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3 A
irp
or
t D
riv
e, S
uit
e 3
An
n A
rb
or
, Mic
hig
an
48
10
8T
el
(7
34
) 9
13
-40
00
Fa
x (
73
4)
91
3-4
31
8w
ww
.ar
vin
ag
ro
up
.co
mAA
rv
ina
r
vin
a GG
ro
up
, LL
Cr
ou
p, L
LC
Oc
tob
er
17
, 20
05
Oc
tob
er
17
, 20
05
So
cie
ty f
or
Ra
dia
tio
n O
nc
olo
gy
Ad
min
istr
ato
rs
So
cie
ty f
or
Ra
dia
tio
n O
nc
olo
gy
Ad
min
istr
ato
rs
22
st
An
nu
al
Me
eti
ng
22
st
An
nu
al
Me
eti
ng
De
nv
er
, Co
lor
ad
oD
en
ve
r, C
olo
ra
do
Ca
nc
er
Pr
og
ra
m S
er
vic
e L
ine
Ca
nc
er
Pr
og
ra
m S
er
vic
e L
ine
Pl
an
nin
g a
nd
De
ve
lo
pm
en
tP
la
nn
ing
an
d D
ev
el
op
me
nt
D: 5
Oct
04
SRO
A Pr
es�n
AAr
vin
a
rv
ina
GGr
ou
p, L
LC
ro
up
, LL
C
2
Can
cer P
rogr
am S
ervi
ce L
ine
Plan
ning
!Pr
esen
ters
:
Nan
cy A
. Lyl
eIn
terim
Ass
ocia
te H
ospi
tal D
irect
or, B
usin
ess
Dev
elop
men
t and
St
rate
gic
Plan
ning
Ore
gon
Hea
lth &
Sci
ence
Uni
vers
ityPo
rtla
nd, O
Rly
len@
ohsu
.edu
ww
w.o
hsu.
edu
Jose
ph M
. Spa
llina
, FA
AMA,
FAC
HE
Dire
ctor
Arv
ina
Gro
up, L
LCA
nn A
rbor
, MI
jspa
llina
@ea
rthl
ink.
net
ww
w.a
rvin
agro
up.c
om
D: 5
Oct
04
SRO
A Pr
es�n
AAr
vin
a
rv
ina
GGr
ou
p, L
LC
ro
up
, LL
C
3
Can
cer P
rogr
am S
ervi
ce L
ine
Plan
ning
!Se
ssio
n ou
tline
:!
Why
an
onco
logy
ser
vice
line
org
aniz
atio
nal
appr
oach
?!
The
plan
ning
pro
cess
.!
A c
ase
stud
y as
a p
ract
ical
exa
mpl
e.
D: 5
Oct
04
SRO
A Pr
es�n
AAr
vin
a
rv
ina
GGr
ou
p, L
LC
ro
up
, LL
C
4
Can
cer P
rogr
am S
ervi
ce L
ine
Plan
ning
!Se
ssio
n de
sign
:!
Adv
ance
d!
Prac
tical
!A
udie
nce
inte
rest
s:!
Are
you
con
side
ring
deve
lopi
ng a
can
cer s
ervi
ce
line?
!H
ow la
rge
is y
ou c
ance
r pro
gram
?!
Why
do
you
thin
k yo
u sh
ould
dev
elop
the
prog
ram
in
to a
ser
vice
line
(how
will
this
org
aniz
atio
nal
appr
oach
/str
ateg
y cr
eate
val
ue?)
?
D: 5
Oct
04
SRO
A Pr
es�n
AAr
vin
a
rv
ina
GGr
ou
p, L
LC
ro
up
, LL
C
5
Can
cer P
rogr
am S
ervi
ce L
ine
Plan
ning
!Le
arni
ng o
bjec
tives
:!
How
to a
sses
s a
prog
ram
�s s
ervi
ce li
ne e
ligib
ility
. !
How
to s
truc
ture
a p
lann
ing
proc
ess
to c
reat
e a
serv
ice
line.
!Le
arn
by e
xam
ple.
D: 5
Oct
04
SRO
A Pr
es�n
AAr
vin
a
rv
ina
GGr
ou
p, L
LC
ro
up
, LL
C
6
Can
cer P
rogr
am S
ervi
ce L
ine
Plan
ning
!So
me
basi
c pl
anni
ng a
ssum
ptio
ns a
bout
the
futu
re
of c
ance
r pro
gram
s:!
Hos
pita
l/spe
cial
ists
rela
tions
will
con
tinue
to g
row
in
com
plex
ity a
nd d
iffic
ulty
to m
anag
e.!
Con
tinue
d ca
ncer
pro
gram
fina
ncia
l cha
lleng
es:
-R
eim
burs
emen
t and
mar
gins
con
tinue
to
shrin
k.-
Bec
omin
g m
ore
capi
tal i
nten
sive
; les
s ca
pita
l av
aila
ble.
