Re: Workers Comp: The real QUACKS!

Author Subject: Re: Workers Comp: The real QUACKS!
Parthenia Medical group Posted At 00:20:24 05/05/2001
Parthenia Medical Group:

Arcadia Management Services!

Ojai Valley Community Medical Group - Ojai, California

Mission City Community Network - North Hills, California

Parthenia Medical Group - North Hills, California

Copper Cities IPA - Bisbee, Arizona

Trudeau Health Systems - Saranac Lake, New York

Arcadian Provider Organization of Puyallup, Washington

Arcadian Management Services works with the following Health Plans (references available):

Aetna U.S. Healthcare
Arizona Physicians Independent Physician Associations
Blue Cross and Blue Shield Plans
Foundation Health Systems
PacifiCare Health Systems, Inc.
Partners Health Plan affiliate of Hum HealthCare Systems
Tower Health Plan
Secure Horizons

Arcadian Management Services received its initial capital through private investors including management.

In May of 1998, Arcadian Management Services raised additional capital through a Series A preferred offering. In addition to individual qualified investors, Acacia Venture Partners of San Francisco and Three Arch Partners of Menlo Park have participated in the financing. Arcadian Management Services anticipates raising additional capital as necessary for the expansion of its operations.

The Board of Directors consists of four investors including John Austin, MD, Chairman, Chief Executive Officer and President. Additionally the following are Directors of Arcadian Management Services, Inc.:

Terry Hartshorn
Director Terry Hartshorn has over 30 years of experience in healthcare. He is the immediate past Chairman of PacifiCare Health Systems, a position he has held since April 1993.

From April 1993 to January 1997, Mr. Hartshorn was President and CEO of UniHealth, a diversified healthcare company. From November 1975 to April 1993, he was President of PacifiCare Health Systems. Prior to 1975, he held various management positions in group practices and hospitals.

David L. Steffy
Director David L. Steffy joined Arcadian Management Services as a director in September 1996. Prior to his involvement with Arcadian Management, Mr. Steffy was a founder of two publicly-traded acute care hospital management companies, Community Health Systems and Republic Health Corporation, which were sold in 1995 and 1986, respectively, to private partnerships.

Mr. Steffy serves as a director of Intensiva Health Care, which operates seventeen long-term acute hospitals and is traded on the NASDAQ stock market. He has also served as a director of Province Health Care, which owns and manages small and medium-sized hospitals. Mr. Steffy currently serves as an instructor of at the University of California at Irvine.

Wilfred E. Jaeger
Director Wilfred Jaeger, M.D. is a founding General Partner of Three Arch Partners, a venture capital firm that focuses exclusively on health care investments. Prior to joining Three Arch Partners, he worked as General Partner with Schroder Ventures and The Phoenix Partners, focusing on medical investments.

Dr. Jaeger received his medical degree from the University of British Columbia in Vancouver, Canada. He practiced medicine for six years before earning an MBA from Stanford University. He serves on the Board of numerous private and public health care companies.

John H. Austin, M.D.
President and CEO John H. Austin, M.D. is President and Chief Executive Officer of Arcadian Management Services, Inc. Prior to joining the company in June 1997, Dr. Austin was President and CEO of UniMed, a physician management company based in Southern California.

From 1987 until 1992, Dr. Austin was Executive Vice President for Health Plan of America, a California HMO. From 1982 until 1987, Dr. Austin was with HealthAmerica, ultimately, as Chief Operating Officer a Nashville based HMO with over one million members.

Dr. Austin received his M.D. degree from the University of California in San Francisco, in 1970, a Masters in Public Health from Harvard University in 1972, and is Board Certified in Internal Medicine.

Cheryl Perkins, R.N.
Vice President of Health Services Cheryl Perkins is Vice President of Medical Services at Arcadian Management Services. She has over 15 years experience in the health care industry with more than 10 of those years focused on managed care. Prior to joining Arcadian Management Services in October 1997, Ms. Perkins was Senior Vice President of Operations of Cost Care Inc., a national utilization and case management company.

Prior to her tenure at Cost Care, Cheryl was Vice President of Utilization Management and Quality Assurance at Health Plan of America, Cheryl was responsible for development and implementation of state of the art utilization management and quality Management Services. Ms. Perkins received her Bachelor of Science degree in Nursing from California State University of Fresno where she graduated with cum laude honors.

