The document provides an overview of Anthony Faneli's experience and qualifications for leadership in healthcare. It discusses his commitment to quality, integrity, innovation, accountability, collaboration, and leadership. It outlines his experience with integrated delivery networks, managed care organizations, health information technology, and perspectives on trends in healthcare reform and personalized medicine. The document promotes Faneli's expertise across multiple areas of the healthcare industry.
1. UNPARALELLED HEALTHCARE
LEADERSHIP, EXPERIENCE AND
INTEGRITY!
PREPARED BY:
ANTHONY E. FANELLI
“The task of the leader is to get his people from where
they are to where they have not been.” ~Henry Kissinger
2. The Patient Comes First:
Commitment to the “Voice of the Customer”
“A customer is the most important visitor
on our premises; he is not dependent on
us. We are dependent on him. He is not
an interruption to our work. He is the
purpose of it. He is not an outsider in our
business. He is part of it. We are not
doing him a favor by serving him. He is
doing us a favor by giving us the
opportunity to do so.”
- Mahatma Gandhi
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3. Our Mission and Vision
Our Mission
We will be the undisputed world leader in
diagnostic testing, information and
services.
Our Vision
Dedicated people improving the health in
patients through unsurpassed diagnostic
insights and innovation.
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4. Our Values
Quality
The patient comes first in everything we do. We strive to provide every patient and every
customer with services and products of uncompromising quality — error free, on time, every
time. We do that by dedicating ourselves to the relentless pursuit of excellence in the
services we provide.
Integrity
Credibility is the key to our success; therefore, all of our processes, decisions and actions
ultimately are driven by integrity. We are honest and forthright in all our dealings with our
customers and with each other. We are responsible corporate citizens in the community we
serve. We strictly comply with the laws and regulations governing our business, not only as a
legal obligation and as a competitive necessity, but because it is the right thing to do.
Innovation
We constantly seek innovative ways to enhance patient care and provide value to our
customers. We support the creativity, courage and persistence that transform information
into knowledge, and knowledge into insights. We seek continuous learning through the
adaptation of existing knowledge, as well as through experimentation, with the full
understanding that we learn from our failures as well as our successes.
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5. Our Values, Continued
Accountability
As a company and as individuals, we accept full responsibility for our performance and
acknowledge our accountability for the ultimate outcome of all that we do. We strive for
continuous improvement, believing that competence, reliability, and rigorous adherence to
process discipline are the keys to excellence.
Collaboration
We believe in teamwork and the limitless possibilities of collaborative energy. We achieve
excellence by putting collective goals ahead of personal interests. We support and encourage
open communication and meaningful cooperation among colleagues from varying
backgrounds and disciplines. We respect individual differences, and we value diversity.
Leadership
We strive to be the best at what we do — both as a company, and as individuals. We
embrace the qualities of personal leadership — courage, competence, confidence and a
passion for surpassing expectations. We will provide growth opportunities for our employees,
quality services and products to our customers and superior returns to our shareholders.
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6. Leadership:
Unite, Lead and Deliver
• Embrace role as a COACH with a passion – provides an
honest, open and encouraging environment that fosters
communication and creativity
• Proactively builds bench-strength
• Liaison between clients, sales and operations
• Provide tools for success
• Cross-functional ingenuity
• Hands-on management style – work in the “trenches” with
my team
• Never more than one step from the customer
• Leads by example
• Visionary and out-of-the-box strategist
• Team player and persuading conductor
• Bottom-line and big picture oriented
• Always one step ahead of the challenge and two steps
ahead of the competition!
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7. The Eleven Critical Qualities of
Leadership: My Daily Mission!
1. Unwavering Courage
2. Self-Control
3. A keen sense of justice
4. Definiteness of decision
5. Definiteness of plans
6. The habit of doing more than paid for
7. A pleasing personality
8. Sympathy and understanding
9. Mastery of detail
10. Willingness to assume full responsibility
11. Cooperation
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8. The Health Care Continuum, Lab
Testing & Personalized Medicine
Personalized Medicine Is…
Personalized medicine is a multi-faceted approach to patient care that not only improves our ability to
diagnose and treat disease, but offers the potential to detect disease at an earlier stage, when it is
easier to treat effectively. Health Information Technology is a key enabler and potential accelerator of
the successful adoption of personalized medicine. The full implementation of personalized medicine
encompasses the 7 phases of the Health Care Continuum denoted below:
Risk Assessment:
Genetic testing to reveal predisposition to disease
Prevention:
Behavior/Lifestyle/Treatment intervention to prevent disease
Detection:
Early detection of disease at the molecular level
Diagnosis:
Accurate disease diagnosis enabling individualized treatment strategy
Treatment:
Improved outcomes through targeted treatments and reduced side effects
Management:
Active monitoring of treatment response and disease progression
Integration of Information:
Seamless and rapid flow of digital information, including genomic, clinical outcome, and claims data 8
9. Attractive Market:
Lab Testing Growth Drivers
• Aging population, growth & longer life expectancies – 65 and older
population will double to 70M by 2025.