D: 5
Oct
04
SRO
A Pr
es�n
AAr
vin
a
rv
ina
GGr
ou
p, L
LC
ro
up
, LL
C
7
Can
cer P
rogr
am S
ervi
ce L
ine
Plan
ning
!C
ompe
titio
n:-
Mor
e in
tens
e (a
mon
g pr
ogra
ms,
bet
wee
n ho
spita
l and
onc
olog
ists
).-
Mar
ket r
estr
uctu
ring:
!Pr
actic
e co
nsol
idat
ion.
!In
fusi
on th
erap
y sh
ifts.
!Fo
r pro
fit c
ompa
ny d
evel
opm
ent.
!Te
chno
logy
gro
wth
:-
Man
y/m
ore
freq
uent
intr
oduc
tions
.-
Mor
e ca
pita
l int
ensi
ve.
-In
crea
ses
in a
ltern
ativ
e/su
bstit
ute
tech
nolo
gies
.
D: 5
Oct
04
SRO
A Pr
es�n
AAr
vin
a
rv
ina
GGr
ou
p, L
LC
ro
up
, LL
C
8
Can
cer P
rogr
am S
ervi
ce L
ine
Plan
ning
!Pr
ogra
m d
evel
opm
ent:
-C
ontin
ued
outp
atie
nt s
hift
(feed
s ho
spita
l/spe
cial
ists
com
petit
ion)
.-
Shift
s to
sel
ecte
d se
rvic
es d
evel
opm
ent (
can�
t af
ford
to b
e ev
eryt
hing
to e
very
one)
.-
Phys
icia
ns a
nd fo
r pro
fits
cont
inue
to e
njoy
ea
se a
nd s
peed
to m
arke
t com
pare
d to
ho
spita
ls.
!C
ance
r pro
gram
s m
ust:
-H
ave
deci
sive
dec
isio
n m
akin
g ag
ility
.-
Stra
tegi
cally
dire
cted
and
man
aged
.
D: 5
Oct
04
SRO
A Pr
es�n
AAr
vin
a
rv
ina
GGr
ou
p, L
LC
ro
up
, LL
C
9
Can
cer P
rogr
am S
ervi
ce L
ine
Plan
ning
!!Ev
eryo
ne w
as
Ever
yone
was
ha
ppy
(wel
l, ha
ppy
(wel
l, al
mos
t al
mos
t ev
eryo
ne)!
ever
yone
)!
!!N
CI d
riven
(can
cer
NC
I driv
en (c
ance
r ce
nter
s)ce
nter
s)
!!C
ente
r of E
xcel
lenc
e C
ente
r of E
xcel
lenc
e co
ncep
t co
ncep
t \\in
trod
uced
in
trod
uced
ea
rly 1
990�
sea
rly 1
990�
s!!
Serv
ice
Line
con
cept
Se
rvic
e Li
ne c
once
pt
intr
oduc
ed la
te 1
990�
sin
trod
uced
late
199
0�s
Pre-
1970
Pre
Pre --
1970
1970
1970
-19
8019
70
1970
--19
8019
80
2000
-20
1020
00
2000
--20
1020
10
1990
�s19
90�s
1990
�s
No
real
role
for
No
real
role
for
serv
ice
lines
.se
rvic
e lin
es.
NIH
/NC
I int
rodu
ce �
Cen
ters
� N
IH/N
CI i
ntro
duce
�C
ente
rs�
conc
ept.
conc
ept.
AM
C�s
beg
in to
look
at a
A
MC
�s b
egin
to lo
ok a
t a
prog
ram
/cen
ter s
truc
ture
, pr
ogra
m/c
ente
r str
uctu
re,
prim
arily
driv
en b
y N
IH
prim
arily
driv
en b
y N
IH
mod
els
in 1
980�
s.m
odel
s in
198
0�s.
Nex
t gen
erat
ion
serv
ice
Nex
t gen
erat
ion
serv
ice
line
deve
lopm
ent.
line
deve
lopm
ent.
Sign
ifica
nt in
vest
men
ts in
Si
gnifi
cant
inve
stm
ents
in
orga
nizi
ng.
orga
nizi
ng.
Few
will
get
it ri
ght a
nd
Few
will
get
it ri
ght a
nd
endu
re.
endu
re.
11ststge
nera
tion
conc
ept
gene
ratio
n co
ncep
t ou
tsid
e of
NC
I/NIH
outs
ide
of N
CI/N
IH
Rea
l con
fusi
on a
bout
R
eal c
onfu
sion
abo
ut
the
mea
ning
, des
ign,
th
e m
eani
ng, d
esig
n,
and
inte
nt.
and
inte
nt.
!!In
crea
sed
com
petit
ion.
Incr
ease
d co
mpe
titio
n.!!
Sign
ifica
nt $
�l Si
gnifi
cant
$�l
perf
orm
ance
pe
rfor
man
ce
expe
ctat
ions
.ex
pect
atio
ns.
!!Li
ttle/
no ro
om fo
r Li
ttle/
no ro
om fo
r pe
rfor
man
ce e
rror
.pe
rfor
man
ce e
rror
.
D: 5
Oct
04
SRO
A Pr
es�n
AAr
vin
a
rv
ina
GGr
ou
p, L
LC
ro
up
, LL
C
10
Can
cer P
rogr
am S
ervi
ce L
ine
Plan
ning
Why
Pla
n an
O
ncol
ogy
Serv
ice
Line
?
