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10/25/2007 2007 Cancer Center Business Summit
Diverse Perspectives. A Common Goal. The Cancer Center Business Summit is a professional forum for exploring imperatives for success in the delivery of cancer care: clinical integration, business diversification and practice consolidation. The 2007 Summit brought together thought leaders from the financial and business community with the stakeholders in the delivery of cancer care to provide diverse viewpoints on the future business models for cancer care and how that future vision can be achieved.For more information, please contact Melissa Roth at mroth@foley.com.
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Foley Partner Michael L. Blau Opens Cancer Center Business Summit
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Foley Partner Michael L. Blau presented the Welcome and Introduction to the Cancer Center Business Summit. In his presentation, he provides context for the Summit by illustrating some of the key trends and business opportunities that are reshaping the cancer care marketplace.
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Cancer Center Business Summit Innovators Survey Results
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To provide baseline information for the Summit, we conducted the Business Innovators Survey. The survey was mailed to virtually every cancer care provider in the United States. It was designed to elicit information about innovative business practices in use today. Results of the survey were presented during this session including, what is a cancer center business innovation, what are the environmental market catalysts, and what are the common characteristics - distinguishing features.
Panelists included: Ronald Barkley, MS, JD, Executive Director of New Hampshire Oncology Hematology and Teri Guidi, MBA, FAAMA, President &CEO of Oncology Management Consulting Group.
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Architectural, Space Planning, and Development Process
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Many hospitals are considering new construction or renovation of older facilities to meet the increasing demand for cancer services resulting from the aging of the baby boomers. Patient centered, staff-friendly facilities that incorporate evidence-based design features that have been proven to have positive effects on patients and staff, happen only with careful planning and an educated design team composed of healthcare architects, staff, administrators, and patients. Often the nursing staff, administrators, and patients have no experience in design or in how the design influences operational processes. This session provided insights on not only healing environments, but the creation of an educated design team that recognizes the operational effects of design that will result in increased patient and staff satisfaction by focusing on patient centered design.
Panelists included: Myra Fouts, RN, MSN, OCN, CNAA, Vice President, Medical Affairs, Aptium Oncology, Inc. and Natalie Miovski, AIA, LEED, AP, Principal, Healthcare Practice, EwingCole.
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Buying, Selling, Merging, and Valuation
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This presentation focused on the business and legal considerations involved in determining fair market value for the purchase and merger of cancer centers and practices. Panelists explained the various approaches to determining fair market value, including the income approach and earnout issues, and described practical approaches toward obtaining a meaningful appraisal of fair market value that appropriately balances business and legal needs. Additionally, the session covered the implications of fair market value determinations in developing legal compliance strategies for the Anti-Kickback Statute, Stark Law, and tax-exempt status considerations. Panelists included: Chris E. Rossman, Partner, Foley & Lardner LLP and Daryl Johnson, Principal, HealthCare Appraisers, Inc.
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Business Models for Cancer Center Success
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Cancer programs of tomorrow will need to bring together and integrate an increasing array of disciplines, organizations, and treatment modalities to provide high-quality, cost-effective, and supportive care. This session, presented by Michael L. Blau, Chair, Health Care Venture Practice, Partner, Foley & Lardner LLP explored the business models by which various cancer care stakeholders can successfully collaborate. Examples of currently successful models for hospital-physician and hospital-hospital collaboration were discussed from a business, financial, and legal perspective.
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Cancer Center Innovators Roundtable
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This roundtable was comprised of nationally recognized leaders in cancer center development. They shared their success stories and lessons learned in the development of comprehensive cancer care centers in the United States and abroad. Moderator: Harvey D. Bickhoff, MPH, Chief Executive Officer, California Cancer Care, Inc.
Panelists: Peter G. Ellis, M.D., Director, Medical Oncology Network, UPMC Cancer Centers John Hennessy, Executive Director, Kansas City Cancer Center William M. Jordan, D.O., President & Chief Executive Officer, The Center for Cancer and Blood Disorders Ravi Patel, M.D., Medical Director, Comprehensive Blood & Cancer Center Lee S. Schwartzberg, M.D., FACP, Medical Director, The West Clinic
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Capital Markets Perspective
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This session, presented by Mitchell L. Kornblit, Managing Director, Shattuck Hammond Partners, focused on the recent trends relating to the financing of cancer center and related clinical businesses in the public and private capital markets. Topics included a consideration of the business plan and operating performance attributes that have contributed to successful financings and current capital markets’ perceptions regarding these businesses. In addition, the valuation multiples and methodologies relating to cancer center transactions was discussed.
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Community-Based Clinical Trials
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The critical path to improving health care is paved by clinical research, which has led to the development of new treatments that have saved lives and improved the quality of life for millions of individuals. Over the past decade, there has been a sharp increase in the number and array of health care providers and institutions conducting clinical research, ranging from traditional academic medical centers to individual physicians. Achieving success in clinical research, however, requires thoughtful planning, a fully integrated and efficient infrastructure, and an unwavering commitment on behalf of investigators and institutions. This session focused on providing insight on strategic planning and decision-making around clinical research, the importance of integrating clinical research into overall operations, and the actions necessary for the successful execution of clinical research projects. Panelists included: LaDale K. George, Partner, Foley & Lardner LLP; Brian Cornblatt, Ph.D., Director, Translational Research, St. Joseph Medical Center of Towson, Maryland; and Peter D. Eisenberg, M.D., FACP, California Cancer Care, Inc.
