Specific examples of where we have produced tangible results for our clients include:

Clinical Integration: A 1,700 physician Independent Physician Association organization.

Scope of JHD Group Work: JHDG was retained to develop a business plan which would facilitate the rapid clinical integration necessary for this client to remain competitive in its markets. The planning and analysis involved assessing alternatives strategies, opportunities for partnership/collaboration with payors and hospitals, the role of an electronic Medical Record system, and how to best overcome internal and external hurdles in implementing the plan.

Results: The work resulted in a detailed analysis of alternative strategies with the risk and opportunities, a payback analysis from an Electronic Medical Record including the effect of CMS "Risk Adjusted" and "Pay-For-Performance". The plan has been approved by the Board and software selection is beginning.

Clinical Integration: An 800 physician independent Physicians Association organization.

Scope of JHD Group Work: This work involved developing a comprehensive business plan which focused on "Clinical Integration" as a market strategy, the selection of the software vendors and supporting technology vendors, the development of a detailed "Roll-out Plan", and the implementation of the systems in individual physician practices.

Results: The first phase of Business Planning, vendor selection, and roll-out planning was completed in 120 days with the Board approving the final plan. The JHD Group has subsequently been managing the implementation which has included developing the supporting infrastructure necessary to maintain an integrated EMR and Practice Management System for 800 physicians, setting the systems up, training the staff and physicians, modifying work flows and staff assignments, and implementing the systems in individual offices.

Clinical Integration: A large physician IPA, affiliated with a large hospital system.

Scope of JHD Group Work: JHD Group was engaged to evaluate the organization's strategy and develop an approach to achieve clinical integration. We subsequently recommended to the Board the implementation of a common Electronic Medical Record and Practice Management System linked to an operations improvement process in all the physician practices. Since that recommendation, a vendor has been selected and installed, the EMR and PMS have been implemented in multiple practices, and a number of operational improvements have been made enabling increased integration.

Results: With the systems in place, this IPA will be able to maintain its PPO contracting position, ensure the organization can continue to handle HMO risk (including Medicare), and ensure clinical integration for care delivery purposes.

Management Consulting: A hospital with more than 500 licensed beds.

Scope of JHD Group Work: JHD Group was engaged to formulate a strategy to clinically integrate the physician community using the hospital’s MSO and Practice Management Services. We led a planning process that will take the hospital’s Clinical Integration abilities to the next level and we are currently engaged to lead the implementation process.

Results: The work resulted in "unstagnating" roles and responsibilities between affiliated entities and moving forward with their EMR implementation with a larger scope and a greater sense of urgency.

Management Consulting: A large multi-specialty group practice operating out of multiple clinics in both a capitated and fee-for-service environment.

Scope of JHD Group Work: We were retained to manage a two year restructuring project with the goal of substantially improving the group’s market position, profitability, supporting infrastructure, and the tools to be used by the group to manage itself effectively. The scope of the work included market development, managed care contracting, medical/utilization management, infrastructure (i.e. accounting, financial reporting, billing, collection, etc.) development, clinic operations improvement, compliance, physician compensation, and staff development.

Results: In the first year of this program, financial controls were put in place, the management was restructured, medical/utilization management was upgraded, a marketing program was designed and implemented, urgent care treatment centers were opened, a managed care contracting strategy was developed and new contracts negotiated, revenue was increased by 8%, and costs were reduced by 10%.

Management Consulting: A large financially distressed multi-hospital system.

Scope of JHD Group Work: The JHD Group was engaged to lead in the restructuring of how over 800 physicians are managed and compensated. This work involves inventorying all of the physician's capabilities and arrangements; assessing capacity utilization and productivity, evaluating compensation methodologies arrangements; and developing an approach for rationalizing the physician capacity and assuring that the SVCMC system has the tools to manage physician cost.

Results: Over a four month period the project produced a detailed plan for physician restructuring including an organizational model, competitive compensations benchmarks, the outsourcing of selected services, and identified savings of over $13 million.

Management Consulting: A large orthopaedic group.

Scope of JHD Group Work: Our firm was engaged over 12 months to manage the entire practice and "turnaround" the financial performance of the organization. For the purposes of our engagement, the focus was to dramatically improve physician income, reduce the indebtedness of the group, and stabilize the operations while reducing the overhead of the group.

Results: Over the period of a year, we deployed 11 senior staff who, in aggregate, worked in excess of 6,000 hours and succeeded in:

• Reducing the overhead rate by over 8%
• Generating sufficient excess cast to fund a previously unfunded $1.2 million requirement.
• Increasing the collection rate 3% resulting in $1.5 million in incremental net revenue
• Increasing physician income in the aggregate by over $1.2 million.

Management Consulting: A large nationally recognized Academic Medical Center.

Scope of JHD Group Work: The JHD Group was engaged to assess the operational improvement opportunities in the Orthopedic and Pediatric Specialty Departments related to improving service to patients and increasing the efficiency and effectiveness of the ambulatory operation. The work involved surveying patients, referring physicians, staff and physician leadership; assessing data from finance and operations, and observing clinic operations.

Results: This work resulted in the identification of the major problem areas, and a detailed approach for restructuring the Department Clinic processes.

Practice Management: A 200 physician anesthesia group.

Scope of JHD Group Work: We were initially engaged to provide an efficiency and effectiveness evaluation, and were subsequently retained under a four year management contract. Under this contract, the JHD Group was responsible in managing all of the non-clinical operations of the physician group including, but not limited to, managed care contracting, billing and collections, accounting and finance, human resources, information systems, physician recruiting, compliance, scheduling, and market development. Our arrangement with the group followed a partnership model where we worked closely with the physicians in developing strategy and policy, and were entirely at risk for the results.

Results: Over a 3 year period, on a doctor adjusted basis, revenue increased 13%, overhead costs reduced to pre-1999 levels, and expenses reduced by 25 basis points (0.25%) per year. The organization and governance was also stabilized.

Practice Management: A large group of Cardiologists and Cardiovascular Surgeons with multiple clinics.

Scope of JHD Group Work: The JHD Group was engaged to manage this group of under a five year incentive based contract with our compensation directly related to improvements in physician income. During this relationship JHDG overhauled the billing and collection function reducing cost by 20 percent, replaced the practice management system, introduced CT scanning technology, developed a comprehensive reporting structure, recruited new physicians, and implemented a referral development program.

Results: Since our Business Partnership started, the practice has been stabilized the income of most of the physicians has increased significantly, and a number of competitive increasing initiatives have been completed.

Practice Management: A large multi-specialty physician group operating out of seven medical centers.

Scope of JHD Group Work: JHDG was engaged to restructure and manage this group over a three year period. The work involved separating the group out from a hospital system, re-organizing it into a multi-specialty configuration, negotiating new Union contracts and payor contracts including capitated agreements; organizing a network of sub-specialists; building from scratch a administrative infrastructure, developing a business and financial plan; and recruiting a management team.

Results: The group began operations in May 2006 without any interruption in service and is now on a program to merge in additional groups and grow market position.