Why
Pla
n an
O
ncol
ogy
Serv
ice
Line
?
Add
ress
co
mpl
icat
ed
orga
niza
tions
Add
ress
co
mpl
icat
ed
orga
niza
tions
Shor
ter t
ime
fram
es to
pla
nSh
orte
r tim
e fr
ames
to p
lan
Mor
e co
mpe
titiv
e en
viro
nmen
tM
ore
com
petit
ive
envi
ronm
ent
Dyn
amic
, ch
angi
ng
envi
ronm
ent
Dyn
amic
, ch
angi
ng
envi
ronm
ent
Gre
ater
ac
coun
tabi
lity
Gre
ater
ac
coun
tabi
lity
No
Mar
gin
for
erro
r (fin
anci
ally
)!N
o M
argi
n fo
r er
ror (
finan
cial
ly)!
Com
plic
ated
bu
sine
ss, m
ore
inte
grat
ed
gove
rnan
ce
stru
ctur
e
Com
plic
ated
bu
sine
ss, m
ore
inte
grat
ed
gove
rnan
ce
stru
ctur
e
Enha
nced
co
mm
unic
atio
ns,
part
icip
atio
n,
colla
bora
tion
&
deci
sion
mak
ing
Enha
nced
co
mm
unic
atio
ns,
part
icip
atio
n,
colla
bora
tion
&
deci
sion
mak
ing
D: 5
Oct
04
SRO
A Pr
es�n
AAr
vin
a
rv
ina
GGr
ou
p, L
LC
ro
up
, LL
C
11
Can
cer P
rogr
am S
ervi
ce L
ine
Plan
ning
Ben
efits
:!
Shou
ld im
prov
e fin
anci
al p
erfo
rman
ce.
!Pr
ovid
es th
e or
gani
zatio
n w
ith s
elf-c
once
pt, s
peci
fic
goal
s, g
uida
nce,
and
con
sist
ency
of d
ecis
ion
mak
ing.
!Im
prov
e de
cisi
on m
akin
g an
d de
cisi
vene
ss.
!Im
prov
es o
vera
ll co
mm
unic
atio
ns a
nd c
oord
inat
ion
with
in th
e se
rvic
e lin
e.!
Enco
urag
es in
nova
tion
and
chan
ge to
mee
t the
ch
alle
nges
of a
com
plex
and
evo
lvin
g en
viro
nmen
t.
D: 5
Oct
04
SRO
A Pr
es�n
AAr
vin
a
rv
ina
GGr
ou
p, L
LC
ro
up
, LL
C
12
Can
cer P
rogr
am S
ervi
ce L
ine
Plan
ning
Pote
ntia
l Pitf
alls
:!
Inad
equa
te o
r ove
rly c
ompl
icat
ed p
roce
ss to
cre
ate.
!Fa
iling
to in
volv
e th
e ap
prop
riate
lead
ers
in th
e pr
oces
s.!
Inad
equa
tely
pre
pare
d or
com
mun
icat
ed b
usin
ess
plan
.!
Not
iden
tifyi
ng o
r add
ress
ing
criti
cal i
ssue
s.!
Org
aniz
atio
n no
t rea
dy fo
r ser
vice
line
app
roac
h (e
stab
lishi
ng a
nd m
anag
ing
expe
ctat
ions
and
pe
rfor
man
ce).
!Fa
ilure
to d
evel
op c
onse
nsus
/agr
eem
ent a
mon
g ex
ecut
ive
and
prog
ram
lead
ers.
!La
ck o
f acc
ount
abili
ty in
impl
emen
tatio
n.
D: 5
Oct
04
SRO
A Pr
es�n
AAr
vin
a
rv
ina
GGr
ou
p, L
LC
ro
up
, LL
C
13
Can
cer P
rogr
am S
ervi
ce L
ine
Plan
ning
Esse
ntia
l Pro
cess
Con
side
ratio
ns:
!B
e se
nsiti
ve to
and
pay
atte
ntio
n to
the
polit
ics.
!D
efin
e th
e pu
rpos
e of
the
mod
el a
nd g
ain
acce
ptan
ce.
!Fo
rm th
e Ad
viso
ry B
oard
exe
cutiv
e co
mm
ittee
ear
ly o
n an
d us
e it
as a
sou
rce
of g
uida
nce.
!U
pdat
e th
e Ad
viso
ry B
oard
rout
inel
y:!
Des
crib
e an
d co
mm
unic
ate
the
plan
ning
pro
cess
an
d sc
hedu
le.
!K
eep
lead
ers
appr
aise
d an
d pr
ovid
e a
foru
m fo
r di
scus
sion
s.!
Def
ine
and
com
mun
icat
e ro
les
and
resp
onsi
bilit
ies
of
orga
niza
tion
lead
ersh
ip.
!R
evie
w p
ast s
trat
egie
s an
d id
entif
y su
cces
ses
and
failu
res.
