Our Cancer Consultants are Experts in Medical and Radiation Oncology
Oncology Management Consulting Group is proud to offer a unique and wide range of creative options to support the needs of you, our client. Our services include traditional consulting engagements, interim management capabilities, mentoring of new administrators, educational sessions and so much more. For decades our experts have provided the finest professional services to oncology providers across the US in a variety of high-level positions. Our highly knowledgeable consultants are nationally recognized specialists that will assist your organization to achieve your business goals and to maximize your organizational performance.
So what differentiates us from our competitors? First it’s our flexibility of approach to each engagement and our sensitivity to the frequently conflicting pressures on oncology care providers. We know that you can do so much, but frequently you cannot do everything necessary to run your center. With our team of experts we can fit in, fill in or fully assist you any way you need us to, with solutions tailored to your very precise needs. OMC Group offers the leadership, vision, and collaboration that you need to adapt to and to succeed in the rapidly changing healthcare industry.
In this age of relentless change, new technologies and fierce competition, planning for 3-5 years out is paramount. OMC Group experts enjoy decades of experience in strategic planning supporting hospitals, health systems and practices in assessing current market position and crafting strategies to improve that position through growth and enhancement of facilities, programs, services, etc. Options for alignments, integration, partnerships and affiliations nearly always play a role in the strategic planning process, and these engagements often include specific pro-formas or ROI analyses developed by our highly experienced financial planners and forecasters. Our strategic plans serve as a framework for decisions and, in many cases for securing support and approval. The planning includes articulation of Mission and Vision, and identification of over-arching Goals accompanied by Measures to monitor success. The goals are then supported with Strategies and Objectives, with accompanying Next Action Steps.
Market Position Analysis – Strategic Initiatives – Business Plans – Implementation Plans – Industry Trends and Implications – SWOT Analysis – Mission and Vision
Comprehensive Revenue Cycle Reviews
Based on countless revenue cycle reviews that we have performed, cancer centers and practices are NOT receiving all payments that they are due. Many are also not compliant. The details involved in accurate and compliant billing and collections are numerous and the processes complex. Federal regulations and interpretations abound and changes are frequent and often confusing. In addition, every non-Federal insurance provider offers numerous plans, each with a separate set of rules to follow in order to receive payment. If the processes that lead to billing and collection of payment for services delivered are not finely tuned, the results can be financially devastating as charges are missed and claims go unpaid due to inaccurate documentation and billing.
OMC Group’s billing specialists maintain extensive, up-to-date experience in reviewing all components of the revenue cycle (for both radiation oncology and medical oncology) such as charge capture, charge entry, claims production, and collections, uncovering any and all opportunities to improve performance. Our clients tell us that OMC Group performs the most comprehensive and detailed reviews in the industry and these reviews regularly identify hundreds of thousands of dollars in missed charges and collections at institutions across the U.S. These exhaustive analyses are always accompanied by concrete, realistic and immediately actionable recommendations to remedy the causes.
Documentation and Charge Capture – Compliant Coding and Billing – Collections Processes – Staffing – Chart Audits – Charge Master/Superbill Review – Physician Evaluation and Management – Coding Education
As the U.S. population ages and hospitals and physician practices start experiencing markedly increased volumes, the need for well-defined processes becomes intense. Each step of the patient care process must be clearly defined, efficiently carried out, and all unnecessary redundancy eliminated. Space and staffing resources are all too scarce to lose any opportunity to maximize value and productivity throughout the center. All aspects of the process must be addressed as patients become more perceptive and more discerning. Exciting new concepts of care delivery are emerging and OMC Group specialists will assist you to maximize your ability to exceed the demands and expectations of your growing patient population.
Our experts will spend significant time with you and your team to assess in-depth your existing operations or to develop all-new systems as appropriate: from staffing, scheduling and documentation to charge capture and billing. We place particular emphasis on clarity of communication and ease of information flow as these are vital not only to efficiency and safety, but also to patient and provider satisfaction and ultimately to optimal financial outcomes.
Process Improvement and Redesign – Management / Organizational Structure – Staff Productivity and Recommendations – Patient and Staff Flow Analysis – Forms and Processes – Policies and Procedures – Capacity Maximization – Throughput Enhancements
Hospital/Physician Integration (Alignment)
Integration of services and care is vital in today’s health care environment. Our work in this arena includes bringing the stakeholders together with common goals that will benefit all, financial projections to estimate the likely outcomes of new relationship models, and implementation plans to move forward. The obvious benefit of these new relationships for hospitals and physicians is outweighed only by the advantages that they afford to your patients – allowing all providers to continue providing the highest quality care in a financially sustainable manner.
Working closely with physicians and hospital leadership, OMC Group specialists will help develop new models for relationships between the two. These situations are often politically charged, and ours is the only oncology-specific consulting firm with a nationally renowned, practicing oncologist and Certified Physician Executive on staff to bridge the political divide. Through a significant amount of face-to-face time with the key players and in-depth data analysis we help to bring the issues forward and then to resolve them, resulting in plans for joint efforts to maximize financial value and to keep interests aligned. Additionally, our team is expert in devising new agreements which permit better distribution of revenue and crafting appropriate employment agreements.
