closely aligned relationship.

• Interviews with key stakeholders to assess readiness; identify common interests and goals, and to articulate potential deal-breakers

• Facilitate multiple working sessions with the planning group to negotiate the deal points

• Complete analysis and projections of service volumes, costs, reimbursement under multiple ownership scenarios to quantify the value of various models

• Definition of multiple contractual relationship options for integrated delivery of outpatient infusion services: ownership, governance, management control, etc.

Challenge: Improve operational efficiency and safety for the medical oncology practice and infusion suite

CASE STUDY #2Large Multi-specialty

Physician Group Affiliated with the

Health System, California

Multi-specialty group with a small medical oncology section asks for expert assessment and recommendations regarding staffing, flow, processes, and a review of coding and billing for chemotherapy and physician professional services.

• Observations and in-depth interviews to identify areas for improvement

• Analysis of staffing mix and productivity.

• Comprehensive review of charts for appropriate documentation and coding

• Complete review of billing and collections

• On-site interim leadership to institute multiple operational and safety recommendations: staff roles, productivity measures, training needs, etc.

• Identification of over $600,000 in missed reimbursement annually

CASE STUDY #3 Community Hospital and

Health System in Mississippi

Challenge: Conduct a complete review of the revenue cycle for infusion and radiation therapy services

Community hospital with employed medical oncologists invited the Oncology Management Consulting Group to assess all phases of the revenue cycle for the infusion center and the radiation oncology center to ensure appropriate documentation, coding, billing, and collections.

• Review charts for compliant documentation

• Review charge masters for completeness and reasonableness of charge amounts

• Review claims and EOBs

Facing unprecedented growth in volumes, and working with the academic partner towards NCI-designation, this center required a full assessment of capacity, projected growth in demand, and facility expansion planning. In addition, strategies to sustain market dominance and to continually support NCI-designation efforts were needed.

• Thorough data analysis: demand and market share, service volumes, expense/revenue/downstream contribution margins

• Extensive interviews with stakeholders: administration, clinicians, referring physicians, community members, etc.

• Task force work to articulate and prioritize strategic initiatives

CASE STUDY #4 Large Teaching Health

System in Eastern United States

Challenge: Formulate strategic and facility plans for two cancer center campuses to support continued growth and coordination with academic partner

• Business pro-formas to quantify potential implications (expense, revenue, etc.) of initiatives

• Space programming and planning in collaboration with architects

CASE STUDY #5 Prominent Academic

Health System in Pennsylvania.

Multi-site, major academic health system in Pennsylvania engages OMC Group’s assistance with strategic planning across the organization including a top-level assessment to review and evaluate a professional affiliation with a renowned NCI designated cancer center. A highly charged political environment necessitates deliberate care and sensitivity to confidentiality issues

• Interviews and investigation to surface sensitive political issues and other critical concerns related to the NCI center affiliation, in particular its value, the potential for additional value, the potential impact of discontinuing the relationship, and opinions regarding other options and desired benefits

• Comprehensive review of key data elements (tumor registry, financial and market data) to understand current and potential market position.

• Opinions and recommendations for future strategic direction for the multiple inpatient and outpatient sites, to guide individual institutional programs while building a consistent strategy across the system

Challenge: Create a consistent strategic direction across all sites

CASE STUDY #6 Health System

Owned Pediatric Oncology Center

Challenge: Formulate strategic plan and build financial management models

The oncology division of a large multi-specialty pediatric group faced inexplicable declines in volumes and pressures to deliver financial performance

• Market assessment of demand for services, current market share, patient migration patterns

• Review and benchmarking of practice financial performance

• Referral pattern research and recommendations

• Work with physicians regarding marketing and referral cultivation: marketing plan, coaching

• Development of referral tracking tools

• Development and training in use of budget planning and monitoring tools for manager

CASE STUDY #7NCI Designated Center

in the Southwest

Challenge: Review multiple sub-specialty outpatient clinics for operational flow and efficiencies

In order to ensure optimal throughput, utilization of capacity, and clarity of information flow, this NCI-designated Cancer Center requested OMC’s assistance in evaluating the operational aspects of several tumor-specific outpatient clinics and the infusion area.