D: 5
Oct
04
SRO
A Pr
es�n
AAr
vin
a
rv
ina
GGr
ou
p, L
LC
ro
up
, LL
C
14
Can
cer P
rogr
am S
ervi
ce L
ine
Plan
ning
!O
ncol
ogy
Serv
ice
Line
App
licab
ility
:!
Aca
dem
ic m
edic
al c
ente
rs.
!Te
achi
ng h
ospi
tals
and
larg
e ca
ncer
pro
gram
s.
!A
sses
smen
t Crit
eria
:!
Subs
tant
ial c
ritic
al m
ass
(NC
C, $
�s, d
isch
arge
s).
!D
istin
ctiv
e m
arke
t and
qua
lity
posi
tion.
!M
arke
t siz
e an
d gr
owth
pot
entia
l.!
Stro
ng a
nd p
ositi
ve re
gion
al re
puta
tion.
D: 5
Oct
04
SRO
A Pr
es�n
AAr
vin
a
rv
ina
GGr
ou
p, L
LC
ro
up
, LL
C
15
Can
cer P
rogr
am S
ervi
ce L
ine
Plan
ning
!A
sses
smen
t Crit
eria
(con
tinue
d):
!M
ultid
isci
plin
ary
appr
oach
to c
are,
co
mm
unic
atio
ns, t
each
ing,
rese
arch
, and
co
mm
unic
atio
ns.
!M
edic
al le
ader
ship
and
inno
vatio
n in
ser
vice
de
liver
y.!
Cos
t effe
ctiv
enes
s.!
Fina
ncia
l con
trib
utio
n to
the
orga
niza
tion.
!C
ultu
re s
uppo
rtiv
e of
ser
vice
line
app
roac
h an
d si
gnifi
cant
cha
nge.
D: 5
Oct
04
SRO
A Pr
es�n
AAr
vin
a
rv
ina
GGr
ou
p, L
LC
ro
up
, LL
C
16
Can
cer P
rogr
am S
ervi
ce L
ine
Plan
ning
!M
etho
dolo
gy; P
lann
ing
and
Stru
ctur
ing
an O
ncol
ogy
Serv
ice
Line
:!
Mar
ket o
ppor
tuni
ties
and
grow
th ta
rget
s.!
Prod
uct d
evel
opm
ent.
!M
arke
ting
stra
tegi
es.
!Fi
nanc
ial a
nd in
vest
men
t pla
ns a
nd s
trat
egie
s.!
Stra
tegi
c di
rect
ion,
str
ateg
ies,
gro
wth
.!
Org
aniz
atio
n an
d or
gani
zatio
nal d
evel
opm
ent:
-A
dmin
istr
ator
�s ro
le/p
ositi
on d
escr
iptio
n.-
Adm
inis
trat
or�s
qua
lific
atio
ns.
!E3
(Exe
cutio
n, E
duca
tion,
Exp
ecta
tions
m
anag
emen
t).
D: 5
Oct
04
SRO
A Pr
es�n
AAr
vin
a
rv
ina
GGr
ou
p, L
LC
ro
up
, LL
C
17
Can
cer P
rogr
am S
ervi
ce L
ine
Plan
ning
Visi
on &St
rate
gic
Alig
nmen
t
Mar
ket
Org
aniz
atio
n
Serv
ices
&O
pera
tions
©20
01 b
y A
rvin
a G
roup
, LLC
.
Str
ate
gic
Bu
sin
es
s
Pla
nn
ing
Mu
st
Fo
cu
s
on
co
re
on
co
log
y s
er
vic
e l
ine
el
em
en
ts.
D: 5
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04
SRO
A Pr
es�n
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Can
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rogr
am S
ervi
ce L
ine
Plan
ning
"Se
rvic
es a
nd te
chno
logi
es
"C
apac
ity a
nd fa
cilit
ies
"C
are
man
agem
ent
"A
cces
s an
d co
nven
ienc
e
"C
linic
al re
sear
ch
"R
efer
ral r
elat
ions
hips
"C
over
age
"R
egio
nal a
ffilia
tions
and
out
reac
h re
latio
nshi
ps
""Sp
ecia
lists
/hos
pita
l str
ateg
ic re
latio
nshi
psSp
ecia
lists
/hos
pita
l str
ateg
ic re
latio
nshi
ps
"M
arke
t, m
arke
ting,
and
diff
eren
tiatio
n
"St
ruct
ure
for o
rgan
izat
ion
and
lead
ersh
ip, a
nd p
erfo
rman
ce"
Web
bas
ed d
ata
and
info
rmat
ion
man
agem
ent
Ma
rk
et
Str
at
eg
ies
Se
rv
ice
s/
Op
er
ati
on
s S
tra
teg
ies
Or
ga
niz
ati
on
Str
ate
gie
s
©20
01 b
y A
rvin
a G
roup
, LLC
.
D: 5
Oct
04
SRO
A Pr
es�n
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p, L
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ine
Plan
ning
Exam
ple:
Plan
Exe
cutiv
e Su
mm
ary
Visi
on &St
rate
gic
Alig
nmen
t
2. M
arke
t3.
