Rapid changes in the health insurance and financing area has created an opportunity for physicians and life sciences companies to work together in the measurement of quality and success.

Life science companies need accurate analysis of utilization of pharmacy use but also benchmark information on overall outcomes and comparisons of successful versus non-successful outcomes. This data may be used for scientific reports, research finds support or authentication, or as a feasibility test to determine best variables for analysis.
Pendulum offers these capabilities to sort through not just procedure level utilization but also case mix adjusted findings and the ability to see complexity trends that may help or compromise the actual scientific findings of a research project. Pendulum is represented at the health services research meetings and pharmacy research meetings.

On September 20 the National Institutes of Health announced its Roadmap for medical research over the next 10 years.

By harnessing the accelerating pace of discoveries being made in laboratories, the roadmap will "truly transform the way we do research " said Elias Zerhouni director of NIH.

The three focus areas include:

1. New Pathways to discovery: tools and techniques for understanding how disease work at the molecular level
   
2. Research teams of the future: includes a new funding program to encourage high risk but high return research in unexplored areas
   
3. Re-engineering clinical research; create a better network of academic medical centers and community based physicians that work jointly on clinical trials. The road map will receive 130 Million next year and 500 million by 2009.

Pendulums interest is in the area of working with primary care and specialty care physicians networks and coalitions as interdisciplinary teams to construct and monitor trials for new applications and innovation in medicine and in so doing further benchmarking information for payers and consumers regarding what works successfully in medical practice improvement.

PHYSICIANS

Pendulum assists physicians with ventures that help improve practice effectiveness as well as offer opportunities for practice growth and revenue.

A variety of strategies have surfaced and have been successfully implemented by large for profit driven companies that can be replicated by determined groups and networks of physicians at a local level. Areas such as: consolidated managed care contracting and billing through locally owned physicians MSO’s, design and development of physician owned banks, opportunities for malpractice coverage at reduced rates, creating of physician owned imaging centers, and development of specialty institutes for cardiology, orthopedics and oncology.

We have a special relationship with the American academy of family practice and the American Osteopathic Association who have referred us groups of family practice and primary care physicians to form groups and networks to support collective action on practice improvement.

What is Pendulums role?

First of all we are not a broker and are not buying practices but rather believe in the independence of physician practice. We believe that small groups of 6 to 12 physicians are more efficient than operating solos and partnerships. Why? Because as expenses eat away at practice revenue and as reimbursement gets more complicated, the thin margin of a small practice makes it vulnerable to acquisition by hospitals or other buyers.

This means that as the physicians consolidate they have a bigger margin, stronger staying power in the face of future changes and simply have better lifestyle as coverage for call, shared expenses and potential equity and annuity of a larger group becomes more attractive. Physician concerns are -- I want to make sure I am part of a quality group. How can you tell if this group has good outcomes without comparing them to other physician’s performance in the market? How do I know I can retain my insurance agreements if I join a different group? What is the competition charging? Is this group good at collections? If I am thinking of staring a smaller group what additional revenue streams are available?”

Pendulum answers these questions.

How is this done?

We have the duel strategy of helping physicians to look for revenue streams they may not have thought of as well as consolidating expenses.

Most payers are watching the federal government inpatient experiment to start paying hospitals on a performance basis. This projects prospective inpatient diagnostic cost groupings (PIPDCG) and will soon be followed by a physician version of DRG’s that intends to make all Medicare prospectively determined based upon diagnosis and severity. If you have data that can prove you have a sicker population you get higher pay rate.

The time to decide to get this information is not after the government or a private health plan suddenly publishes your practice on a list of substandard physicians in the newsletter. The time to prepare is right now, moving your quality standards as a group up a notch and begin monitoring trends so there are some patterns to your success in improving outcomes.