• OMC conducted in-depth interviews with line staff and involved physicians to learn the expectations and assumptions of the participants

• Real-time observations of operations on-site revealed significant “disconnects” between management’s assumptions and functional realities

• Recommendations included revision of job descriptions and development of consistent policies and procedures to maximize efficiency and to enable increased staffing cross-coverage

Challenge: Articulate a competitive strategy to reduce fragmentation of services andphysician loyalties

CASE STUDY #8 Community Hospital in a Highly Competitive

Metropolitan Area Near Washington DC

OMC was invited to assist a community hospital faced with multiple competing community, academic and NCI-designated Cancer Centers in developing a strategy to maximize physician loyalty and articulating a competitive strategy to attain market dominance in subspecialty services:

• Analysis of hospital financial position for oncology services to prioritize subspecialties for focused development (recruitment, specialty services, technology expansion)

• Market share analysis leading to identification of target niche program opportunities

• Confidential interviews identifying physician drivers to key services and programs

• Recommendations to reallocate prime office suites to key practices and drive higher levels of referral and utilization loyalties

• Capitalize on unique sub-specialty niche of staff physicians

An intricate and wide-ranging engagement for a large regional health system in North Carolina. This health system is experiencing rapid growth in a competitive market and myriad challenges regarding the merger of two competing private practices. A number of politically charged situations and unique integration challenges have led to a particularly complex and delicate project. An across-the-board review included

• Financial feasibility analysis of costs and expected revenues for a proposed radiation joint venture

• Comprehensive system wide strategic planning for clinical and supportive services and programs

• Complete program planning for the new facility

• Development of new hospital/physician relationship models for two disciplines

• A detailed assessment of outreach market opportunities

CASE STUDY #9 Large Regional

Health System in North Carolina

Challenge: Multi-dimensional business development engagement

CASE STUDY #10

Challenge: Multi-dimensional business development engagement

Mid-sized community hospital in a competitive market outside New York City requires support with facility development, construction and strategic direction for a proposed cancer center. An existing affiliation with an NCI designated cancer center was also to be reassessed. The new center will house physician-owned radiation, “time-share” suites for medical oncology, hospital-based infusion and several other cancer program components. This complex, multi-faceted engagement exposed rather delicate, politically sensitive situations requiring precise management and negotiations. Responsibilities included:

• Re-evaluating the value and terms of an academic affiliation with an NCI center

• Developing strategy for succession planning in key practices and improvement of hospital/physician relationships.

• Facilitating detailed and substantially sensitive negotiations for medical oncology “time-shares” with multiple competing practices

• Leading a task force to develop a comprehensive strategic plan

• Developing policies, procedures and budget for the new infusion center

• Successful preparation for an American College of Surgeons survey

• Developing and negotiating the Medical Director contract

Mid-sized Community Hospital in the New York

City Vicinity

CASE STUDY #11Large Multi-specialty Physician Group and Community Hospital

in the Pacific Northwest

A large multi-specialty private physician clinic and the community hospital they serve, engage OMC to assist in determining and selecting among the options for programmatic and financial alignment for outpatient cancer-related services. Considerable attention is necessary to overcome long-standing tensions and formulate joint strategy for growth:

• Interviews and review of financials to qualify and quantify the current state for both entities

• Leadership summit leading to agreements regarding delineation of control, distribution of revenue

• Task Force sessions result in shared vision, strategic programmatic priorities and marketing plans including development of a joint venture facility and a joint approach to entry into a new market

Challenge: Achieve alignment of the two entities and define future strategic direction

Prior to investing significant capital funds, this community hospital requested OMC’s assistance in evaluating options to develop radiation oncology capabilities:

• Research and assessment of local/regional competition for radiation therapy services

• Market demand analysis: population, incidence rates and estimated cases

• Projections for radiation therapy service utilization (professional and technical)

• Projections for operating expenses: staffing, supplies, marketing, contracts, occupancy, etc.