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Economic Implications of Advancements in Radiation Technology
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This presentation reviewed current radiotherapy facilities in the United States and treatment modalities, including niche modalities. The expanding variety of modalities were discussed, and the rationale behind these proposals. The clinical aspects of new modalities, purchasing considerations, and emotional and strategic issues were also reviewed. Panelists defined an economic decision formula for new technology, and discussed how this impacts the stakeholders in radiotherapy.
Panelists included: Anthony M. Berson, M.D., Radiation Oncology, St. Vincent’s Comprehensive Cancer Center and Richard Emery, Vice President, Aptium Oncology, Inc.; Executive Director, Trinitas Comprehensive Cancer Center.
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Financing Development and Expansion
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This session reviewed the options available to physicians, hospitals, and entrepreneurs in accessing capital to pursue cancer center initiatives. Panelists discussed how market participants are accessing the debt and equity markets to pursue their development goals. This session also reviewed the role of professional developers and management companies that have multiple “partnership” offerings available to help providers execute and navigate through the development and financing of their cancer center initiatives.
Panelists included: Grant R. Chamberlain, Managing Director, Shattuck Hammond Partners and Peter S. Myhre, Chief Executive Officer, MarCap Corporation.
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Innovator Case Studies: Academic Medical Centers
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This session included two case studies on Academic Medical Centers. Ambulatory Satellite Network Development: Dana-Farber Cancer Institute This case study, presented by Elizabeth A. Liebow, Vice President of Clinical Business Development, Dana-Farber Cancer Institute, described one academic medical center’s experience in developing a network of satellite clinics. The focus was on why Dana-Farber is developing the network, how it is going about doing so, and the process for selecting the locations and the community partners with which it is working. Specifically, the session focused on the partnerships between the AMC and community hospitals: What’s in it for the AMC, what’s in it for the community hospital, and what are the lessons learned? Case Study: UPMC Cancer Centers This case study, presented by Beth Wild Shiring, Vice President & Chief Operating Officer, Business Services, UPMC Cancer Centers, discussed the evolution of UPMC Cancer Centers’ hub and satellite network in Western Pennsylvania and beyond. The focus was on our key strategies associated with building a comprehensive cancer center network such as cancer service line management, strategic partnerships, and network-wide innovation.
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Innovator Case Studies: Community Hospitals
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This session included two case studies on Community Hospitals.
Case Studies: Cedars-Sinai Outpatient Cancer Center
This case study was presented by Paul R. O’Dea, Executive Director, Cedars-Sinai Outpatient Cancer Center at the Samuel Oschin Comprehensive Cancer Institute; Vice President, Aptium Oncology, Inc. The founding and evolution of the Cedars-Sinai Outpatient Cancer Center was discussed, including an examination of the organizational structure and physician participation. In addition, the market demographics and the challenges to success were assessed. And finally, the innovations undertaken to differentiate the Center in a highly competitive market were reviewed.
A “Clinical Operating System” for Today’s Cancer Center
This case study was presented by Angela Blackburn, Vice President, Clinical Operations, Mary Crowley Cancer Research Centers. Providing comprehensive patient care is becoming an increasingly challenging prospect for cancer centers. Centers have to keep pace with an array of new treatment options such as imaging technologies, radiation therapy options, clinical trials, translational therapies, to name a few. Indeed, due to the relatively modest efficacy of conventional chemotherapy, it is no longer possible to overlook these new treatment possibilities, especially the ones arising from investigative drugs in early phase clinical trials. It is critical for cancer centers to architect a centralized “clinical operating system,” an information systems platform that can enable timely data exchange between clinical systems (Electronic Medical Records (EMR), Lab, Clinical Trials, RT, PET, Scheduling) and provide role-based dashboards for administrators, practitioners, research nurses, and front office staff to support their decision making process.
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Innovator Case Studies: Oncology Networks
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This session included two case studies on Oncology Networks.
Cancer Clinics of Excellence (CCE), A National Affiliation: That Makes Sense for Community Oncology Practices
This case study was presented by Leonard A. Kalman, M.D., Chief Medical Officer, Cancer Clinics of Excellence. This presentation included a description of CCE, its history, structure, function, and what it has to offer to community oncology practices.
Catholic Health Initiatives National Oncology Research Network
This case study was presented by Alan Armer, Ph.D., Vice President, Research & Development, Catholic Health Initiatives. The Catholic Health Oncology Network is a nationally integrated clinical research initiative focused on advancing cancer care through clinical trials by Catholic Health Initiatives’ community hospitals and their affiliated physicians. Participation in this network enables our community hospitals to expand their efforts to locally offer patients access to high quality, leading-edge cancer studies. The ability to deliver large pools of protocol-eligible trial patients, trained investigators, and streamlined administrative processes makes Catholic Health Initiatives a highly attractive partner in the clinical development of new therapeutic approaches to treating cancer.
