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© 2 0 1 9 C a r d i o v a s c u l a r I n s t i t u t e o f t h e S o u t h , A l l R i g h t s R e s e r v e d .

Journey to an OISDavid Konur, FACHEChief Executive Officer

OEIS Conference, St. Petersburg, FLApril 6, 2019

Craig Walker, MDFounder, CMO

© 2 0 1 9 C a r d i o v a s c u l a r I n s t i t u t e o f t h e S o u t h , A l l R i g h t s R e s e r v e d .

Disclosures

Nothing to disclose

© 2 0 1 9 C a r d i o v a s c u l a r I n s t i t u t e o f t h e S o u t h , A l l R i g h t s R e s e r v e d .

Healthcare Reform in the News

Harper’s Magazine

October 1960• “The crisis of the uninsured”• “Soaring cost”• “Over-utilization of services”• “Find something to replace fee-for service

system”

© 2 0 1 9 C a r d i o v a s c u l a r I n s t i t u t e o f t h e S o u t h , A l l R i g h t s R e s e r v e d .

Over

700Staff

Employees*Over 800 Total

Over

40NPs

Over

60 Physicians

• Clinics: 242,053• Hospital: 80,002• Telecardiology: 814

Patient Visits = 322,055*

Hospital Procedures = 27,301*• Includes Cath Lab & EP

25 Locations

*Telecardiology & Clinics

2States

*LA & MS Visits & Procedures: February 1, 2018 – January 31, 2019

CIS Today

© 2 0 1 9 C a r d i o v a s c u l a r I n s t i t u t e o f t h e S o u t h , A l l R i g h t s R e s e r v e d .

CIS Markets

• 18 Clinic Locations • 7 Telecardiology Programs

© 2 0 1 9 C a r d i o v a s c u l a r I n s t i t u t e o f t h e S o u t h , A l l R i g h t s R e s e r v e d .

We Believe Size Matters

“To determine our destiny”

© 2 0 1 9 C a r d i o v a s c u l a r I n s t i t u t e o f t h e S o u t h , A l l R i g h t s R e s e r v e d .

We touch a patient every minute of every day

© 2 0 1 9 C a r d i o v a s c u l a r I n s t i t u t e o f t h e S o u t h , A l l R i g h t s R e s e r v e d .

Physicians rarely invest in innovation until there is a proven payer source

© 2 0 1 9 C a r d i o v a s c u l a r I n s t i t u t e o f t h e S o u t h , A l l R i g h t s R e s e r v e d .

© 2 0 1 9 C a r d i o v a s c u l a r I n s t i t u t e o f t h e S o u t h , A l l R i g h t s R e s e r v e d .

© 2 0 1 9 C a r d i o v a s c u l a r I n s t i t u t e o f t h e S o u t h , A l l R i g h t s R e s e r v e d .

Published - January 18, 2016

© 2 0 1 9 C a r d i o v a s c u l a r I n s t i t u t e o f t h e S o u t h , A l l R i g h t s R e s e r v e d .

Current Hospital Partners

1. Terrebonne General Medical Center – Houma, LA (1986)

2. Opelousas General Medical Center – Opelousas, LA (2003)3. Lane Regional Medical Center – Zachary, LA (2006)

4. Lady of the Sea General Hospital – Galliano, LA (2009)

5. Lafayette General Medical Center – Lafayette, LA (2011)

6. St. Martin General Hospital – Breaux Bridge, LA (2012)

7. Thibodaux Regional Medical Center – Thibodaux, LA (2013)8. University Hospital and Clinics/LSU – Lafayette, LA (2013)

9. Baton Rouge General Medical Center – Baton Rouge, LA (2015)

10.Abrom Kaplan Hospital – Kaplan, LA (2016)

11.Acadia General Hospital – Crowley, LA (2016)

12.Anderson Regional Medical Center – Meridian, MS (2017)13.Jennings American Legion Hospital – Jennings, LA (2017)

14.Allen Parish Hospital – Kinder, LA (2018)

Co-Management and/or Telecardiology Agreements

© 2 0 1 9 C a r d i o v a s c u l a r I n s t i t u t e o f t h e S o u t h , A l l R i g h t s R e s e r v e d .

Consumerismis Changing Healthcare

• High Deductible Plan• Forcing Consumers to Shop– Accessing Online Medical Services– Biometric Use Skyrocketing– Internet and Awareness

• “I want, What I want!”• I don’t want to go to hospital if I have a Choice!!

© 2 0 1 9 C a r d i o v a s c u l a r I n s t i t u t e o f t h e S o u t h , A l l R i g h t s R e s e r v e d .