Org
aniz
atio
n
1. S
ervi
ces
&O
pera
tions
1. A
.Se
rv
ice
s e
nh
an
ce
me
nt
s (
1, 2
, 3)
1. B
.Fa
cil
ity
de
sig
n: s
er
vic
es
, ph
ysic
ian
o
ff
ice
s, c
lin
ica
l r
es
ea
rc
h &
s
up
po
rt
un
de
r o
ne
ro
of
.
1.D
. We
lln
es
s a
nd
cli
nic
al
re
se
ar
ch
e
xp
an
sio
n.
3.A
Mu
lti
ple
t p
hys
icia
n p
ra
cti
ce
s,
su
bs
pe
cia
lty
de
pth
, an
d a
t le
as
t a
20
%
inc
re
as
e in
th
e n
um
be
r o
f p
hys
icia
ns
w
ith
in s
ev
en
ye
ar
s.
3.B
.Str
ate
gic
re
lati
on
sh
ip (
s)
wit
h
se
lec
te
d p
hys
icia
ns
re
qu
ire
d.
3. C
.Re
vis
ed
ph
ysic
ian
le
ad
er
sh
ip
mo
de
l.
2. A
.Ex
pa
nd
pr
ima
ry
ca
re
ba
se
by
15
% i
n
SS
A f
or
pr
og
ra
m g
ro
wth
an
d
inc
re
as
ed
re
gio
na
l o
rie
nta
tio
n.
2. B
. Pr
og
ra
m d
iff
er
en
tia
tio
n b
as
ed
on
r
eg
ion
al
ex
pe
rti
se
in m
ult
iple
ar
ea
s,
ed
uc
ati
on
an
d r
es
ou
rc
e a
dv
oc
at
e, a
nd
c
lin
ica
l r
es
ea
rc
h e
xp
er
tis
e.
Fu
nd
am
en
ta
l S
tr
at
eg
ic D
ire
cti
on
:A
dv
an
ce
th
e p
ro
gr
am
to
a l
ev
el
as
th
e
re
gio
na
l le
ad
er
& in
no
va
tor
.
D: 5
Oct
04
SRO
A Pr
es�n
AAr
vin
a
rv
ina
GGr
ou
p, L
LC
ro
up
, LL
C
20
Can
cer P
rogr
am S
ervi
ce L
ine
Plan
ning
!O
rgan
izat
iona
l Clim
ate:
!C
hang
e an
d ris
k ta
king
enc
oura
ged?
!Se
rvic
e lin
e or
gani
zatio
nal s
truc
ture
exi
st?
!Ev
iden
ce th
at m
atrix
man
agem
ent h
as b
een/
will
be
acce
pted
?!
Polit
ical
con
side
ratio
ns/li
kely
acc
epta
nce
(hos
pita
l an
d m
edic
al s
taff)
for s
igni
fican
t org
aniz
atio
nal
chan
ge?
!St
ruct
ured
for s
ucce
ssfu
l im
plem
enta
tion
and
expe
ctat
ion
man
agem
ent?
D: 5
Oct
04
SRO
A Pr
es�n
AAr
vin
a
rv
ina
GGr
ou
p, L
LC
ro
up
, LL
C
21
Can
cer P
rogr
am S
ervi
ce L
ine
Plan
ning
!O
ncol
ogy
serv
ice
line
mis
sion
and
vis
ion
stat
emen
ts
mus
t:!
Exis
t?!
Be
spec
ific,
real
istic
, cha
lleng
ed, a
nd ro
utin
ely
visi
ted/
revi
ewed
.!
Rep
rese
nt c
onse
nsus
, buy
in, a
nd a
re s
hare
d an
d liv
ed.
D: 5
Oct
04
SRO
A Pr
es�n
AAr
vin
a
rv
ina
GGr
ou
p, L
LC
ro
up
, LL
C
22
Can
cer P
rogr
am S
ervi
ce L
ine
Plan
ning
D: 5
Oct
04
SRO
A Pr
es�n
AAr
vin
a
rv
ina
GGr
ou
p, L
LC
ro
up
, LL
C
23
Can
cer P
rogr
am S
ervi
ce L
ine
Plan
ning
!Fi
nanc
ial p
erfo
rman
ce; a
tool
to m
easu
re:
!H
isto
rical
pos
ition
.!
Und
erst
and
your
risk
s.!
Futu
re s
ucce
ss.
!H
ow to
mea
sure
?!
ICD
cla
ssifi
catio
n ba
sed.
!In
patie
nt a
nd o
utpa
tient
.!
Con
trib
utio
n m
argi
n an
d to
tal m
argi
n.!
By
dise
ase
cate
gory
.!
Prim
ary
diag
nosi
s on
ly?
!A
lloca
te c
ompl
icat
ed c
ases
by
seco
ndar
y di
agno
sis
(to d
isea
se c
ateg
ory)
.!
Hem
atol
ogy
incl
uded
?
