Looking for Solutions, putting it together, what is at stake?

Dakota Tribal Wisdom: When you discover you’re riding a dead horse, the best strategy is to dismount. However in healthcare, we often try other strategies with dead horses….:

-Authorunknown.ModifiedbyMedicManagementGroup,LLC

Healthcare version of Dakota tribal wisdom…..

1.Buyastrongerwhip.2.Changeriders.

3.Threatenthehorsewithtermination.

4.Saythingslike,“Thisisthewaywehavealwaysriddenthishorse.”

5.Appointacommitteetostudythehorse.6.Arrangetovisitothersitestoseehowthey

ridedeadhorses.7.Lowerthestandardssothatdeadhorsescanbeincluded.

8.Appointatigerteamtorevivethedeadhorse.

9.Ridethedeadhorse“outsidethebox.”10.Buyacommercialoff-the-shelfdeadhorse.

11.Createatrainingsessiontoincreaseourridingability.

12.Reclassifythedeadhorseas“living-impaired.”

13.Comparethestateofdeadhorsesintoday’senvironment.

14.Changetheautopsyreporttodeclarethat“Thishorseisnotdead.”

15.Killalltheotherhorses,sothisonewilllookthesame.

16.Namethedeadhorse“ParadigmShift”andkeepridingit.

Authorunknown.ModifiedbyMedicManagementGroup,LLC.

17.Ridethedeadhorse“smarter”notharder.

18.ChangetheDeadHorse’scompensationmodel.

19.Harnessseveraldeadhorsestogetherforincreasedspeed.

20.Doatimemanagementstudytoseeifthelighterriderswouldimproveproductivity.

21.Declarethat“Nohorseistoodeadtobeat.”

22.Callthedeadhorsea“jointventure”andletothersrideit.

23.Provideadditionalfundingtoincreasethehorse’sperformance.

24.Doacostanalysisstudytoseeifcontractorscanrideitcheaper.

25.Purchaseadditionaldeadhorsesandcallitan“integratedhealthsystem”.

26.Declarethehorseis“better,faster,andcheaper”dead.

27.Formaqualitycircletofindusesfordeadhorses.

28.Declarethat“Thishorsewasprocuredwithcostasanindependentvariable.”

29.GetthehorseaWebsite.

30.Promotethehorsetoasupervisoryposition.

4

A STORM IS COMING…..

…Called Consumerism

WHOSE VISION?

EHR

PatientInfo Data

PatientInfo

Lab Order

Lab Order

EHR

EHREHR

EHREHR

EHR

Referral

Referral RxRx

Hospital Info

Reports

Guidelines

PatientInfo

PatientInfo

Reports

Guidelines

PatientInfo

LabResults

X Ray Order

RadiologyReport

RadiologyReport

X Ray Order

LabResults

Do your patients really care if you are in an ACO, PHO or are a Medical Home?

Learnthisword:CONSUMERISM

MarkBertolini,ChairmanandCEOAetnacommentingonCVSmerger

We believe that this agreement further validates the important role that CVS Health's integrated and innovative pharmacy care model plays in today's health care system… …Strategy is to solve a need…patients are in the ‘system only 0.4% of the time…

•  CVS is in the community 85% of population within 5 miles of a CVS

•  Aetna in provider community…building open source patient centered community model

•  Forget Minute Clinic…forget current store model …No longer about Big Data…personal healthcare…’AAA triptik’

DRUG STORE - OR COMPETITION?

7

Mission, Sites, Services

Degree Of Business Integration

Impa

ct O

n C

ost ,

Qua

lity,

And

Pro

fitab

ility

Access to Capital

Joint Negotiations w/Payers

and Suppliers Shared

Operating Standards

Share Expertise Across Business Units

Rationalizing Care Sites & Delivery

Shared Clinical Systems

Triaging Patients

Across Sites

GROUP FORMATION FOR LEVERAGE

DEVELOPING EFFICIENCY THROUGH BEST IN CLASS OPERATIONS

REDUCING VARIATION AND MANAGING CARE

USE OF NEW TECH TO MONITOR

PATIENTS

WHAT ELSE?

RE-ENVISION YOUR PRACTICE

Lower Operating

Costs

SUCCESSFUL PHYSICIAN GROUP

1. DETERMINE HOW TO RUN YOUR BUSINESS BETTER

9

• Assemble an ‘A’ team

• Develop annual business plans, marketing plans and operating budgets

• Address any issues now

• Keep better records – Identify opportunities to maximize revenue and cash

– Reduce overhead via tighter expense control and considering outsourcing

2. INVEST IN NEW TECHNOLOGY – BE THE DISRUPTIVE PRACTICE

10

3. STUDY POSSIBLE MERGERS AND ACQUISITIONS THAT FIT YOUR BUSINESS MODEL AND HELP ACHIEVE YOUR GOALS

11

4. IDENTIFY HOW TO STAND OUT FROM THE COMPETITION

12

• Access

• Technology

• Sub-Specialties

• Procedures / Services

FINALLY, EXECUTE YOUR PLANS

13

You will need to make a choice…

Our challenge to you… Innovation Cocktail Hour

Findtwopeople,sharewhatyouseeasthe

future…