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Oncologist-Hospital Alignment: Implementing the Relationship  Ronald Barkley, MS, JD, CCBD Group  Teri Guidi, MBA, FAAMA, Oncology Management Consulting Group  Erich Mounce, MHA, West Clinic 2

Case Study - Fact Pattern  Quality Care: a private oncology medical group with 10 med oncologists + 2 rad oncologists  Memorial Care: local health system with 3 hospitals, 150-MD affiliated practice and 2 employed med onc  Quality Care and Memorial Care leadership want to form a collaborative relationship  In the preceding session, the form of the new collaborative relationship was determined  Now, in this session, we will move to the next level: actual implementation of operations 3

Case Study - Fact Pattern 1.Governance and control through Joint Operating Committee format 2.Quality Care has free-standing cancer center located ½ mile from Memorial Care hospital with 340B drug pricing program; 2 offices in MOBs next to Memorial Care hospitals and a 3 rd office in another town 3.Quality Care practice manager/CEO is business- oriented MBA; Memorial Care oncology service line director is clinical-oriented RN, the CoC “champion” 4

Case Study - Fact Pattern 4.Chemo drug mixed on-site at Quality Care by pharm techs under PharmD supervision; chemo drug mixed at Memorial Care pharmacy departments and delivered to the HOPD infusion centers 5.Quality Care has Varian EMR; Memorial Care with enterprise-wide EPIC EMR 6.Quality Care bills w/in 3 days of service; Memorial Care Finance Dept responsible for all billing and batch bills twice monthly 5

Case Study - Fact Pattern 7.Quality Care has an active clinical trials program through CRO and would like to continue with this arrangement 8.Congratulations! You have just been advised that you will be accountable for the successful implementation of operations 9.And you have been cautioned by your CEO that “failure is simply not an option” 10.What do you do now? 6

What do you do now?  The Getting Started Part  The People Part  The Infrastructure Part  The Communications Part 7

The Getting Started Part 1.Establish JOC working relationships  Communications, expectations, meetings  Governance, control, decision making issues  Articulating and facilitating strategy and vision 8

The Getting Started Part 1.Establish JOC working relationships Communications, expectations, meetings Governance, control, decision making issues Articulating and facilitating strategy and vision 2.Develop the Work Plan with assignments, deadlines, accountabilities 9

Elements of the Work Plan The People Part 1.Management structure – reporting lines 10

Elements of the Work Plan The People Part 1.Management structure – reporting lines 2.Consolidated staffing plan – org chart  Example of organizational chart below 11

Executive Cancer Council WEST CANCER CENTER Physician Services Breast Center Sites Radiation Oncology Inpatient Services Surgical Services Inpatient Oncology Floors Research & Education UT ACORN Philanthropic Campaign SVP Oncology Service Line West Clinic Methodist Healthcare

Elements of the Work Plan The People Part 1.Management structure – reporting lines 2.Consolidated staffing plan – org chart 3.Reconciling employee benefits 13

Elements of the Work Plan The People Part 1.Management structure – reporting lines 2.Consolidated staffing plan – org chart 3.Reconciling employee benefits 4.Managing people expectations and fears throughout the process 14

Elements of the Work Plan The Infrastructure Part 5.Facilities requirements 15

Elements of the Work Plan The Infrastructure Part 5.Facilities requirements 6.IT/EMR interoperability 16

Elements of the Work Plan The Infrastructure Part 5.Facilities requirements 6.IT/EMR interoperability and output 7.Drug procurement, drug management 17

Elements of the Work Plan The Infrastructure Part 5.Facilities requirements 6.IT/EMR interoperability and output 7.Drug procurement, drug management 8.Revenue cycle  pre-auth  Coding  billing & collecting  provider credentialing 18

Elements of the Work Plan The Infrastructure Part 5.Facilities requirements 6.IT/EMR interoperability and output 7.Drug procurement, drug management 8.Revenue cycle pre-auth coding billing & collections provider credentialing 9.Research/clinical trials 19

The Communications Part 11.Communications plan  internal  patients  payers  community 20

11.Communications plan internal patients payers community 12.Monitoring progress, trouble shooting and taking corrective action The Communications Part 21

Oncologist-Hospital Alignment: Implementing the Relationship Questions? Ronald Barkley, MS, JD Teri Guidi, MBA, FAAMA Erich Mounce, MHA 22

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