D: 5
Oct
04
SRO
A Pr
es�n
AAr
vin
a
rv
ina
GGr
ou
p, L
LC
ro
up
, LL
C
24
Can
cer P
rogr
am S
ervi
ce L
ine
Plan
ning
#M
arke
ting
and
mar
ket s
trat
egie
s m
ust f
ocus
on
prom
otio
n, p
lace
,and
cha
nnel
ing
Mar
ketin
gM
ixSt
rong
Med
ium
Wea
kC
omm
ents
Prod
uct
Qua
lity
reco
gniti
on b
y pa
yors
XO
utpa
tient
com
pone
nt is
not
fully
func
tiona
l?Vi
able
car
ve o
utPr
ice
Need
to m
aint
ain/
enha
nce
pack
aged
pric
e, c
ase
rate
sX
Need
to e
duca
te p
ayor
s ab
out
diffe
rent
ial p
ricin
gO
utpa
tient
com
pone
nt s
houl
d co
ntrib
ute
to fu
ture
pric
e co
mpe
titiv
enes
sPr
omot
ion
Min
imal
inve
stm
ent i
n pr
omot
ion
in a
Xco
mpe
titve
mar
ket
Inad
equa
te fo
cus,
dire
ctio
n, a
nd ta
rget
ing
in p
rom
otio
nal s
trat
egie
sX
XPr
oxim
ity to
(AM
C) d
iffic
ult (
high
nam
eLo
cal
Reg
iona
lre
cogn
ition
)Li
ttle
regi
onal
pay
or a
war
enes
s
Onc
olgy
Ser
vice
Lin
e M
arke
t Se
gmen
t Pro
file
Plac
e &
C
hann
el'g
D: 5
Oct
04
SRO
A Pr
es�n
AAr
vin
a
rv
ina
GGr
ou
p, L
LC
ro
up
, LL
C
25
Can
cer P
rogr
am S
ervi
ce L
ine
Plan
ning
!D
o yo
u kn
ow th
e st
atus
of y
our r
elat
ions
hips
with
spe
cial
ists
, can
cer
prog
ram
phy
sici
ans?
!D
o yo
u ha
ve a
n ad
equa
te c
ompl
emen
t of c
ance
r pro
gram
ph
ysic
ians
?
!W
hat i
s th
eir l
oyal
ty to
the
hosp
ital a
nd c
ance
r pro
gram
?
!W
hat a
re th
eir n
eeds
and
how
wel
l are
they
bei
ng m
et?
!W
ho is
the
canc
er p
rogr
am b
uild
er(s
)?
!W
hat d
o w
e kn
ow a
bout
wha
t the
com
petit
ion
is d
oing
and
thei
r ab
ility
to a
ttrac
t our
can
cer p
rogr
am?
!A
re w
e/is
our
mar
ket v
ulne
rabl
e to
for-
prof
it en
try?
!W
hat i
s th
e sp
ecia
lists
� rol
e in
our
can
cer p
rogr
am m
arke
ting?
!W
hat a
re th
e po
tent
ial h
ospi
tal/s
peci
alis
ts p
oint
s of
par
tner
ship
?
Va
luin
g R
ela
tio
ns
hip
s w
ith
Sp
ec
iali
sts
D: 5
Oct
04
SRO
A Pr
es�n
AAr
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rv
ina
GGr
ou
p, L
LC
ro
up
, LL
C
26
Can
cer P
rogr
am S
ervi
ce L
ine
Plan
ning
RO
RO
Hos
pita
l
Hos
pita
lH
ospi
tal
Hos
pita
l
Net
wor
k Sp
onso
r
MO
MO
MO
MO
Key
:R
adia
tion
Onc
olog
y Jo
int V
entu
reP
hysi
cs C
ontra
ctH
ospi
tal:
Infu
sion
Th
erap
y O
nly
Hos
pita
l: C
ance
r Cen
ter
Mgt
Con
tract
M
O:
Med
ical
Onc
olog
y O
ffice
RO
: R
adia
tion
Onc
olog
y C
tr
Clin
ical
R
esea
rch
Con
sort
ium
MO
MO
Ne
two
rk
Str
uc
tur
e:
All
sh
ap
es
an
d k
ind
s
D: 5
Oct
04
SRO
A Pr
es�n
AAr
vin
a
rv
ina
GGr
ou
p, L
LC
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up
, LL
C
Can
cer P
rogr
am S
ervi
ce L
ine
Plan
ning
!A
ffilia
tion/
netw
ork
goal
s an
d op
port
uniti
es?
!Jo
int v
entu
re $
$$$$
$!
Clin
ic/p
hysi
cian
pra
ctic
e $
$$$
!Pr
ogra
m/s
ervi
ce m
anag
emen
t $$
$!
Clin
ical
ser
vice
s $
$$
!A
ffilia
tion
$$
!C
linic
al re
sear
ch $
I n t e g r a t i o n
Hig
h
Lo
w
Tie
r
IIIIII
D: 5
Oct
04
SRO
A Pr
es�n
AAr
vin
a
rv
ina
GGr
ou
p, L
LC
ro
up
, LL
C
28
Can
cer P
rogr
am S
ervi
ce L
ine
Plan
ning
!O
rgan
izat
iona
l str
uctu
re:
!A
dvis
ory
boar
d:-
Mul
tidis
cipl
inar
y an
d in
terd
isci
plin
ary.
