As physician organizations become larger, they encounter challenges in evolving governance, increasing operating efficiency and effectiveness, managing growth, adding ancillary services, and retaining experienced and sophisticated management. Frequently these issues are related to the transition from a small "family" culture to a culture that will support a growing clinical enterprise, and at other times it relates to the desire of the physician owners to have a growing and high performance – professionally managed organization.

Market Leader Position Scale Location Access Market Commitment to Quality Position Clinical Quality Research Patient Service Quality HEDIS/Outcomes Tracking Clear Business Goals and Strategy Mission - Vision Operating Objectives Market Strategy Strong Relationships Hospitals Payors Referring Physicians Sub-specialists

On-going Market Development Referral Development Ancillary Development Managed Care Contracting Understood/Accepted Governance Process Representative Board of Directors, Executive Committee, Committee structure Shareholder involvement process Strong Technology Infrastructure Medical Technology Communications Practice Management/EMR Data Manipulation Incentive Based Physician Compensation Production Market Development Group Development

Cohesive and Supporting Culture Quality Group Goals Collaboration and Compromise Living with the "rules" Group Commitment Strong Framework of Financial and Operating Controls "Layered" financial reporting down to the physician level Operating Reports Well Developed and Integrated Revenue Cycle Management Charge Capture Coding Billing Contract Compliance Denials Management Collections Professional Management Clear Organizational Structure Management to Performance Measures Lean Operation Cohesive Enterprise Management Team

Our practice management capability enables physicians to focus on practicing medicine while we do what we do best – take care of the business side.В  The JHD Group brings professionals who each have 20 - 30 years of experience managing physician groups. Our methodologies are proven, particularly when it comes to critical areas such as revenue cycle, managed care contracting, governance, and staff management. Our approach emphasizes strong accountability for performance – focusing on the success factors critical to physician practice management, providing significant financial incentives based on mutually agreed performance targets; taking responsibility for staff management, recruitment and professional development; and providing depth of industry knowledgeable oversight and support. The key components of our practice management agreements include:

	Agreeing to a business plan for practice development and growth which includes market goals, basic strategies, roles, and expected financial outcomes.
	The JHD Group providing a senior interim management team (including an Interim CEO) until such time as permanent JHD Group professionals can become available. Depending on the needs of the practice, our management team will include a CEO, CMO, CFO, and as appropriate a COO. Any client practice staff currently in these positions are considered as candidates for permanent positions under the Practice Management Agreement.
	The JHD Group going "at risk" for a portion of our fees subject to achieving the targeted performance goals.
	A "no-fault" termination clause after the first year because we seek to have an on-going relationship of trust more than relying on contractual commitments.
	Automatic contract renewal after the first five years unless either party elects to terminate.