IndianaCTSI - ResNet

1. IndianaCTSI - ResNet Gerald Pan, Patty Lin & Andrew Fisher

2. Summary of Current ResNet Operations • ResNet is a recruitment organization of approaching patients discuss research opportunities available to them • No central office and RAs work in different clinics to recruit coming patients • Investigators are charged on a “Per approach” basis • ResNet meets a difficulty about how to increase efficiency of recruiting patients and how to cover cost • ResNet needs a more acceptable and transparent billing process 4

3. Patients’ information gathering • Patients don’t • show up Patients are late by more than 15 minutes, doctors usually reject to meet them. Consulting doctors about the suitability of recruitments RAs approach patients to explain the contents of studies and ask if they are willing to join Agreement Rejection or Soft Rejection Follow-up mails or calls Current Patient Approach Process 4

4. Observations from Shadowing Visit • Many different situations can occur in the process of approaching patients, leading to an incredibly complex recruitment process that PI’s don’t fully understand. • Implication: PI’s need to be convinced of the complexity and it must be negotiated into recruiting prices • RA’s are largely at the mercy of the clinics in which they work to recruit patients • Implication: The working relationship between ResNet and the facilities where they recruit needs to be preserved • A large amount of clerical work, coordinator work & traveling frequently take up valuable recruitment time • Implication: In order to more completely cover costs, ResNet must more accurately track & bill non-recruitment time 4

5. Current Revenue Breakdown Revenues • Revenue based on per-approach fees charged by the number of approached without consideration of time-spent and eligibility • Management Fees charged by multiple ratios depending on management & coordination effort • Set-up Fees charged based on four levels of recruiting complexity 4

6. Time Spent per Approach varies widely as well • Among studies with over 2,000 identified patients, most studies average less than 50 minutes of RA time per billable approach • However, some studies take longer than an hour per approach, and at the extreme end take upwards of 5 hours per approach 4

7. Revenue Analysis • Using the per-approach pricing model at current negotiated rates, ResNet’s expected revenue from all currently on-going studies is $330,964 • If converted to per-enrollment, expected revenue decreases to $153,733 • This means that investigators are overpaying by 115%, in aggregate

8. Training Pricing Finacial Recommended course of action Track Billable Clerical Hours • RA’s should track billable hours on a per-project basis, which should be aggregated and charged to the study PI Train RAs On Conversion Techniques • Ask high-performing RAs to train teammates on how to encourage patients to enroll if eligible; incentivize higher performance Enrollment Pricing Model • Charge higher rates on a per-enrollment basis – equitable to study PI A la Carte Pricing Menu • Capture revenue for follow-up, phone, and sensitivity requirements; the increase in effort by ResNet RA’s should be billed Financial Earlier Rate Negotiation • Require study PI to begin rate negotiation process prior to submitting grant proposals – each study will require different rate Negotiate Higher Rates • Aggregated data will provide PI with more transparency and reassurance of better resource utilization Revenue Forecast • Employ Pricing Tool in negotiations, and to forecast overall estimated revenue from a study 12

9. Per-Study Revenue Forecast Tool • Forecast revenue generation with pricing tool: Revenue Forecast

10. Summary • ResNet’s recruitment is a labor-intensive process. Rather than reduce labor costs, raising revenues should be the main goal • Change the charging system to completely reflect the complexity of studies • Strengthen the link between cost and revenue