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IndianaCTSI - ResNetGerald Pan, Patty Lin & Andrew Fisher
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Summary of Current ResNet Operations
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• ResNet is a recruitment organization of approaching patients discuss research opportunities available to them
• No central office and RAs work in different clinics to recruit coming patients
• Investigators are charged on a “Per approach” basis
• ResNet meets a difficulty about how to increase efficiency of recruiting patients and how to cover cost
• ResNet needs a more acceptable and transparent billing process
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Current Patient Approach Process
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Patients don’tshow up
Patients are late by more than 15 minutes, doctors usually reject to meet them.
Patients’ information gathering
Consulting doctors about the suitability of recruitments
RAs approach patients to explain the contents of studies and ask if they are
willing to join
Rejection or Soft Rejection
Agreement Follow-up mails or calls
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Observations from Shadowing Visit
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• Many different situations can occur in the process of approaching patients, leading to an incredibly complex recruitment process that PI’s don’t fully understand.• Implication: PI’s need to be convinced of the complexity and it must be negotiated
into recruiting prices• RA’s are largely at the mercy of the clinics in which they work to recruit
patients• Implication: The working relationship between ResNet and the facilities where they
recruit needs to be preserved• A large amount of clerical work, coordinator work & traveling frequently take
up valuable recruitment time• Implication: In order to more completely cover costs, ResNet must more accurately
track & bill non-recruitment time
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Current Revenue Breakdown
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Revenues•Revenue based on per-approach fees charged by the number of approached without consideration of time-spent and eligibility
•Management Fees charged by multiple ratios depending on management & coordination effort
•Set-up Fees charged based on four levels of recruiting complexity
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Time Spent per Approach varies widely as well
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• Among studies with over 2,000 identified patients, most studies average less than 50 minutes of RA time per billable approach
• However, some studies take longer than an hour per approach, and at the extreme end take upwards of 5 hours per approach
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Revenue Analysis
• Using the per-approach pricing model at current negotiated rates, ResNet’s expected revenue from all currently on-going studies is $330,964
• If converted to per-enrollment, expected revenue decreases to $153,733• This means that investigators are overpaying by 115%, in aggregate
Revenue Projections at Current RatesComparison of Per-Approach and Per-Enrollment Models
Study NameApproached
PatientsEnrolled Patients
Current Billing Rate (Per
Per Approach Model
Per Enrollment Model
SRFit 499 292 52$ 25,948$ 15,184$ Zollinger (PEP) 163 85 51$ 8,313$ 4,335$ In-Peace 31 14 50$ 1,550$ 700$ RAPID 1186 586 50$ 59,300$ 29,300$ REACH 131 100 50$ 6,550$ 5,000$ CHIP 1757 566 47$ 82,579$ 26,602$ COMBO 697 334 47$ 32,759$ 15,698$ HIPPO 315 130 45$ 14,175$ 5,850$ HIP FIT 482 244 45$ 21,690$ 10,980$ PACT 1775 911 44$ 78,100$ 40,084$
Total 330,964$ 153,733$ Difference: 115%
*chart does not include startup or management fees, or billable clerical hours
Estimated Revenue
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Recommended course of action
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Train RAs On ConversionTechniques
• Ask high-performing RAs to train teammates on how to encourage patients to enroll if eligible; incentivize higher performance
Track Billable Clerical Hours
• RA’s should track billable hours on a per-project basis, which should be aggregated and charged to the study PI
Enrollment Pricing Model
• Charge higher rates on a per-enrollment basis – equitable to study PI
A la Carte Pricing Menu
• Capture revenue for follow-up, phone, and sensitivity requirements; the increase in effort by ResNet RA’s should be billed
Negotiate Higher Rates
• Aggregated data will provide PI with more transparency and reassurance of better resource utilization
Revenue Forecast• Employ Pricing Tool in negotiations, and to forecast overall
estimated revenue from a study
Training
Pricing
Finacial
Financial
Earlier Rate Negotiation
• Require study PI to begin rate negotiation process prior to submitting grant proposals – each study will require different rate
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Per-Study Revenue Forecast Tool
• Forecast revenue generation with pricing tool: Revenue Forecast
Study Inputs Associated FeesStudy Enrollees: 200 $13,000
Phone Component Yes $10,000Follow-up Yes $5,000Anticipated Study Time 4 $10,000Sensitivity Yes $5,000Expected Conversion Adjustment No $0Set-Up Fee B $1,500Program Manager Fee 10% $549
Per EnrolleeEntire Study
Total Study Recruitment Fees
$45,049$225
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Summary
1.ResNet’s recruitment is a labor-intensive process. Rather than reduce labor costs, raising revenues should be the main goal
2.Change the charging system to completely reflect the complexity of studies
3.Strengthen the link between cost and revenue