-K
ey le
ader
s an
d st
akeh
olde
rs re
pres
ente
d.!
Exec
utiv
e co
mm
ittee
(of t
he A
dvis
ory
Boa
rd):
-Fo
ur to
six
mem
bers
.!
Serv
ice
line
med
ical
dire
ctor
s.!
Serv
ice
line
dire
ctor
.
D: 5
Oct
04
SRO
A Pr
es�n
AAr
vin
a
rv
ina
GGr
ou
p, L
LC
ro
up
, LL
C
29
Can
cer P
rogr
am S
ervi
ce L
ine
Plan
ning
!Se
rvic
e Li
ne D
irect
or:
!D
eter
min
e m
ix o
f lin
e an
d st
aff f
unct
ions
:-
Line
= o
pera
tions
, ser
vice
s,
equi
pmen
t/tec
hnol
ogie
s, fa
cilit
ies,
qua
lity
mon
itorin
g, re
gula
tory
com
plia
nce.
-St
aff =
pro
gram
pla
nnin
g, s
trat
egy,
bus
ines
s pl
anni
ng, m
arke
ting,
clin
ical
pro
gram
phy
sici
an
rela
tions
hips
, ref
errin
g ph
ysic
ian
rela
tions
hips
, ad
viso
ry b
oard
and
exe
cutiv
e co
mm
ittee
.!
Cle
ar p
ositi
on d
escr
iptio
n (fo
rm fo
llow
s fu
nctio
ns).
!D
irect
or m
ust b
e ca
pabl
e of
ope
ratin
g in
a m
atrix
or
gani
zatio
n (c
omm
unic
atio
ns, o
rgan
izat
iona
l, an
d le
ader
ship
ski
lls) i
n m
ost s
ettin
gs.
D: 5
Oct
04
SRO
A Pr
es�n
AAr
vin
a
rv
ina
GGr
ou
p, L
LC
ro
up
, LL
C
Can
cer P
rogr
am S
ervi
ce L
ine
Plan
ning
Se
rv
ice
Lin
e L
ea
de
rs
hip
Re
qu
ire
me
nts
"O
pera
tiona
l exp
ertis
e an
d re
gula
tory
man
agem
ent
"Se
rvic
es, e
quip
men
t, an
d te
chno
logy
pla
nnin
g"
Faci
lity
prog
ram
min
g an
d pl
anni
ng"
Lead
ersh
ip (i
nclu
ding
gov
erna
nce
rela
tions
)"
Stra
tegi
c an
d bu
sine
ss p
lann
ing
"Fi
nanc
ial p
lann
ing
and
man
aged
car
e co
ntra
ctin
g"
Qua
lity/
outc
omes
man
agem
ent
"In
form
atic
s, in
form
atio
n, a
nd th
e in
tern
et"
Out
reac
h, p
reve
ntio
n, a
nd n
etw
ork
man
agem
ent
"O
rgan
izat
iona
l dev
elop
men
t and
cul
ture
man
agem
ent
"M
arke
ting
©20
01 b
y A
rvin
a G
roup
, LLC
.
D: 5
Oct
04
SRO
A Pr
es�n
AAr
vin
a
rv
ina
GGr
ou
p, L
LC
ro
up
, LL
C
31
Can
cer P
rogr
am S
ervi
ce L
ine
Plan
ning
!B
usin
ess
plan
app
rova
l (ex
ecut
ive
man
agem
ent,
exec
utiv
e co
mm
ittee
, adv
isor
y bo
ard)
.!
Succ
essf
ul e
xecu
tion
= su
cces
sful
exp
ecta
tions
and
co
mm
unic
atio
ns m
anag
emen
t.!
Ass
ignm
ent o
f res
pons
ibili
ty a
nd a
ccou
ntab
ility
into
in
divi
dual
per
form
ance
pla
ns:
!�C
onse
quen
ce�
man
agem
ent
!M
onito
ring
and
disc
uss
prog
ress
rout
inel
y:!
Exec
utiv
e co
mm
ittee
and
adv
isor
y bo
ard.
!Ex
ecut
ive
man
agem
ent.
!R
evie
w th
e bu
sine
ss p
lan
annu
ally
and
per
iodi
cally
up
date
it.
Ke
y Im
ple
me
nta
tio
n C
on
sid
er
ati
on
s
D: 5
Oct
04
SRO
A Pr
es�n
AAr
vin
a
rv
ina
GGr
ou
p, L
LC
ro
up
, LL
C
32
Can
cer P
rogr
am S
ervi
ce L
ine
Plan
ning
!C
ase
stud
y an
d ex
ampl
e:!
Ore
gon
Hea
lth &
Sci
ence
Uni
vers
ity (P
ortla
nd, O
R)
Onc
olog
y Se
rvic
e Li
ne.
Oct
05
NL
OH
SU C
ance
r Ser
vice
Lin
e -C
ase
Stud
y.pp
s
D: 5
Oct
04
SRO
A Pr
es�n
AAr
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rv
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GGr
ou
p, L
LC
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up
, LL
C
33
Can
cer P
rogr
am S
ervi
ce L
ine
Plan
ning
Qu
es
tio
ns
?
