Pendulum provides management services for startup and expanding ventures owned by physician's, hospitals and employers.
Contractual Arrangements for Management Services
These can be long term contracts or short term transitional management agreements. These agreements are constructed like an employee leasing agreement with salaries and benefits set by the client but paid through a management fee paid to Pendulum. In cases where a startup company is cash poor but needs excellent management talent to get started, a commitment to Pendulum can be made to ease cashflow pressure but still give the client access to top notch experts in managing joint ventures, physician networks and community based health plans owned by physicians and employers.
Assistance with Capitalization
In some cases, Pendulum has assisted the client organization in obtaining capital to grow an existing company. In a startup, we have assisted the client in constructing the business plan that is then turned into an investment agreement for individual physicians to create a startup pool of dollars that is eventually matched by commercial sources of capital including investment houses, venture capital and commercial banks.
What Pendulum Brings
In addition to management talent and capital, Pendulum brings infrastructure in the form of superior medical management strength that is clinically based and directly managed by the client's medical directors.
Our system is a proprietary system that focuses its key objectives on successful outcomes. The old fashioned approach to measuring cost of units and volume of units of care does not document individual severity levels of patients and complexity of diagnosis when more than one illness is present.
Pendulum's Information systems capture both inpatient and outpatient data along with ancillary and pharmacy data and compares it to datasets in a given area to compare performance.
In today’s world of Pay for Performance having access to good clinical data that is severity adjusted and presented in the context of outcomes oriented research, gives the physicians and the hospital a strong argument against mass discounts and denials of care in the name of cost containment.
TYPICAL MANAGEMENT SERVICES AGREEMENTS
Independent Practice Associations that are moving toward an integrated network to leverage better pay and share expenses like malpractice and overhead expenses, can benefit from the management talent, capital and contracted infrastructure. We focus on medical management so local claims payers and health plans often are willing to work with us to better their satisfaction with employer clients. In many cases, employers would like to contract directly for multi-specialty and/or single specialty health services; Pendulum makes an excellent partner.
Physician Hospital Joint Ventures
Many early joint ventures failed due to lack of money and/or lack of focus on improving outcomes. There is even some residual suspicion today that prevents hospitals from working well with physicians on such things as imaging centers, cardiac labs, orthopedic hospitals and surgery centers. Pendulum can offer a buffer and allow combined billing charges to be made on a global basis using ETG’s that represent severity-adjusted episodes tied to diagnosis. This makes more dollars available, as the patient may be more complicated in their diagnosis. It also takes away all medical necessity challenges as the diagnosis fixes a package of services at a predetermined price, again tied to patient need, not the insurance company slide rule.
Community Based Health Plans
A reemergence in the local health plan has come as a result of strong downward pressure on fees and inflation of medical practice expenses. For the hospital and the physicians these provider based health plans offers a great local alternative to accrue patients and have input into reimbursement. The missing elements have been a technology solution to reward quality and a management solution to get and keep experienced health plan talent.
We think that as employers move away from the discount mentality and toward the need to assure themselves they are purchasing quality care, a new definition for the hybrid Community Health Plan can offer physicians and hospitals another chance to strongly influence the market, both in terms of Pay for Performance as well as generating a true return on investment for each successful step towards integrating the delivery of care.
The flexibility to outsource some aspect of building and operating your health care venture has always existed. What we offer is a package of services that generates income ( market development ventures) and also strengthens the physician's and or hospital's bottom line by being able to avoid large expenditures of cash for technology. Employers have been interested in direct contracting for years. As the market moves away from cost and discount agreements toward agreements for quality, these employers will influence health plans and, if they cannot, they will come directly to local hospitals and physicians IF they can prove they have a better product.