From time to time we wish to update our clients and consultants on company progress and activities. As always we thank our valued clients, for trusting us with your examination and review needs. We also thank our staff nationwide as well as our physician/consultants for their great work in support of MCN. Our staff and managers have worked hard to achieve many notable results, some of which we will share in this report.

The period 2013-2014 has been and continues to be a remarkable one for MCN as we continue to set the standard within the industry for technological and performance advancements. While not the oldest in our space (MCN was founded in 1985) MCN was the first company in the medical assessment field to develop a web presence – thus the valued 3-letter url mcn.com – the first to pioneer online ordering and access, and the first national network, moving from a regional to national presence in 1997. Achievements reached in 2013-2014 include the following:

• In the second half of 2013 the company released a new information management system after about two years of development. This system is internally called Cadence, and replaced the original system called Andante that we deployed in 2000 (we enjoy musical terms). Cadence is a robust program that contains, in a secure environment, all data pertaining to our work. This includes individual claim files, claimant information, and client tracking as well as physician/consultant information such as credentials and report delivery statistics.
• MCN has continued to enhance our client portal, a platform where clients may order services, access select information in real-time, and complete functions such as uploading and retrieving files and receiving case status updates.
• In the coming weeks we are launching an updated provider portal, following strenuous testing and development. This portal allows physician/consultants access to their files for retrieving and reviewing records, editing and uploading reports, and performing other important functions.
• We are undergoing a security certification process and will receive our SSAE-16 SOC1 certification later this summer.
• All of our data is maintained at the highest level of security using secure socket layer (https) for data in motion and 256 bit AES (Advanced Encryption Standard) for data at rest.
• We have significantly grown our URAC-accredited Independent Review Organization (IRO) division, providing peer reviews for healthcare claims for some of the largest carriers in the nation. This team processes evidence-based reports that address medical necessity and appropriateness of treatments or services.
• We have grown our physician recruiting development department to maintain our status of having a large, comprehensive and national physician network credentialed to the highest standards.

We have a fine group of managers overseeing operations, client service, information systems, human resources, and sales and account management. We are proud of our team, especially the great bench of talent residing at MCN which has allowed us to source most new leaders internally with promotions to their new roles.

We are proud of a number of data points and gains flowing from an initiative started in earnest in the first quarter of 2014. We have challenged many assumptions present in our marketplace that make little sense in the larger scheme of health care. Primary among these initiatives was a decision to more strongly engage our suppliers (our consultant physicians) in being responsible for holding up their end of quality in terms of fully addressing all aspects of their evaluation assignments and being timely in their report delivery.

As a company designed around medical services and led by a physician, we found ourselves asking why the industry that we are in has tended to not expect the best from consultants, instead regularly relying upon inspection and correction by non-clinical staff after the report is provided by a consultant to address any concerns and to achieve quality. Medical training and practice does not include a non-clinician shadowing and correcting doctor errors. Why in the medical review business did this become the norm? Rather, in the world of most health care services, it is expected that doctors are accountable for their work product. Prior to our changes, we relied upon inspection and correction, leading to rework that was often not to up to our standards, and often led to delays in report issuance with the back and forth processes that were required before the report was acceptable. We have been heartened by the results of setting clear standards to consultants. Our consultants by and large welcomed respect and accountability that this involves, and the ability to deliver the quality that they have been trained in and practice in the course of their clinical work.

While our turnaround times have always been competitive with the work of our peers, as a result of these efforts to-date this year we’ve experienced more than a 30% reduction in total turn-around time from date of examination to delivery of report. We have also seen a sizable reduction in rework and clarifications that contribute to this reduced time.

Our new focus embraces modern quality concepts common to hospital initiatives and general business trends. These are often given names like TQM (Total Quality Management), ISO 9000, Six Sigma, and others. All these include a variety of principles including the importance of root cause analysis, continuous improvement, and supplier/contractor engagement and accountability. One basic truism of achieving quality is that it can’t be achieved by inspection and correction – rather, it requires that quality is built in the entire system and involves the engagement of all stakeholders. In our case this means MCN’s clients, consultants, and staff.

We prepared for these changes by sharing the concepts with consultants and staff, redoubling our efforts in orientation and credentialing, and providing clear and concise documentation along with examination files. We communicated the responsibility for consultants to be accountable for producing a finished product within required time parameters, and personally proofing for content and syntax before allowing their signature to be affixed.

Many consultants have expressed support and appreciation of our joint efforts on quality. MCN staff are pleased to be part of this improvement effort as they see the improved impact of their work with less need to engage in frustrating rework, clarifications, or calling on late reports. We are very appreciative of all who have participated in this significant cultural and process change, which is ongoing.

Importantly, the clients’ experience is being positively impacted and is supported by their own data and audits.

One client, a national carrier, provided us first quarter data that demonstrated:

•  MCN’s average turnaround time is 9.8 days with the contracted time of 15 days being met 92% of the time. Their other vendors have an average turnaround time of 13 days with 81% within specifications.
• In addition to our superior turnaround, MCN had an exception rate of 3% vs. 20% among competitors serving this client. Exceptions include meeting turnaround specifications as well as 25 other measures including clinical metrics.

It is common to tout one’s processes and attributes but what really matters is how it is experienced by clients. The difference is being experienced and is a source of delight by those who order our services, and one of great pride for the great staff and consultants who are working together to achieve these meaningful results. Our clients are noticing with growth in referrals, and the awarding and renewals of a number of significant and prestigious contracts with global, national and regional companies.

From all of us at MCN, both staff and consultants, we thank our valued clients for their support and business as we work hard to innovate and excel in our field.