• Expense projections for major and minor capital equipment: clinical machinery, computer hard/software, furniture, etc.

• Five-year financial pro-forma under multiple volume scenarios

CASE STUDY #12Community Hospital in

Central Plains

Challenge: Demand analysis and multi-year pro-forma for radiation therapy

A health system and a private medical oncology group engaged OMC to facilitate the acquisition of the practice by the system’s for-profit arm, with particular focus on developing physician employment agreements acceptable to all parties including reasonable and appropriate performance incentives to ensure alignment of program and financial interests for the physicians and hospitals.

• Confidential interviews with all physicians and key health system executives

• Review of physician income and expenses

• Draft of proposed contractual terms, program control, productivity expectations, benefit structure, etc.

• Benchmarks and options for performance measures and incentive structure: clinical productivity, service quality, operational efficiency, etc.

• Develop a calculation model for financial results for physicians and health system

CASE STUDY #13Non-profit Health System

and Private Medical Oncology Group

in Upper Mid-West

Challenge: Develop physician employment and compensation contracts for health-system owned private medical oncology practices.

OMC Group is contracted to conduct an in-depth review of medical oncology operational systems and processes for a 2-hospital health system in a well-populated, suburban locale in Wisconsin. Processes evaluated include charge capture, charge entry, billing and budgeting for both pharmacy and infusion services. On-site interviews were conducted with line staff and management of the infusion center, outpatient registration, pharmacy, billing/patient accounts, finance, medical records, and more. OMC was able to:

• Locate inappropriate charge master mapping that resulted in over $20,000 in missed payments

• Identify missed opportunities in unnecessary write-offs totaling nearly $100,000

• Pinpoint significant gaps in system-wide processes, potentially saving in excess of $100,000 dollars in missed charges and denials

CASE STUDY #14Two-Hospital Health System in Wisconsin

Challenge: Detailed review of operational systems & processes

OMC Group conducted an operations and billing process review for a recently established, hospital-owned private practice in southern Pennsylvania. The delivery of chemotherapy had recently been restructured from a hospital-based service to a freestanding, private practice-based model and the new delivery model was to be assessed to ensure that the systems in place were appropriate. Specific attention was necessary in light of the recent changes put forth in the Medicare Prescription Drug Improvement and Modernization Act of 2003 (MMA). OMC Group’s team of billing and operations specialists observed and evaluated systems and procedures at multiple practice sites and:

• Revealed numerous areas for documentation improvement and reduced liability

• Identified countless process and procedure enhancements to improve charge capture, clean claim production and collections

• Implemented a number of methods to reduce denials and secure maximum appropriate reimbursement

CASE STUDY #15Hospital-Owned Private

Practice in Southern Pennsylvania

Challenge: In-depth operations & billing process review

A small community hospital in rural Indiana enlists OMC Group’s experts to identify potential structural models for the delivery of outpatient cancer care. Aging equipment, a lack of visibility in the community and a fractured structure of cancer services have led to an out-migration of patients to other providers.

• Outlined critical issues and high-level financial implications of joint ventures with one or more partners

• Recommended alternative contractual arrangements for professional services

• Developed a plan for the recruitment of specialists to private or hospital practice

• Provided multiple options for on-going analysis and development

CASE STUDY #16Community Hospital

in Rural Indiana

Challenge: Investigate & develop multiple potential structural models for outpatient cancer care

Oncology Management Consulting Group has assisted many premier cancer centers, community hospitals, clinics and oncology practices throughout the U.S. Assistance has been far-reaching and varied and has encompassed all aspects of oncology services. The following represents a partial list of clients that we have supported:

