UNPARALELLED HEALTHCARE

LEADERSHIP, EXPERIENCE AND

INTEGRITY!

ANTHONY E. FANELLI

“The task of the leader is to get his people from where

they are to where they have not been.” ~Henry Kissinger

The Patient Comes First: Commitment to the “Voice of the Customer”

“A customer is the most important visitor on our premises; he is not dependent on us. We are dependent on him. He is not an interruption to our work. He is the purpose of it. He is not an outsider in our business. He is part of it. We are not doing him a favor by serving him. He is doing us a favor by giving us the opportunity to do so.”

- Mahatma Gandhi

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My Leadership Mission Statement I am a healthcare executive that tactfully challenges my audience. I tailor my messages through value-based & disruptive solutions that inspire emotion, builds consensus, and drives stakeholders to act. Today’s sales environment is more complex than ever. Selling is not about building relationships. It is about the nature of the relationships. Sales experience drives the majority of customer loyalty. I TEACH FOR DIFFERENTIATION, TAILOR FOR RESONANCE & TAKE CONTROL!

Also, as a front-line leader, I am the fundamental link between roadmap strategy, consensus and execution. World-class managers today are defined not just by their ability to coach the “known,” but by their ability to innovate around “unknown obstacles.” In essence I identify the economic drivers that will arm customers with the data or information to back up assertions and provide knowledge-based solutions that optimize decision making, improve health outcomes, reduce treatment costs, mitigate risk, penetrate new markets, and maximize TRIPLE AIM ROADMAPS FOR HEALTCARE.

Another great trait that all great leaders share is a desire to continue to learn from other great leaders and refine their best practices. Embrace change and be adaptable. Discipline and self-control are crucial. “There is no elevator to success. You have to take the stairs.” ~ Zig Ziglar

I am assertive and direct in my management style, but very considerate of people. Many of my associates have realized that my frankness is one of my greatest strengths. It fosters open and honest interactive communication that spawns collaborative creativity and reinforces innovative behaviors that find better ways to advance a deal and drive productivity. I embrace my role as a coach with a passion and proactively build bench-strength. I have a hands-on management style and work in the trenches with my team. I am never more than one step away from my customers.

As a mentor, I understand the uniqueness of each of my direct reports and relate to them in a way that helps each person flourish by creating developmental opportunities and continuously assess performance and skill growth over time. I gauge progress through field travel, pre/post call preparation, weekly conference calls, quarterly meetings, team-building activities, sales achievement/territory management metrics, performance evaluations, and professional assessment tools. During my progressive leadership career, I have built, mentored, and motivated diverse high-performance sales teams with zero percent voluntary attrition. Proudly, my direct reports earned over 30 national and business unit sales performance awards. Coaching isn’t just a huge driver of sales performance – it’s also a major factor in employee retention and extra effort.

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Leadership: Unite, Lead and Deliver • Embrace role as a COACH with a passion – provides an

honest, open and encouraging environment that fosters communication and creativity

• Proactively builds bench-strength

• Liaison between clients, sales and operations

• Provide tools for success

• Cross-functional ingenuity

• Hands-on management style – work in the “trenches” with my team

• Never more than one step from the customer

• Leads by example

• Visionary and out-of-the-box strategist

• Team player and persuading conductor

• Bottom-line and big picture oriented

• Always one step ahead of the challenge and two steps ahead of the competition!

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The Eleven Critical Qualities of Leadership: My Daily Mission!

1. Unwavering Courage

2. Self-Control

3. A keen sense of justice

4. Definiteness of decision

5. Definiteness of plans

6. The habit of doing more than paid for

7. A pleasing personality

8. Sympathy and understanding

9. Mastery of detail

10. Willingness to assume full responsibility

11. Cooperation

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The Health Care Continuum & Personalized Medicine

Personalized Medicine Is…

Personalized medicine is a multi-faceted approach to patient care that not only improves our ability to diagnose and treat disease, but offers the potential to detect disease at an earlier stage, when it is easier to treat effectively. Health Information Technology is a key enabler and potential accelerator of the successful adoption of personalized medicine. The full implementation of personalized medicine encompasses the 7 phases of the Health Care Continuum denoted below:

Risk Assessment: Genetic testing to reveal predisposition to disease

Prevention: Behavior/Lifestyle/Treatment intervention to prevent disease

Detection: Early detection of disease at the molecular level

Diagnosis: Accurate disease diagnosis enabling individualized treatment strategy

Treatment: Improved outcomes through targeted treatments and reduced side effects

Management: Active monitoring of treatment response and disease progression

Integration of Information:

Seamless and rapid flow of digital information, including genomic, clinical outcome, and claims data

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Attractive Market: Healthcare Growth Drivers • Aging population, growth & longer life expectancies – 65 and older

population will double to 70M by 2025.

