1. The ICC Business Plan: Implementation, Challenges, Successes Paul Gionfriddo June 2003

2. Session Outline ICC Business Plan. Process for selling the plan from the top level to the front line (3-part sell). Process for implementing the business plan. Challenges & successes. Learnings & recommendations.

3. The Business Plan Business Objectives Differ from ICC Mission/Objectives. ICC Business Plan Acknowledged and Addressed Risks to Members. Business Plan Incorporated Marketing Strategies. Business Plan Identified Sources of Sustaining Revenues.

4. Business Objectives Differ from ICC Mission/Objectives ICC Mission: Affordable access to quality health care for all residents of Williamson, Travis, and Hays Counties. Business Objectives (2001): To reduce costs to ICC members for caring for the medically indigent, through collaborative initiatives. To support and help launch a funding initiative for safety net health care providers by 2004. To generate annual income of up to $1 million for ICC operations by 2004.

5. ICC Business Plan Acknowledged and Addressed Risks to Members Loss of brand identity. Loss of control of patient data. Loss of services. Loss of revenue and market share in reorganized system. Increase of market share without increased revenues. Loss of values.

6. Business Plan Incorporated Marketing Strategies Adoption of Communications Plan and Strategies for reaching patients, providers, and public. Development of ICC Logo, and “I-Care” program aimed at patients. Development of mass media messages for public. Implementation of Web-based communications strategies for partners.

7. Business Plan Identified Sources of Sustaining Revenues (in order): Partner contributions from reduced costs of doing business (leads to business rationales). Foundation grants and awards. Government grants. HFD Funding (if approved by voters). Fees for use of services and aggregate databases. Self-sustaining MPI/CDR program through fees and/or assessments.

8. Process for Top Down and Bottom Up Sale Board Committees – (e.g. Fast Track Implementation Team (FIT), Legal Team, Pharmacy Committee) One-on-one and Training (Medicaider) CEO Representation Manager/Business Owner Buy-In Front Line Staff

9. Process for Implementation of Business Plan Grant objectives aligned with business objectives. Development of value props and business rationales for and by members. Productive use of outside parties (e.g. HFD, Travis County Medical Society). In bad times, it’s about leveraging resources.

10. Challenges The Plan wouldn’t mean anything unless it actually (and accurately) described the business activity of the entity. It isn’t the strategic plan. Before developing the plan, Board and staff needed to agree on what we wanted to happen, and what we would do to get us there. We needed to keep the Business Plan in focus. The ICC and its members had to write clear, concise value propositions. We needed a business rationale for each major initiative.

11. ICC Sample Value Props. Effectively channel more patients into funded sources reducing the overall proportion of self pay patients. Reduce the number of ambulatory care sensitive admissions to local hospitals by providing preventive care, chronic disease management, and a broad range of protocols and pathways for persons with asthma, diabetes, and other conditions.

12. ICC Business Rationales One Page Outlines: Summary. Rationale for the Initiative. Development Costs. Ongoing Costs. Return on Investment.

13. Successes Sticking to the plan enabled us to focus our efforts and develop our Big Five: MPI/CDR; Common Eligibility; Disease Management; New Access Initiatives: Project Access, Seton Care Plus, MAP Expansion; Pharmacy to meet Business Objectives 1 and 3 (Support for members and support for the ICC). Sticking to the plan enabled us to recruit others to carry the ball on HFD funding (i.e., the ICC was not going to morph into a political action committee) to meet Business Objective 2 (Support for a HFD).

14. Focusing on Members: Quantifying Success “Big 3” members planning for core support for ICC in 2004, 2005. ICC members have pledged $100,000 to Medicaider. 340B expansion identified for 700 MHMR Clients. 340B opportunity found for 1-2 more DSH hospitals. 15-20% of uninsured patients are Medicaid eligible. Value of Project Access donated care to be calculated.

15. Learnings and Recommendations Align Business Plan with Strategic Plan and Vice-versa. Develop the Business Plan as the plan for sustainability. Create and quantify business rationales for every major business “activity.” Stick with what you do – not with which you don’t (e.g. outreach, Promotores).

16. ICC Quick Stats, May 2003 Number enrolled Providers Participating MPI/CDR 136,17812 Common Eligibility 6,22911 Disease Management 4045 Project Access 48562 physicians Seton Care Plus 4,557Seton MAP Expansion 2,756City of Austin Pharmacy n/a