CLIENT LIST

Akron General Medical CenterAkron, OH

New Mexico Oncology HematologyAlbuquerque, NM

Univ. of New MexicoAlbuquerque, NM

St. John’s HealthAnderson, IN

Provena Mercy Medical CenterAurora, IL

Shivers Cancer FoundationAustin, TX

‘Specially for ChildrenAustin, TX

Battle Creek Health SystemBattle Creek, MI

Bay Regional Medical CenterBay City, MI

Bend Memorial ClinicBend, OR

Cascade Healthcare CommunityBend, OR

Suburban Hospital and Health SystemBethesda, MD

Mountain States Tumor InstituteBoise, ID

St. Joseph’s HospitalBuckhannon, WV

Alamance Regional Medical CenterBurlington, NC

St. Luke’s HospitalCedar Rapids, IA

Summit HealthChambersburg, PA

Charleston Area Medical CenterCharleston, WV

Riverbend Medical GroupChicopee, MA

North Cypress Medical CenterCypress, TX

Univ. of Colorado Cancer CenterDenver, CO

Morehead Memorial HospitalEden, NC

Elmhurst Memorial HospitalElmhurst, IL

The Regional Cancer CenterErie, PA

Cook Children’s Health Care System Fort Worth, TX

Univ. of Texas Medical BranchGalveston, TX

Jennifer Cadiz, MDHarris, NY

Holyoke Medical CenterHolyoke, MA

Wayne Memorial HospitalHonesdale, PA

St. Vincent’s Health SystemIndianapolis, IN

Memorial Hospital and Health Care Center

Jasper, IN

Dartmouth/Hitchcock Cheshire Medical

Keene, NH

Baptist Hospital of East TennesseeKnoxville, TN

Lafayette Hematology-OncologyLafayette, LA

Our Lady of LourdesLafayette, LA

Lewistown HospitalLewistown, PA

Univ. of Louisville – Brown Cancer Center

Louisville, KY

University Medical CenterLubbock, TX

Centra HealthLynchburg, VA

Virtua HealthMarlton, NJ

Sutter Gould Medical GroupModesto, CA

Montgomery Cancer CenterMontgomery, AL

BlueRidge HealthCareMorganton, NC

Cardinal HealthNashville, TN

Merck & CoWhitehouse Station, NJ

Ortho-Biotech IncBridgewater, NJ

Claxton-Hepburn Medical CenterOgdensburg, NY

Ottumwa Regional Medical CenterOttumwa, IA

Lourdes HospitalPaducah, KY

Parma General HospitalParma, OH

Singing River Hospital SystemPascagoula, MS

St. Joseph’s HospitalPaterson, NJ

MNAP Oncology CenterPhiladelphia, PA

Temple University Medical CenterPhiladelphia, PA

Office of Frederic Price. MDPittsburgh, PA

Buxmont Oncology Hematology Associates

Quakertown, PA

CLIENT LIST (continued)

Rapid City Regional HospitalRapid City, SD

Renown HealthReno, NV

SouthLake ClinicRenton, WA

William Beaumont HospitalsRoyal Oak, MI

Cancer Therapy and Research CenterSan Antonio, TX

ICU Medical Inc.San Clemente, CA

Central Coast Medical OncologySanta Maria, CA

Adirondack Medical CenterSaranac Lake, NY

Anderson Cancer InstituteSavannah, GA

Dendreon Corp.Seattle, WA

Grandview HospitalSellersville, PA

Summit HealthcareShow Low, AZ

Michiana Hematology-OncologySouth Bend, IN

Genentech, Inc.South San Francisco, CA

Trinity HealthSteubenville, OH

Medical Offices of Dr. Rocco CarusoStony Brook, NY

Capital Regional Medical CenterTallahassee, FL

North Mississippi Hematology & Oncology

Tupelo, MS

DCH Health SystemTuscaloosa, AL

Ventura County Medical CenterVentura, CA

Precision Radiotherapy CenterWarren, OH

ProHealth CareWaukesha, WI

Forsyth Regional Cancer CenterWinston-Salem NC

Franciscan Skemp/Mayo Health System

LaCrosse, WI

San Antonio Community HospitalUpland, CA

Sutter Medical FoundationSacramento, CA

Riverside Medical CenterKankakee, IL

Martin Memorial Health SystemStuart, FL

CLIENT LIST (continued)

Oncology Management Consulting Group215-766-1280 • www.oncologymgmt.com

solutions@oncologymgmt.com