• Alzheimer's disease and other dementias will grow each year as the U.S. population age 65+ continue to increase. By 2025, the number of people age 65 and older with Alzheimer's disease is estimated to reach 7.1 million — a 40 percent increase from the 5.1 million age 65+ affected in 2015.

• Chronic disease growth rates – cancer, diabetes, CVD, and COPD.

• Post-acute care industry expansion.

• Healthcare Reform, Value-Based Care, Triple AIM Roadmaps, PCMH, CMS requirements, and DSRIP Waivers.

• Industry consolidation

• Key managed care relationships

• Population Health Analytics & HIT adaptation

• Alternative Delivery Models & Care Delivery Systems

• Escalating opiate, substance and alcohol abuse among teens, adults, and special populations.

• Advances in genomics & personalized medicine

• Pharmacogenomics / companion diagnostics

• Cost pressures will reward lower cost and more efficient providers

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Integrated Delivery Network: The Ultimate Delivery Model Objectives of Integrated Delivery Networks • Quality Improvement and Cost Reduction:

• Reducing administrative/overhead costs

• Sharing risk

• Eliminating cost-shifting

• Outcomes management and continuous quality improvement

• Reducing inappropriate and unnecessary resource use

• Efficient use of capital and technology

• Consumer Responsiveness:

• Seamless continuum of care from “Womb to Tomb”

• Focus on health of enrollees

• Expand footprint and increase access to providers and services

• Community Benefit:

• Improvement of community health status

• Addressing the prevention of social issues which affect community health – HIV, substance abuse, infant mortality, child abuse, aging & high risk populations

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Current Trends of Integrated Delivery Networks • Purchasing PCPs to capture patients in order to increase revenue and utilization of

primary and ancillary service lines.

• Shortage of primary care physicians leading to increased care from PAs and NPs.

• Generate revenue and decrease costs – government and state incentive programs (Meaningful Use, Patient-Centered Medical Homes, Health Homes, DSRIP, Triple Aim Healthcare Roadmaps).

• Outcomes management and continuous quality improvement with increasing focus on clinical and population improvements over time through 4 main areas: Infrastructure Development (Process), System Redesign (Process), Clinical Outcome Improvements (Outcomes), and Population Focused Improvements (Outcomes).

• Revenue Cycle Management – billing claims to denial management.

• Implementing technology like Medication Therapy Management and other Population Health Analytics tools to proactively manage high-risk patients in order to reduce hospital stay and readmissions with improved outcomes.

• Core laboratories as the main hub of clinical diagnostic testing; all assays that can be performed in network must remain in network.

• Re-entering the health insurance market; heightened relationships with MCOs.

• Adopting and implementing EMR systems per the ARRA of 2009. Also upgrading HIS / LIS to achieve a plug-in model for seamless integration with practice workflow and future HIT and Telemedicine applications.

• Interfacing EHRs with RHIOs / SHINS per the ARRA of 2009 to facilitate a secure electronic exchange of clinical information among providers. Goal is to achieve true Connected Communities of Health Interoperability.

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Integrated Delivery Networks: My View From The Inside

• Migrating specialists to the EMR.

• Incentivized to provide personalized medicine and evidence-based preventive medicine across the Health Care Continuum.

• Patient Protection and Affordable Care Act to have a positive impact on PCP patient access in 2015 with a focus on the rural Medicaid populations. However, higher annual deductibles and co-payments will cause hospitals and other providers to intensify efforts to collect directly from patients.

• Shifting non-critical care patients from inpatient beds and EDs to outpatient and home care.

• Seeking products or services that will make their network best of breed and emulated throughout the region.

• Seamless network for the treatment of pain management, addiction medicine, agonist therapy, inpatient / outpatient care, and primary and behavioral health care integration initiatives.

• PCP as the hub of all relevant activity and responsible for the coordination of value-based, patient-centric, and community-based care.

• Pursuing strategic partnerships to mutually penetrate new markets, expand ancillary services, increase revenue and transform patient care through the adaptation of cutting-edge technologies.

• Looking for ease of use in terms of time and hassle saved as well as the highest quality and most compelling value.

