Clinical Co-Management Arrangements Presented by: Ted Clemans & Bill Clayton Guest Speaker: Steve Eisentrager

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1 Presented by: Ted Clemans & Bill Clayton Guest Speaker: Steve Eisentrager

2 Our Credentials Clark Schaefer Hackett (Accounting & Consulting Firm) Ted Clemans, is a Principal with Clark Schaefer Hackett and focuses his practice on physician hospital integration and is skilled at the specialty of negotiating and structuring physician support models. Ted has conducted numerous healthcare turnarounds. Bill Clayton, MBA is a Principal with Clark Schaefer Hackett and has more than 20 years of experience in healthcare management with responsibilities ranging from Systems Implementation Engineer to Chief Operations Officer. Bill s focus is on turnaround management and compensation models.

3 Our Credentials Manage Independent and Hospital Owned Medical Groups Conduct Valuations for Healthcare Entities Negotiate Physician Compensation Programs Implement and Manage Co-Management Programs Conduct Operational Turnaround for Healthcare Entities Coordinate Audits, Tax Management and Outsource Accounting Placement of Key Staff (CEO, CFO and Practice Managers) Conduct Revenue Cycle Improvement Programs Conduct and Review 990s Implement Accountability (benchmarking) for Healthcare Entities Business Advisors / Strategic Partners for our Clients Turnaround Management

4 Special Guest Steve Eisentrager, M.B.A. & President Steve Eisentrager is the President of Ohio Valley Surgical Hospital. Steve has been in healthcare for over 25 years focusing on surgical centers and hospital operations. Steve has a diverse background which includes financial management, revenue enhancement and operational improvements.

5 Clinical Co-Management Description Physician Management Management Agreement Matrix / Benchmarks Target Goals (Base Plus Incentive) Payment for Participation Traditional Examples: Cardiac area GI Center

6 Physician LLC Co- Management Agreement Hospital Finance Strategy Operations Efficiency Quality

7 Step One Environmental Need Please give us the assessment of why in your situation you found the need to create and implement a Clinical Co-Management Arrangement for your physician community.

8 Step One Environmental Need Need to tie in the physicians Expand services Increase the clinical strength Have first hand provider input to improve services Compensate the physicians for input / management Decrease market fragmentation

9 Step Two Optional Models Available What models / structure did you consider when going through your review of potential options to have greater integration of your physician community?

10 Step Two Optional Models Available PHO IPA Ownership / Employment Outside Partners Lease Model

11 Step Three Site Visits / Review of Models What discovery and research did you do in reviewing your potential options for greater physician integration?

12 Step Three Site Visits / Review of Models Small committee of physicians Site visits Selected PCPs

13 Step Four Market & Operational Need What process did you go through to discover your need for the operational focus?

14 Step Four Market & Operational Need Input of area physicians Market opportunity/assessment Physician needs assessment Service gap analysis

15 Step Five Business Plan How did you go about creating the business plan for your Clinical Co-Management program?

16 Step Five Business Plan Two Major Forces Service Need Management Support / oversight Design of program via surveys and discussions

17 Step Six Operational Implementation / Execution Please describe how you implemented your Clinical Co- Management Arrangements and your service line?

18 Step Six Operational Implementation / Execution Developed vision Developed goals and timelines Management engineering throughput program Physician input Routine evaluation versus one-time event management

19 Step Seven Draft Management Agreement How did you develop the management agreement for the physicians to oversee the service line?

20 Step Seven Draft Management Agreement Management and governance structure Quality structure Matrix structure Fees

21 Step Eight Valuation Process What process did you go through to have a valuation conducted insuring fair market value for the Clinical Co- Management Arrangement?

22 Step Eight Valuation Process Reasonableness guidelines Services & proposed compensation terms Market reasonableness assessment Valuation qualifications

23 Step Nine Matrix / Incentive system Describe your incentive goals and how you developed the goals?

24 Step Nine Matrix / Incentive system Patient satisfaction Physician services survey Test results compliance Others

25 Questions? THANK YOU! Ted Clemans Bill Clayton, MBA Thank you to Steve Eisentrager!

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