• Alzheimer's disease and other dementias will grow each year as the U.S.
population age 65+ continue to increase. By 2025, the number of people
age 65 and older with Alzheimer's disease is estimated to reach 7.1 million
— a 40 percent increase from the 5.1 million age 65+ affected in 2015.
• Chronic disease growth rates – cancer, diabetes, CVD, and COPD.
• Post-acute care industry expansion.
• Healthcare Reform, Value-Based Care, Triple AIM Roadmaps, PCMH, CMS
requirements, and DSRIP Waivers.
• Industry consolidation
• Key managed care relationships
• Population Health Analytics & HIT adaptation
• Alternative Delivery Models & Care Delivery Systems
• Escalating opiate, substance and alcohol abuse among teens, adults, and
special populations.
• Advances in genomics & personalized medicine
• Pharmacogenomics / companion diagnostics
• Cost pressures will reward lower cost and more efficient providers.
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10. Attractive Market:
Lab Testing Is A Valuable Service
• Small component of total cost that
influences 70-80% of physician
decisions: 2-3% of total spend of $2.8
Trillion
• 10% of spend, moving toward
personalized medicine as companion
diagnostics improve efficacy and safety
• Screening, early detection and
monitoring reduce downstream costs
• Decision support tools guide providers
to better patient outcomes
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11. Scientific Innovation:
The Shift to Personalized Medicine
Companion diagnostics and personalized medicine
• IL-28B
• BRAF V600E metastatic melanoma (Zelboraf)
• Vysis ALK Break Apart FISH probe (XALKORI)
• K-RAS
• HLA-B* 5701, HLA by NGS
• EGFR Mutation Analysis
• HCV GenoSure NS3/4a
• PhenoSense, PhenoSense GT
• HERmark
• SNP Microarray-Oncology
• CYP 450 2C19
• BRCA 1/2 Sequencing
• Intelligen NGS Therapeutic Panel, NGS Universal Carrier Screening, NGS Gene Panels
• 4th Generation HIV test
• HistoPlus: Lung Cancer
• GeneSeq: Cardiomyopathy NGS panels
• Thiopurine metabolites, expanded Inflammatory Bowel Disease (IBD) offerings
• SNP Microarray-Oncology
• NanoString Prosigna Breast Cancer Prognostic Gene Signature Assay
Women’s health
• ROMA
• Nuswab STD testing on a single swab
• Expanded Vaginosis and Candida testing
• Expanded options for HPV DNA testing
• Age-based guideline testing initiative for HPV
• Non-Invasive Prenatal Screening 11
12. Five Step Pipeline Model:
Build a Robust & Sustainable Pipeline
• PROSPECT & ENGAGE: Identify prospects, diagram organizational
chart, qualify prospects, secure appointments, and maximize the
pipeline. Never be more than one step from your clients – both
internal & external.
• DIFFERENTIATE & ENTICE: Teach for differentiation; offer unique
perspectives and drive two-way communication. Align yourself with
early adopters and thought leaders.
• BUILD VALUE: Tailor for resonance through value-based &
disruptive solutions; identify stakeholder value & economic drivers.
Permeate account, present solutions, define opportunity costs &
gain technical wins.
• CONFIRM & CLOSE: Take control; inspire emotion & build
consensus; is comfortable discussing money and drives stakeholders
to act (can tactfully challenge and pressure the customer).
Develops constructive tension.
• MAKE REFERENCEABLE: Deliver value, make reference able and
discover new needs. Leverage current clients and deliver patient-
centric, knowledge-based solutions according to the “Voice of the
Customer.”
