© 2 0 1 9 C a r d i o v a s c u l a r I n s t i t u t e o f t h e S o u t h , A l l R i g h t s R e s e r v e d .
Journey to an OISDavid Konur, FACHEChief Executive Officer
OEIS Conference, St. Petersburg, FLApril 6, 2019
Craig Walker, MDFounder, CMO
© 2 0 1 9 C a r d i o v a s c u l a r I n s t i t u t e o f t h e S o u t h , A l l R i g h t s R e s e r v e d .
Disclosures
Nothing to disclose
© 2 0 1 9 C a r d i o v a s c u l a r I n s t i t u t e o f t h e S o u t h , A l l R i g h t s R e s e r v e d .
Healthcare Reform in the News
Harper’s Magazine
October 1960• “The crisis of the uninsured”• “Soaring cost”• “Over-utilization of services”• “Find something to replace fee-for service
system”
© 2 0 1 9 C a r d i o v a s c u l a r I n s t i t u t e o f t h e S o u t h , A l l R i g h t s R e s e r v e d .
Over
700Staff
Employees*Over 800 Total
Over
40NPs
Over
60 Physicians
• Clinics: 242,053• Hospital: 80,002• Telecardiology: 814
Patient Visits = 322,055*
Hospital Procedures = 27,301*• Includes Cath Lab & EP
25 Locations
*Telecardiology & Clinics
2States
*LA & MS Visits & Procedures: February 1, 2018 – January 31, 2019
CIS Today
© 2 0 1 9 C a r d i o v a s c u l a r I n s t i t u t e o f t h e S o u t h , A l l R i g h t s R e s e r v e d .
CIS Markets
• 18 Clinic Locations • 7 Telecardiology Programs
© 2 0 1 9 C a r d i o v a s c u l a r I n s t i t u t e o f t h e S o u t h , A l l R i g h t s R e s e r v e d .
We Believe Size Matters
“To determine our destiny”
© 2 0 1 9 C a r d i o v a s c u l a r I n s t i t u t e o f t h e S o u t h , A l l R i g h t s R e s e r v e d .
We touch a patient every minute of every day
© 2 0 1 9 C a r d i o v a s c u l a r I n s t i t u t e o f t h e S o u t h , A l l R i g h t s R e s e r v e d .
Physicians rarely invest in innovation until there is a proven payer source
© 2 0 1 9 C a r d i o v a s c u l a r I n s t i t u t e o f t h e S o u t h , A l l R i g h t s R e s e r v e d .
© 2 0 1 9 C a r d i o v a s c u l a r I n s t i t u t e o f t h e S o u t h , A l l R i g h t s R e s e r v e d .
© 2 0 1 9 C a r d i o v a s c u l a r I n s t i t u t e o f t h e S o u t h , A l l R i g h t s R e s e r v e d .
Published - January 18, 2016
© 2 0 1 9 C a r d i o v a s c u l a r I n s t i t u t e o f t h e S o u t h , A l l R i g h t s R e s e r v e d .
Current Hospital Partners
1. Terrebonne General Medical Center – Houma, LA (1986)
2. Opelousas General Medical Center – Opelousas, LA (2003)3. Lane Regional Medical Center – Zachary, LA (2006)
4. Lady of the Sea General Hospital – Galliano, LA (2009)
5. Lafayette General Medical Center – Lafayette, LA (2011)
6. St. Martin General Hospital – Breaux Bridge, LA (2012)
7. Thibodaux Regional Medical Center – Thibodaux, LA (2013)8. University Hospital and Clinics/LSU – Lafayette, LA (2013)
9. Baton Rouge General Medical Center – Baton Rouge, LA (2015)
10.Abrom Kaplan Hospital – Kaplan, LA (2016)
11.Acadia General Hospital – Crowley, LA (2016)
12.Anderson Regional Medical Center – Meridian, MS (2017)13.Jennings American Legion Hospital – Jennings, LA (2017)
14.Allen Parish Hospital – Kinder, LA (2018)
Co-Management and/or Telecardiology Agreements
© 2 0 1 9 C a r d i o v a s c u l a r I n s t i t u t e o f t h e S o u t h , A l l R i g h t s R e s e r v e d .
Consumerismis Changing Healthcare
• High Deductible Plan• Forcing Consumers to Shop– Accessing Online Medical Services– Biometric Use Skyrocketing– Internet and Awareness
• “I want, What I want!”• I don’t want to go to hospital if I have a Choice!!
© 2 0 1 9 C a r d i o v a s c u l a r I n s t i t u t e o f t h e S o u t h , A l l R i g h t s R e s e r v e d .