Ken Zimmerman
Chief Financial Officer Ken Zimmerman is the Chief Financial Officer of Arcadian Management Services, Inc. Prior to joining Arcadian, Mr. Zimmerman was the Chief Financial Officer of Adesso Specialty Services Organization which managed physician networks in nine specialties. Prior to that, Mr. Zimmerman was Chief Financial Officer of Interactive Diagnostic Services, Inc., a radiology managed care company. Mr. Zimmerman also served as Chief Financial Officer of Merit Behavioral Care, a managed mental health company, where, during his tenure as CFO, the company grew from inception to over $300 million in revenues. At Merit, Mr. Zimmerman participated in the initial capitalization of the company, the IPO five years later, the acquisition of three competing companies and the eventual sale of the company.

Mr. Zimmerman has a BA in Economics and an MBA, both from Stanford University.

Jeffrey C. McManus, B.S., M.D.
Senior Medical Executive Jeffrey C. McManus, M.D., has been the acting Medical Executive of the Ojai Valley Community Medical Group (IPA) since 1988. He is responsible for development and implementing board approved policies and procedures relating to the provision of high quality, cost effective medical services to the patient population served by Integrated Health Management.

Dr. McManus received his undergraduate degree in Bio-Electrical Engineering from Loyola Marymount University and his Doctor of Medicine degree from the University of California Irvine. He is a Board Certified in Internal Medicine.

Chase S. Milbrandt, M.B.A.
Vice President of Business Development Chase Milbrandt is responsible for the development of Arcadian business opportunities; from the identification of markets suited for the Arcadian model, through the creation of fully-operational provider networks. Mr. Milbrandt is experienced in managed care environments including the development of integrated delivery systems, managed care strategy, risk contracting, and managed care information systems. He is versed in legal and operational issues relating to MSOs, PHOs, IPAs, and other similar organizational models. His experience also includes consulting with hospitals and physicians in vision-oriented strategic planning.

Chase Milbrandt joined Arcadian Management Services in October of 1998. Mr. Milbrandt received his Bachelor of Arts Degree in Business Administration from Pacific University, Forest Grove, Oregon, and his Masters of Business Administration from the University of Portland.

David Lontok
Vice President of Operations David G. Lontok is Vice President of Operations at Arcadian Management Services, Inc. He has over 10 years of managed care experience in IPA development, management and administrative operations. Prior to joining the company in October 1999, he was Associate Vice President for Heritage Medical Systems, a physician practice management company with a membership base of over 350,000 capitated lives and a multi-state provider network, including a Limited Knox-Keene licensed entity in California.

Prior to that, he served as Corporate Director of Operations and Business Systems at UniMed Management Services. He also served as Director of Operations at MedGroup Management, an MSO that managed seven IPAs with a combined membership of over 50,000 lives in the Southern California area. Prior to this, he was responsible for network development at several different PPOs including SMC/MedSense, PPO Alliance and the Admar corporation.

He received his Bachelor of Science degree in Biology from the University of California at Irvine and is working on his Masters in Public Health Administration at California State University, Long Beach.


Surviving or Thriving

Hospitals and physicians are feeling the aftershocks of dramatic changes in healthcare. Reimbursement is declining and patient volume is decreasing resulting in a loss of revenue to healthcare providers that is threatening access to care in non-urban markets.

The 1997 Balanced Budget Act and other legislative and regulatory changes have transformed the healthcare environment significantly for providers. Managed care arrangements are determining where patients are seen and by whom, often increasing the out-migration of services from these communities. In addition, traditional Medicare reimbursement is being cut back while funding for providers under risk contracting has increased. The result is a tremendous drive toward managed Medicare plans.

The market forces of commercial and public managed care plans are the future of healthcare. Managed care plans are entering small and medium-sized markets in order to provide the access to providers demanded by employers and Medicare. Success in these communities will depend on hospitals and physicians organizing to respond to, and benefit from, the opportunities created in managed care.