Driving Forces

Physician Perspective• Frustration w/Hosp. Policy• Road blocks to Teaching• Patient Expense/Experience• Inventory Selection• Staffing/Processes

Management Perspective• Frustration w/Hosp.• Recruiting• Competitive Advantage• Financial Diversification• Capital Decision Making

© 2 0 1 9 C a r d i o v a s c u l a r I n s t i t u t e o f t h e S o u t h , A l l R i g h t s R e s e r v e d .

OBL Opened in May 2017- Treated 1,517 Patients- Performed 4,075 Procedures

© 2 0 1 9 C a r d i o v a s c u l a r I n s t i t u t e o f t h e S o u t h , A l l R i g h t s R e s e r v e d .

© 2 0 1 9 C a r d i o v a s c u l a r I n s t i t u t e o f t h e S o u t h , A l l R i g h t s R e s e r v e d .

© 2 0 1 9 C a r d i o v a s c u l a r I n s t i t u t e o f t h e S o u t h , A l l R i g h t s R e s e r v e d .

© 2 0 1 9 C a r d i o v a s c u l a r I n s t i t u t e o f t h e S o u t h , A l l R i g h t s R e s e r v e d .

© 2 0 1 9 C a r d i o v a s c u l a r I n s t i t u t e o f t h e S o u t h , A l l R i g h t s R e s e r v e d .

OBL Procedure Mix 2018

47%

19%

9%

7%

6%

6%5%

2018 OBL Procedures

Peripheral Arterial Diagnostics

Arterial Atherectomy Only

Arterial Atherectomy & Stent

Arterial PTA

Peripheral Venous Diagnostics

Venous Stent

Arterial Stent Only

88% Peripheral Arterial – 12% Venous

© 2 0 1 9 C a r d i o v a s c u l a r I n s t i t u t e o f t h e S o u t h , A l l R i g h t s R e s e r v e d .

All Procedures

3,291

3,046 3,131 2,939

3,775 3,7984,051 3,943

3,8154,023

3,508 3,586 3,651

0 0 0 0 0135

356487 553

686 626 681551

0

500

1,000

1,500

2,000

2,500

3,000

3,500

4,000

4,500

Qtr 1 2016

Qtr 2 2016

Qtr 3 2016

Qtr 4 2016

Qtr 1 2017

Qtr 2 2017

Qtr 3 2017

Qtr 4 2017

Qtr 1 2018

Qtr 2 2018

Qtr 3 2018

Qtr 4 2018

Qtr 1 2019

Hospital vs. OBL All Procedures

Hospital CIS OBL Linear (Hospital)

© 2 0 1 9 C a r d i o v a s c u l a r I n s t i t u t e o f t h e S o u t h , A l l R i g h t s R e s e r v e d .

Peripheral Procedures

406

294

403 396

330

398

487444 462

602

485

419

505

0 0 0 0 0

135

356

487

553

686

626

681

551

0

100

200

300

400

500

600

700

800

Qtr 1 2016

Qtr 2 2016

Qtr 3 2016

Qtr 4 2016

Qtr 1 2017

Qtr 2 2017

Qtr 3 2017

Qtr 4 2017

Qtr 1 2018

Qtr 2 2018

Qtr 3 2018

Qtr 4 2018

Qtr 1 2019

Hospital vs. OBL Peripheral Procedures

Hospital CIS OBL Linear (Hospital)

© 2 0 1 9 C a r d i o v a s c u l a r I n s t i t u t e o f t h e S o u t h , A l l R i g h t s R e s e r v e d .

Patient Satisfaction

OBL

© 2 0 1 9 C a r d i o v a s c u l a r I n s t i t u t e o f t h e S o u t h , A l l R i g h t s R e s e r v e d .

The Future of OIS

© 2 0 1 9 C a r d i o v a s c u l a r I n s t i t u t e o f t h e S o u t h , A l l R i g h t s R e s e r v e d .

Houma Market-Hybrid OIS

© 2 0 1 9 C a r d i o v a s c u l a r I n s t i t u t e o f t h e S o u t h , A l l R i g h t s R e s e r v e d .

Houma Market-2 Cathlabs

© 2 0 1 9 C a r d i o v a s c u l a r I n s t i t u t e o f t h e S o u t h , A l l R i g h t s R e s e r v e d .

Houma Market

Corindus

© 2 0 1 9 C a r d i o v a s c u l a r I n s t i t u t e o f t h e S o u t h , A l l R i g h t s R e s e r v e d .

Conclusions

• OIS’s Raise the standard of care– Provide greater access to care– Improved outcomes– Lower cost– More convenient– Do not cannibalize hospitals

• Coronary space is next

“Which is what our patients want and is in line with the Healthcare Debate since at least 1960!”

© 2 0 1 9 C a r d i o v a s c u l a r I n s t i t u t e o f t h e S o u t h , A l l R i g h t s R e s e r v e d .

Thank you!

David Konur, FACHEChief Executive Officer

Craig Walker, MDFounder, CMO

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