Partnership Options – Professional and Management Services Agreements – Co-management Agreements – Structure, Governance, Operations, Compensation – Financial Projections
Financial and Market Analyses
Making informed decisions requires due diligence: What is the best setting and structure for services, a physician-owned practice or a hospital outpatient department? What is the source of funding for new initiatives, service line revenue or capital investment? What growth potential exists and where? Such questions can be answered with rigorous financial and market analysis.
OMC Group has developed extensive proprietary tools and data sets which we combine with purchased and/or publicly available data, enabling OMC Group to assess the market in terms of demand and competition for various diagnosis groups and services, generally taking the data down to the zip code level for maximum specificity. In addition, our team includes several very senior and very talented professionals who have expertise in constructing virtually any type of financial analysis – from major equipment acquisition to practice mergers and new construction. These analyses provide our clients with the information necessary to select the most advantageous cost and reimbursement structure, to project the return on investment for large expenditures and to identify the source of funds to support on-going operations. Coupled with market analysis, multi-year pro-formas can be constructed for new businesses and to estimate the impact of increased volumes.
Comparison of Reimbursement in Varying Care Settings – Financial Analysis of the Complete Service Line – Industry Trends and Implications – Proforma for New Centers, New Services, New Businesses – Demand Analysis for Services – Market Share, In- and Out-migration Patterns – Projected Volumes for Services – Compensation and Employment Agreements
New Cancer Center Development
OMC Group enjoys significant involvement in countless projects to renovate, expand, or develop new facilities – both hospital-based and freestanding centers. We have taken a wide variety of roles, from working with clients on program planning (which programs and services should be included), space programming (the projections for square footage and programmatic/service adjacencies), and layout/design. We have found that most clients prefer to have the choice of developers, architectural and construction firms in order to select the best fit and pricing for that work. OMC Group also has relationships with numerous firms throughout the country and we are pleased to offer recommendations. In either case, we work hand in hand with developers, architects, construction firms, and the client’s own facilities/planning team, participating as advisors and reality checks throughout the process. Our consulting staff has experience with many models for facility design ensuring the appropriate combination of function and patient-focused results.
Infusion Centers and Radiation Centers – Specialty Clinics and Breast Centers – Services to be Offered – Program Planning – Facility Layout and Design – Demand Analysis – Volume Projections – Financial Pro-formas – Facility Space Planning – Operations Plans
Performance and Financial Benchmarking
Even the best-of-class cancer centers seek to continuously improve their performance. Benchmarking against one’s peers is an excellent way to identify opportunities to enhance efficiency, cost-effectiveness, and financial outcomes. There are numerous sources for such data, but few are specific to oncology. OMC Group has developed an extensive proprietary database with the capability of benchmarking virtually any area of a cancer center’s performance. Using our ground-breaking —National Oncology Benchmark Study, (NOBS)– we can compare your facility to other similar centers for countless data points – number of nurses needed for an infusion suite, number of radiation therapists needed for a radiation department, and so many more. This allows you to pin point efforts around staffing ratios and work-loads, physical capacity and throughput down to the diagnosis level.
Financial Benchmarking is also a powerful tool. Again combining our own proprietary data set and other external information and tools, we can benchmark costs and revenue against other similar centers and practices in terms of financial performance such as Staffing, Purchasing, Productivity, Physician Compensation, etc. This work provides you with the information necessary to identify any areas where additional focus can lead to improved financial results through actions such as renegotiating payer contract terms, change drug acquisition channels, or through process overhaul to streamline collections or to maximize staff efficiency for increased production.
Staffing and Skill Mix – Productivity Benchmarks – Utilization Analysis – Service Line Financial Contribution Analysis
Interim Leadership and Implementation
With recruitment for experienced administrators now taking as long as one year or more and training for in-house candidates being absolutely essential for success, the demand for experienced interim management professionals is soaring. OMC Group is the only oncology-specific consulting firm able to offer this unique support.
OMC Group’s interim specialists maintain a proven track record of success at cancer centers and oncology practices across the U.S. Their expertise includes recognized accomplishments in past permanent positions at multiple academic centers, community hospitals, small rural centers and physician practices of all sizes. These positions at hospitals have included; CEO, Vice-President, Division Director, and Director of Oncology Services and in physician practices they have included; VP Practice Operations, Administrator and Executive Director. An exceptionally significant aspect of our talent pool includes several nursing management specialists.
This notable wealth of talent easily translates to our distinctive ability to place these skilled executives – most with 20 plus years of healthcare expertise – into cancer centers and practices to maintain operations during recruitment of a permanent leader or during reorganizations to ensure a smooth transition. Our interim leaders have helped hospitals to attain American College of Surgeons Commission on Cancer accreditation, to reorganize into a service line structure, to establish multidisciplinary clinics, and more.
Turn Around Management – Interim Direction During Recruitment – Tools for Revenue Related Issues – Policies and Procedures – ACoS Readiness Prep – Marketing Plan Development – Critical Staffing Issues (incl. nursing) – New Service and Program Development – Mentoring – Implementation of Strategic Initiatives – Development of Multi-disciplinary Programs – Process Redesign