Providers Taking the Lead: Responding to the Managed Care Challenge

Small and medium-sized medical communities must find a way to respond to the challenges of managed care. To access the patients moving into managed care plans and retain the dollars generated through improved utilization of services, physicians and hospitals will need to create an effective provider organization that can manage global capitation contracts. With aligned financial and operational incentives, physicians and hospitals will improve access to care for residents, reduce out-migration of services and increase revenue for providers. In addition, a local, provider-driven organization will have increased leverage with health plans and local control of the healthcare services in the community.

In Partnership with Providers: Arcadian Management Services

Arcadian Management Services brings providers the necessary tools for developing and implementing a successful provider organization. Arcadian takes the administrative headaches out of capitation management allowing providers to take advantage of the recent changes in the 1997 Balanced Budget Act. We provide the resources, expertise and technology required to take advantage of the opportunity created from the transition from a fee-for-service model to capitated/risk environment. In partnership with physicians and hospitals, Arcadian Management Services builds the organizational structure and provides the administrative services for providers to "thrive" in the managed care arena.

A Vision for Managed Care

Arcadian Management is dedicated to organizing small and medium-sized providers to respond successfully to managed healthcare. Success will be measured by improved access to care, increased control for local hospitals and physicians, and the retention of healthcare resources in the community.

The Arcadian model for small and medium-sized healthcare is based on the following premises:

Success for providers must embrace an effective managed care strategy that includes participation in "global risk" heath plan contracting.
Success in risk contracting will require significant strategic and operational expertise for physicians and hospitals.
The result will be improved access to healthcare, reduced out-migration of services, and a medical community that will continue to meet the health care needs of the community.
Arcadian Management Services is a network of healthcare provider organizations. Each local provider network has dedicated resources, local governance and local medical management. The capital and resources necessary for managed care contracting are provided by Arcadian Management Services and the expert resources and sophisticated information technology necessary to ensure the success of providers.

As a part of a larger network, providers will realize the benefits of managed care through:

Increased leverage with health plans
Increased access to patients
Access to revenue generated by improved patient care management
Opportunity to coordinate care for patients in and out of the service area

Retention of local control of medical management

Arcadian Management Services provides comprehensive management to providers with an emphasis on services that will equip physicians and hospitals for success in managed care. Through a unique business model that aligns the local physicians and hospital in a single contracting network, Arcadian Management Services organizes a fully functioning contracting network and provides all of the managed care administrative services necessary to assume and manage global risk contracts.

Management services include:

Provider Network Development

Arcadian Management Services will create the organizational structure necessary for working with managed care plans and contracting with local primary care and specialist physicians, local hospital, ancillary providers, and referral specialists and hospitals.

Health Plan Contracting

Arcadian Management Services will be your partner in health plan contracts. Experienced in capitation contracting, Arcadian Management Services will negotiate with health plans on behalf of the physicians and hospitals. As your partner in managed care, Arcadian Management Services will hold the health plan contracts, sheltering providers from the risks of low enrollment.

Provider Compensation Plans

In collaboration with the local providers, Arcadian Management Services will develop provider compensation strategies that align the physicians and hospital, and will retain the savings created from reduced out-migration in the local medical community.

Capitation Management

Arcadian Management Services takes the administrative headaches out of capitation management allowing providers to take advantage of the recent changes in the 1997 Balanced Budget Act. AMS provides comprehensive administrative services including claims administration, patient eligibility, accounting, risk pool determination as well as financial analysis and reporting. AMS provides the information technology for capitation management and provides support to you through electronic connectivity that enables local providers to have easy access to important data.

Utilization Management and Case Management

Clinical management is the key to success in risk contracting. Arcadian Management Services works with local providers to design and implement a medical management program that assures the appropriate level of care for patients at the right place with contracted providers. Medical management includes prospective, concurrent and retrospective review of medical services with an emphasis on reducing variation and improving outcomes.

Arcadian Management Services provides the administrative support for a local Utilization Review Committee that establishes policies and procedures, reviews complex cases, develops disease management and clinical pathways that meet the needs of the community.

Dedicated Resources

Arcadian Management Services provides on site and local staff to support medical management and provider contracting. Centralized staff manages the health plan contracting, data transactions and financial functions.

Contact Arcadian Management Services

To find out how Arcadian Management Services can work for your organization, contact:

Chase S. Milbrandt
Vice President of Business Development

825 Washington Street, Suite 300
Oakland, California 94607

Phone: 510/832-0311 x31
Fax: 510/832-0170

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