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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.
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 clients 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 understand individual severity levels
of patients and complexity of diagnosis when more than one illness
is present.
Pendulum 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.
Physician networks
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 infra structure. 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.
Physicians 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 offered 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, the need to create 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 as they are market development
ventures and also strengthens the physicians and or hospitals 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.
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