Diagnostic Assessments: Often the starting point for many clients is a Diagnostic Assessment where the major issues are identified, quantified, and then organized into an improvement plan.

Our assessments are designed to be objective, data intensive, and fast. We can provide a comprehensive review covering all the core processes and supporting functions in a 5 – 30 day timeframe. This diagnostic assessment will benchmark your operations against high performance organizations, and will summarize the strengths and weaknesses in terms of "performance gaps". With each performance gap, we will identify the tangible impact that gap is having on the operations, such as, reduced income, physician hassle, unsatisfactory or compromised patient service, and how that gap can be closed. Included in the assessment is a business case for change, and a "road map" for implementing the needed changes.

Strategic and Market Planning: With strategic planning, the goal is to step back, and as an organization, re-assess "Where are we going and how are we going to get there?" Effective strategic planning addresses questions such as "How should the mission, goals and values be articulated given the current situation?"; "What market strategy should we pursue in order to continue to grow market share, differentiate ourselves, and increase the "bond" with our community physicians?"; "What service lines, facilities, staff, infrastructure, and market outreach programs will be necessary to support the growth?"; "How should the physician partnership be developed in such a way to be supportive of the growth plan and assure physician/leadership transitions?"; and "What are the financial requirements and expected outcomes associated with the strategy?"

Our strategic planning process follows a methodology based on extensive use of market and current position data, broad physician stakeholder involvement, a systematic review of the organization's current strengths, weaknesses, opportunities, and threats (SWOTs), and a "building block" approach to developing a specific strategy which makes sense for the client's market situation. When the planning is completed, there is broad agreement on organizational mission and goals, the market facing strategies, the execution requirements, and how to go about implementation including the role of new investments.

Revenue Cycle Management: The goal of revenue cycle management is to improve cash generation by redesigning the processes and controls related to charge capture - coding - billing – collection; integrating technology tools as a means to make the process more seamless; and establishing "expected reimbursement" controls to assure payor compliance.

Our approach is based on redesigning the process to more effectively control revenue from when the patient appointment is first made to when the last dollar is collected. This redesigned process is reinforced with a performance "report card" which increases the visibility of results, and a more aggressive approach to "payor management" toward assuring payor contract compliance, responding to denials, and touching each account sufficiently to keep it from aging beyond its value. We usually see a 4%-14% improvement in income from monies which have been "lost in the system" once the Revenue Cycle has been improved.

Practice Turnaround/Operational Improvement: Physician practices are often "underperforming", and at times to a point where they are seriously compromising physician income. Physician reaction is usually to try and reduce overhead cost when the solution is really in revenue development and control, streaming workflow, increasing the use of technologies, and more closely measuring results.

We work with physician organizations facing either a "burning platform" situation, and/or a serious decline in physician income toward not only improving income, but also improving the patient experience and reducing physician hassle. We provide an end-to-end process review from the patient and physician perspective, eliminating inefficiencies, improving controls and shortening cycle times. This involves eliminating non-value added activities and bottlenecks, increasing accountability and setting aggressive and measurable goals. In addition, managed care contracts are renegotiated to be "clinically relevant" and competitive, fee schedules are revised, and the billing and collections function is upgraded. Using these methodologies, we have been able to achieve dramatic turnarounds in months.

Practice Mergers/Acquisitions: As with any business – size matters. Larger physician organizations have the advantages of being more effective in negotiating with payors and hospitals, more able to secure the capital necessary to invest in technologies and ancillary services, and better positioned to find solutions to issues such as malpractice coverage.

The JHD Group is experienced in physician organization development having worked with IPA’s, "tightly owned" physician organizations, and "confederated" (single tax ID – loose affiliation) physician models. We can assist in the development of the "value proposition" necessary to make merger discussions real, and serve as a facilitator to the process. We also have experience in physician group consolidation where numerous small physician groups come together to create a large group. In this context we can help with the anti-trust challenges, developing a governance process, selecting leadership, and post-merger integration.

Hospital – Physician Development: Hospitals and hospital systems are increasingly looking to develop owned or closely affiliated physician capabilities as a means to respond to the movement towards ambulatory care and consumerism, and to secure market position. In this regard, the challenge is how to not repeat the mistakes of the early 1990s and yet have an operationally cohesive model and an economically effective delivery system.

We can assist by helping develop a strategy for a "fabric" of physician relationships which draws on facility joint ventures, hospital-affiliated or owned group practices, Stark Harbor based EMR funding/Implementation initiatives, "incubating" physician practices, MSO support services, and the like. With a strategy in place, we can support or lead in the implementation of all, or parts of, the plan.