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13. Integrated Delivery Network:
The Ultimate Delivery Model
Objectives of Integrated Delivery Networks
• Quality Improvement and Cost Reduction:
• Reducing administrative/overhead costs
• Sharing risk
• Eliminating cost-shifting
• Outcomes management and continuous quality improvement
• Reducing inappropriate and unnecessary resource use
• Efficient use of capital and technology
• Consumer Responsiveness:
• Seamless continuum of care from “Womb to Tomb”
• Focus on health of enrollees
• Expand footprint and increase access to providers and services
• Community Benefit:
• Improvement of community health status
• Addressing the prevention of social issues which affect community
health – HIV, substance abuse, infant mortality, child abuse, aging
& high risk populations
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14. Current Trends of Integrated Delivery Networks
• Purchasing PCPs to capture patients in order to increase revenue and utilization of
primary and ancillary service lines.
• Shortage of primary care physicians leading to increased care from PAs and NPs.
• Generate revenue and decrease costs – government and state incentive programs
(Meaningful Use, Patient-Centered Medical Homes, Health Homes, DSRIP, Triple Aim
Healthcare Roadmaps).
• Outcomes management and continuous quality improvement with increasing focus on
clinical and population improvements over time through 4 main areas: Infrastructure
Development (Process), System Redesign (Process), Clinical Outcome Improvements
(Outcomes), and Population Focused Improvements (Outcomes).
• Revenue Cycle Management – billing claims to denial management.
• Implementing technology like Medication Therapy Management and other Population
Health Analytics tools to proactively manage high-risk patients in order to reduce
hospital stay and readmissions with improved outcomes.
• Core laboratories as the main hub of clinical diagnostic testing; all assays that can be
performed in network must remain in network.
• Re-entering the health insurance market; heightened relationships with MCOs.
• Adopting and implementing EMR systems per the ARRA of 2009. Also upgrading HIS /
LIS to achieve a plug-in model for seamless integration with practice workflow and
future HIT and Telemedicine applications.
• Interfacing EHRs with RHIOs / SHINS per the ARRA of 2009 to facilitate a secure
electronic exchange of clinical information among providers. Goal is to achieve true
Connected Communities of Health Interoperability. 14
Integrated Delivery Networks:
My View From The Inside
15. • Migrating specialists to the EMR.
• Incentivized to provide personalized medicine and evidence-based preventive
medicine across the Health Care Continuum.
• Patient Protection and Affordable Care Act to have a positive impact on PCP patient
access in 2015 with a focus on the rural Medicaid populations. However, higher annual
deductibles and co-payments will cause hospitals and other providers to intensify
efforts to collect directly from patients.
• Shifting non-critical care patients from inpatient beds and EDs to outpatient and home
care.
• Seeking products or services that will make their network best of breed and emulated
throughout the region.
• Seamless network for the treatment of pain management, addiction medicine, agonist
therapy, inpatient / outpatient care, and primary and behavioral health care
integration initiatives.
• PCP as the hub of all relevant activity and responsible for the coordination of value-
based, patient-centric, and community-based care.
• Pursuing strategic partnerships to mutually penetrate new markets, expand ancillary
services, increase revenue and transform patient care through the adaptation of
cutting-edge technologies.
• Looking for ease of use in terms of time and hassle saved as well as the highest quality
and most compelling value.
• A “Patient First” approach through community focus groups and commitment to the
“Voice of the Customer.”
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Integrated Delivery Networks:
My View From The Inside, Cont.
16. Integrated Delivery Networks:
My View From The Inside, Cont.
• Direct to consumer marketing to expand footprint and provide the convenience of one-
stop-shopping throughout the network’s continuum of health care services and
providers.
• Offers a wide range of Health Resources for the community from wellness programs to
support groups to clinical trials in order to increase patient access and engagement.
• Shared service and purchase service agreements within and out of network to increase
efficiencies and reduce redundancies and costs.
• Taking a proactive approach to HealthCare Reform; preparing for new CCM CPT Code,
ICD-10 conversions, DSRIP, Triple Aim Healthcare Roadmaps, and future CMS metrics
and policies.
• Times are tough for rural hospitals and officials in many states are looking at new
models for healthcare delivery in rural areas. Anatomic pathology groups with
contracts to serve rural hospitals will be affected by any changes in how rural hospitals
are funded and operated. This problem is linked to the deteriorating finances of many
rural hospitals.
• One suggested approach to replace the existing community hospital model for rural
area is called a hybrid model. It is based on freestanding emergency departments
(FSED) that have links to primary care providers. Such a care model would challenge
clinical laboratories in the region to provide necessary medical laboratory testing to the
freestanding EDs in rural communities.
• Ongoing FTE reductions are adversely affecting patient care.
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17. Integrated Delivery Networks:
Partnerships = Pull Through
Over the years, I have partnered with numerous IDNs.