D: 5
Oct
04
SRO
A Pr
es�n
AAr
vin
a
rv
ina
GGr
ou
p, L
LC
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up
, LL
C
34
Can
cer P
rogr
am S
ervi
ce L
ine
Plan
ning
Att
ac
hm
en
ts
D: 5
Oct
04
SRO
A Pr
es�n
AAr
vin
a
rv
ina
GGr
ou
p, L
LC
ro
up
, LL
C
35
Can
cer P
rogr
am S
ervi
ce L
ine
Plan
ning
!Th
e A
rv
ina
Gr
ou
p, L
LC
is a
nat
iona
l hea
lth c
are
man
agem
ent
cons
ultin
g fir
m w
ith s
ervi
ces
tailo
red
to m
eet t
he d
iver
se a
nd
evol
ving
nee
ds o
f hea
lthca
re p
rovi
ders
. O
ur fi
rm is
ded
icat
ed
to re
com
men
ding
sol
utio
ns th
at e
nhan
ce fi
nanc
ial v
iabi
lity
of
our c
lient
s.!
Ar
vin
a G
ro
up
, LL
Cco
nsul
tant
s ar
e ex
perie
nced
pr
ofes
sion
als
who
are
exp
erts
in m
anag
emen
t, pl
anni
ng,
finan
ce, f
orec
astin
g an
d m
odel
ing,
phy
sici
an-h
ospi
tal
rela
tions
hips
, and
can
cer p
rogr
ams.
!A
rv
ina
Gr
ou
p, L
LC
appr
oach
es a
nd s
ervi
ce to
clie
nts
have
co
ntrib
uted
to th
eir
succ
ess.
Our
clie
nts
enco
mpa
ss
orga
niza
tions
of e
very
siz
e an
d sp
ecia
lty a
cros
s th
e co
untr
y,
from
sm
all c
omm
unity
hos
pita
ls a
nd p
hysi
cian
gro
up p
ract
ices
to
aca
dem
ic m
edic
al c
ente
rs a
nd la
rge
inte
grat
ed d
eliv
ery
syst
ems.
D: 5
Oct
04
SRO
A Pr
es�n
AAr
vin
a
rv
ina
GGr
ou
p, L
LC
ro
up
, LL
C
36
Can
cer P
rogr
am S
ervi
ce L
ine
Plan
ning
!N
ancy
Lyl
e cu
rren
tly s
erve
s as
the
Asso
ciat
e H
ospi
tal
Dire
ctor
for S
trat
egic
Pla
nnin
g &
Bus
ines
s D
evel
opm
ent a
t O
rego
n H
ealth
& S
cien
ce U
nive
rsity
�s H
ospi
tals
and
Clin
ics.
M
s. L
yle
has
over
27
year
s of
adm
inis
trat
ive,
pl
anni
ng/s
trat
egy,
and
clin
ical
exp
erie
nce,
incl
udin
g Vi
ce
Pres
iden
t, B
usin
ess
Dev
elop
men
t; D
irect
or, I
nteg
rate
d C
linic
al N
etw
orks
for a
larg
e he
alth
sys
tem
in H
oust
on,
Texa
s; a
nd v
ario
us s
ervi
ce li
ne d
irect
or p
ositi
ons.
Her
ed
ucat
iona
l bac
kgro
und
incl
udes
rece
ivin
g a
BS
Deg
ree
in
Nur
sing
from
Ohi
o St
ate
Uni
vers
ity a
nd M
aste
rs D
egre
e in
H
ealth
care
Adm
inis
trat
ion
from
the
Uni
vers
ity o
f Tex
as.
D: 5
Oct
04
SRO
A Pr
es�n
AAr
vin
a
rv
ina
GGr
ou
p, L
LC
ro
up
, LL
C
37
Can
cer P
rogr
am S
ervi
ce L
ine
Plan
ning
!Jo
seph
M. S
palli
na, F
AA
MA
, FA
CH
E, d
irect
or a
nd fo
unde
r of
the
Arvi
na G
roup
, LLC
, has
ove
r 28
year
s of
hea
lthca
re
man
agem
ent,
plan
ning
, and
con
sulti
ng e
xper
ienc
e. H
e ha
s ex
pert
ise
in s
trat
egic
pla
nnin
g, in
tegr
ated
del
iver
y sy
stem
de
sign
, clin
ical
pro
gram
pla
nnin
g an
d in
tegr
atio
n, a
nd
finan
cial
feas
ibili
ty a
naly
ses.
Mr.
Spal
lina
is a
freq
uent
sp
eake
r for
pro
fess
iona
l soc
ietie
s an
d au
thor
of a
rtic
les
focu
sing
on
clin
ical
pro
gram
pla
nnin
g an
d in
tegr
atio
n. M
r. Sp
allin
a re
ceiv
ed h
is B
A d
egre
e fr
om th
e U
nive
rsity
of
Roc
hest
er a
nd h
is M
BA
from
Syr
acus
e U
nive
rsity
.