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Innovator Case Studies: Physician Practices
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This session included two case studies on Physician Practices. Case Study: New Mexico Oncology Hematology Consultants, Ltd. This case study was presented by Barbara L. McAneny, M.D., Chief Executive Officer, New Mexico Oncology Hematology Consultants, Ltd. One of the goals of New Mexico Oncology is to provide cancer care by making our practice indispensable to the local structure of health care delivery. It is necessary, but not sufficient, that the patients demand access, so our major focus is on providing patients with everything they want as well as need. We must also provide a diversity of services so that we are not as vulnerable to changes in payment. Our newest challenge is to preserve the economic viability of our referral sources.
Case Study: The West Clinic This case study was presented by Lee S. Schwartzberg, M.D., FACP, Medical Director, The West Clinic. The West Clinic is a multi-specialty group focusing on oncology, hematology, and other advanced medical care. The programmatic vision has always been to provide comprehensive state-of-the-art treatment in a patient-focused environment. Innovations supporting that vision include CT radiology beginning in 1989, MRI and PET scanning beginning in 2001, and a full array of interventional radiology services. Locally, the clinic coordinated innovative hospital-practice arrangements for specialized services such as genetic counseling and high-dose chemotherapy/stem cell transplantation. Commitment to research has always been a focus for the West Clinic as a flagship of ACORN, a national research network of over 30 practices conducting pharmaceutical Phase I-IV research utilizing a centralized model. Recently, the West Clinic merged with a leading cardiology group, in order to optimize imaging efficiencies and office space. Further, in 2006, the West Clinic opened its first international clinic, West Clinic Singapore. West Clinic Shanghai opens in October 2007. Our international operations strive to bring comprehensive Western oncology expertise to the emerging Asian market.
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Payor Perspective Roundtable
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This roundtable addressed several questions concerning how payments are handled today, followed by recommendations for improving the payment process in the future: - How do we address the differences in the level of payment by site?
- What issues do we have with Medicare payment?
- What issues do we have with the off-label use of pharmaceuticals?
- How should research be paid?
- How do we pay for survivorship, psychosocial issues, and end of life issues?
- How can we pay for cost effectiveness?
- How do we pay for quality?
- What is the patient responsibility for payment?
After the panelists addressed each of these questions, we posed the question, “If you could change payment policy, what would you do?” Moderator: - Peter D. Eisenberg, M.D., FACP, California Cancer Care, Inc.
Panelists: - Michael Kolodziej, M.D., Medical Director, US Oncology, Inc
- Lee N. Newcomer, M.D., Senior Vice President, Oncology, United Healthcare
- William Rogers, M.D., FACEP, Medical Officer, Office of the Administrator, Centers for Medicaid and Medicare Services
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Practice Consolidation, Aggregation, and Joint Ventures
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This session focused on business models for collaborative ventures between and among physicians, medical groups and/or practice management companies and capital partners to create coordinated, community-based, patient-centric cancer programs that provide a broad spectrum of oncology-related services. Panelists explored physician practice integration arrangements between medical oncologists (MOs) and radiation therapists (RTs), between RTs and urologists (or other specialists), and among MOs, RTs, medical specialists, and surgical specialists. Also discussed was physician staffing of community hospital programs, and the business and legal implications of practice management company arrangements. Panelists included: Michael L. Blau, Chair, Health Care Venture Practice, Partner, Foley & Lardner LLP and Anthony M. Berson, M.D., Radiation Oncology, St. Vincent’s Comprehensive Cancer Center.
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Surviving and Thriving in Your Evolving Market Situation
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Today’s climate for the provision of outpatient cancer care has become highly competitive. To succeed, it is vital to understand your market and to formulate strategies for achieving market dominance. This session, presented by Teri U. Guidi, MBA, FAAMA, President & CEO, Oncology Management Consulting Group, discussed how to assess your market: How large is it? What share do you and your competitors currently command? Where are the opportunities to leverage your strengths and where are there gaps that you can fill?
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The Next Generation of Health Information Technology Tools
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This panel discusses current oncology practices that have successfully implemented practice management, EMR, and billing. The panel is diverse with representation from administration, physicians and EMR project managers.
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The Quality Imperative, Pay-for-Performance
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Payors have clearly proven that hospitals that provide high-quality care also are the ones that are the most efficient and cost effective. Pay-for-performance (P4P) is a strategy to offer incentives to providers for delivering higher-quality care as measured by selected evidence-based standards and procedures. In its current form, P4P will reward the high performers not only with additional reimbursement but also with additional patient volume. This is in part due to its sibling policies of consumerism and transparency that are components of the Value Based Purchasing (VBP) policies that payors are adopting in the reimbursement of health care services. Panelists for this session included: Brett M. Hickman, Partner, Health Industries Advisory Practice, PricewaterhouseCoopers LLP; Michael N. Neuss, M.D., Oncology Hematology Care, Inc.; and Warren H. Skea, Ph.D., Manager, Health Industries Advisory Practice, PricewaterhouseCoopers LLP.
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