IndianaCTSI - ResNetGerald Pan, Patty Lin & Andrew Fisher

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

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

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

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

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

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

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

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

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