• BayCare Health System
• Lee Memorial Health System
• HCA Healthcare
• IASIS Healthcare
• USF Health
• VA Sunshine Health
• Florida Rural Health Association
• Community Health Systems
• Tampa General Health
• Sarasota Memorial Healthcare System
• Lee Memorial Healthcare System
• NCH Healthcare System
• Orlando Health
• Florida Hospital Healthcare System
• Ocala Health
• Shands Healthcare
• Central Florida Health Alliance
• Health First
• University Community Health
• Rochester Health
• Catholic Health
• Kaleida Health
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18. Managed Care Organizations:
Broaden Relationships With Managed Care
Managed Care Experience
• Aetna
• Amerigroup
• AvMed
• Beech Street
• Blue Cross Blue Shield
• Choice Managed Care (Workers’ Comp)
• Cigna
• Commercial
• CorVel (Workers’ Comp)
• Coventry Health Care
• Empire – NYS Employees
• Fidelis
• First Health (Workers’ Comp & Medical)
• First Service Administrators
• Focus (Workers’ Comp)
• Freedom Health
• Health First
• Health Options
• Health Choice
• Healthy Kids Florida
• Health Now
Managed Care Experience
• Hernando County Government
• Hillsborough County Government
• Humana
• Independent Health
• Magellan
• Manatee Health Network*
• Medicaid
• Medicare
• Memorial Employee Health Plans*
• Pasco County Government*
• Pinellas County Schools*
• Rockport (Workers’ Comp)
• TRICARE
• UnitedHealthcare
• Univera
• WellCare
• Wellpoint
• NUMEROUS OTHERS
*Denotes plans that I negotiated . ALL plans I have vast experience in
the implementation, compliance & leakage management processes.
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19. Health Information Technology:
Unparalleled Excellence & Experience
• 20+ years in vertically integrated networks: primary care
physician, specialty physician, IDN & acute/post-acute
hospital sales – Abbott Diagnostics, SBCL/Quest Diagnostics,
Florida Hospital & Florida Drug Screens.
• 20+ years of developing demo data bases; conducting
internal and external client training; and spearheading
process improvements per the “Voice of the Customer” –
Abbott Diagnostics, SBCL/Quest Diagnostics, Florida Drug
Screens, LLC & Niagara Falls Memorial Medical Center.
• 20+ years in primary care & specialty physician EMR sales –
SBCL TORO and Quest Diagnostics CARE360 EHR / PM /
RCM. Initiated PMS and LIS interfaces and bridges.
• 5+ years in IDN, hospital, primary care & specialty physician
EMR/EHR operations – Florida Hospital (SYSTOC) and
NFMMC (PracticePartner, Shared Medical Systems,
eClinicalWorks).
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20. Health Care Reform = Opportunity
Increased Access, Parity, Integration and Prevention
Health Reform Basics
• The American Recovery & Reinvestment Act of 2009
• The Affordable Care Act of 2010
• Mental Health Parity and Addiction Equity Act of 2008
• Primary and Behavioral Health Care Integration
• Grants
• Health Homes
• Patient-Centered Medical Homes
• Eligibility & Enrollment – Medicaid and ACA Health Insurance Exchanges
• National Prevention Strategy
• Preventive Task Force
• Community Transformation Grants
• Prevention and Public Health Fund
• Prevention Services Covered Under the ACA
• Medicare Preventive Services Coverage
• Medicaid Preventive Services Financing
• Employer Wellness Programs
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21. 12 Disruptive Forces in Healthcare:
Challenges to Respond to a Changing Marketplace
• The transition from-fee-for-service to value-based
reimbursement.
• Shifting volumes and lower reimbursements
• The transition to population health management
• Increasing oversight, greater focus on quality and
compliance
• Growing need for care management and team care models
• Shifting demographics
• Escalating government regulation
• Health information technology (HIT) advances
• Expanding use of big data and digital health tools
• Coming shortages of providers
• Patients who are informed and involved in their own
healthcare decision-making
• Shrinking availability of financial resources
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22. Key Points Summary:
My Value
• Progressive and diverse healthcare industry experience
• Proven producer and winner
• Versatile leader and team player
• P & L and territory management skill
• Contract negotiation, implementation, compliance and
leakage reduction acumen
• Vertically Integrated Delivery System expertise
• C-Suite relationships
• HIT, population health management, and connectivity
ingenuity
• Cross-functional leadership
• Leadership Tools
• Growth & Retention Tools
• IDN Business Development Strategies
• Proactive approach to Health Care Reform
• Commitment to the “Voice of the Customer” 22