• A “Patient First” approach through community focus groups and commitment to the “Voice of the Customer.”

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Integrated Delivery Networks: My View From The Inside, Cont.

Integrated Delivery Networks: My View From The Inside, Cont. • Direct to consumer marketing to expand footprint and provide the convenience of one-

stop-shopping throughout the network’s continuum of health care services and providers.

• Offers a wide range of Health Resources for the community from wellness programs to support groups to clinical trials in order to increase patient access and engagement.

• Shared service and purchase service agreements within and out of network to increase efficiencies and reduce redundancies and costs.

• Taking a proactive approach to HealthCare Reform; preparing for new Part D requirements, ICD-10 conversions, DSRIP, Triple Aim Healthcare Roadmaps, and future CMS metrics and policies.

• Times are tough for rural hospitals and officials in many states are looking at new models for healthcare delivery in rural areas. Anatomic pathology groups with contracts to serve rural hospitals will be affected by any changes in how rural hospitals are funded and operated. This problem is linked to the deteriorating finances of many rural hospitals.

• One suggested approach to replace the existing community hospital model for rural area is called a hybrid model. It is based on freestanding emergency departments (FSED) that have links to primary care providers. Such a care model would challenge clinical laboratories in the region to provide necessary medical laboratory testing to the freestanding EDs in rural communities.

• Ongoing FTE reductions are adversely affecting patient care.

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Integrated Delivery Networks: Partnerships = Pull Through Over the years, I have partnered with numerous IDNs.

• BayCare Health System

• Lee Memorial Health System

• HCA Healthcare

• IASIS Healthcare

• USF Health

• VA Sunshine Health

• Florida Rural Health Association

• Community Health Systems

• Tampa General Health

• Sarasota Memorial Healthcare System

• Lee Memorial Healthcare System

• NCH Healthcare System

• Orlando Health

• Florida Hospital Healthcare System

• Ocala Health

• Shands Healthcare

• Central Florida Health Alliance

• Health First

• University Community Health

• Rochester Health

• Catholic Health

• Kaleida Health

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Managed Care Organizations: Broaden Relationships With Managed Care Managed Care Experience • Aetna

• Amerigroup

• AvMed

• Beech Street

• Blue Cross Blue Shield

• Choice Managed Care (Workers’ Comp)

• Cigna

• Commercial

• CorVel (Workers’ Comp)

• Coventry Health Care

• Empire – NYS Employees

• Fidelis

• First Health (Workers’ Comp & Medical)

• First Service Administrators

• Focus (Workers’ Comp)

• Freedom Health

• Health First

• Health Options

• Health Choice

• Healthy Kids Florida

• Health Now

Managed Care Experience • Hernando County Government

• Hillsborough County Government

• Humana

• Independent Health

• Magellan

• Manatee Health Network*

• Medicaid

• Medicare

• Memorial Employee Health Plans*

• Pasco County Government*

• Pinellas County Schools*

• Rockport (Workers’ Comp)

• TRICARE

• UnitedHealthcare

• Univera

• WellCare

• Wellpoint

• NUMEROUS OTHERS

*denotes plans that I negotiated . The other

plans I have experience with, helped to set-up, implement

& manage compliance / leakage issues

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Health Care Reform = Opportunity Increased Access, Parity, Integration and Prevention

Health Reform Basics • The American Recovery & Reinvestment Act of 2009

• The Affordable Care Act of 2010

• Mental Health Parity and Addiction Equity Act of 2008

• Primary and Behavioral Health Care Integration

• Grants

• Health Homes

• Patient-Centered Medical Homes

• Eligibility & Enrollment – Medicaid and ACA Health Insurance Exchanges

• National Prevention Strategy

• Preventive Task Force

• Community Transformation Grants

• Prevention and Public Health Fund

• Prevention Services Covered Under the ACA

• Medicare Preventive Services Coverage

• Medicaid Preventive Services Financing

• Employer Wellness Programs

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Key Points Summary: My Value • Progressive and diverse healthcare industry

experience

• Proven producer and winner

• Versatile leader and team player

• P & L and territory management expertise

• Contract negotiation, implementation, compliance and leakage reduction acumen

• IT and connectivity proficiency

• Cross-functional leadership acumen

• Leadership Tools

• Growth & Retention Tools

• IDN Business Development Strategies

• Proactive approach to Health Care Reform

• Commitment to the “Voice of the Customer”

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