Driving Forces
Physician Perspective• Frustration w/Hosp. Policy• Road blocks to Teaching• Patient Expense/Experience• Inventory Selection• Staffing/Processes
Management Perspective• Frustration w/Hosp.• Recruiting• Competitive Advantage• Financial Diversification• Capital Decision Making
© 2 0 1 9 C a r d i o v a s c u l a r I n s t i t u t e o f t h e S o u t h , A l l R i g h t s R e s e r v e d .
OBL Opened in May 2017- Treated 1,517 Patients- Performed 4,075 Procedures
© 2 0 1 9 C a r d i o v a s c u l a r I n s t i t u t e o f t h e S o u t h , A l l R i g h t s R e s e r v e d .
© 2 0 1 9 C a r d i o v a s c u l a r I n s t i t u t e o f t h e S o u t h , A l l R i g h t s R e s e r v e d .
© 2 0 1 9 C a r d i o v a s c u l a r I n s t i t u t e o f t h e S o u t h , A l l R i g h t s R e s e r v e d .
© 2 0 1 9 C a r d i o v a s c u l a r I n s t i t u t e o f t h e S o u t h , A l l R i g h t s R e s e r v e d .
© 2 0 1 9 C a r d i o v a s c u l a r I n s t i t u t e o f t h e S o u t h , A l l R i g h t s R e s e r v e d .
OBL Procedure Mix 2018
47%
19%
9%
7%
6%
6%5%
2018 OBL Procedures
Peripheral Arterial Diagnostics
Arterial Atherectomy Only
Arterial Atherectomy & Stent
Arterial PTA
Peripheral Venous Diagnostics
Venous Stent
Arterial Stent Only
88% Peripheral Arterial – 12% Venous
© 2 0 1 9 C a r d i o v a s c u l a r I n s t i t u t e o f t h e S o u t h , A l l R i g h t s R e s e r v e d .
All Procedures
3,291
3,046 3,131 2,939
3,775 3,7984,051 3,943
3,8154,023
3,508 3,586 3,651
0 0 0 0 0135
356487 553
686 626 681551
0
500
1,000
1,500
2,000
2,500
3,000
3,500
4,000
4,500
Qtr 1 2016
Qtr 2 2016
Qtr 3 2016
Qtr 4 2016
Qtr 1 2017
Qtr 2 2017
Qtr 3 2017
Qtr 4 2017
Qtr 1 2018
Qtr 2 2018
Qtr 3 2018
Qtr 4 2018
Qtr 1 2019
Hospital vs. OBL All Procedures
Hospital CIS OBL Linear (Hospital)
© 2 0 1 9 C a r d i o v a s c u l a r I n s t i t u t e o f t h e S o u t h , A l l R i g h t s R e s e r v e d .
Peripheral Procedures
406
294
403 396
330
398
487444 462
602
485
419
505
0 0 0 0 0
135
356
487
553
686
626
681
551
0
100
200
300
400
500
600
700
800
Qtr 1 2016
Qtr 2 2016
Qtr 3 2016
Qtr 4 2016
Qtr 1 2017
Qtr 2 2017
Qtr 3 2017
Qtr 4 2017
Qtr 1 2018
Qtr 2 2018
Qtr 3 2018
Qtr 4 2018
Qtr 1 2019
Hospital vs. OBL Peripheral Procedures
Hospital CIS OBL Linear (Hospital)
© 2 0 1 9 C a r d i o v a s c u l a r I n s t i t u t e o f t h e S o u t h , A l l R i g h t s R e s e r v e d .
Patient Satisfaction
OBL
© 2 0 1 9 C a r d i o v a s c u l a r I n s t i t u t e o f t h e S o u t h , A l l R i g h t s R e s e r v e d .
The Future of OIS
© 2 0 1 9 C a r d i o v a s c u l a r I n s t i t u t e o f t h e S o u t h , A l l R i g h t s R e s e r v e d .
Houma Market-Hybrid OIS
© 2 0 1 9 C a r d i o v a s c u l a r I n s t i t u t e o f t h e S o u t h , A l l R i g h t s R e s e r v e d .
Houma Market-2 Cathlabs
© 2 0 1 9 C a r d i o v a s c u l a r I n s t i t u t e o f t h e S o u t h , A l l R i g h t s R e s e r v e d .
Houma Market
Corindus
© 2 0 1 9 C a r d i o v a s c u l a r I n s t i t u t e o f t h e S o u t h , A l l R i g h t s R e s e r v e d .
Conclusions
• OIS’s Raise the standard of care– Provide greater access to care– Improved outcomes– Lower cost– More convenient– Do not cannibalize hospitals
• Coronary space is next
“Which is what our patients want and is in line with the Healthcare Debate since at least 1960!”
© 2 0 1 9 C a r d i o v a s c u l a r I n s t i t u t e o f t h e S o u t h , A l l R i g h t s R e s e r v e d .
Thank you!
David Konur, FACHEChief Executive Officer
Craig Walker, MDFounder, CMO