Our Services

Speaking & Seminars

Fulcrum Strategies offers professional speaking services for conferences, meetings and more. Ron Howrigon has been speaking professionally since before founding Fulcrum Strategies. With 18 years of experience in the managed care industry, and 11 years as a physician consultant, Ron incorporates his experience on both sides of the negotiation table into his presentations, which are informative, engaging and entertaining. We are pleased to announce that our newest team member, Cindy Nyberg, will also be providing professional speaking services.

Some of the engagements in our speakers' portfolios include:

  • Medical Group Management Association (MGMA)
  • Radiology Business Managers Association (RBMA)
  • Ohio Association of Rheumatology (OAR)
  • Ohio State Medical Society (OSMA)
  • Association of Community Cancer Centers (ACCC)
  • American College of Emergency Physicians (ACEP)
  • Coalition of Hematology and Oncology Practices (CHOP)
  • Cancer Care Business Summit
  • Bayer Pharmaceutical / ICPME - Business IQ
  • American Association of Orthopedic Executives (AAOE)
  • American Healthcare Radiology Administrators (AHRA)
  • Southern Oncology Association of Practices (SOAP)
  • Indiana Medical Group Managers Association (IMGMA)
  • Indiana Association of Orthopedic Executives (IAOE)
  • Indiana Oncology Society (IOS)
  • Georgia Association of Orthopedic Executives (GAOE)
  • Professional Association of Healthcare Office Management (PAHCOM)
  • Association of Otolaryngology Administrators (AOA)
  • Medical Office Managers Society of South Jersey
  • Medical Group Managers Association (MGMA)
  • Southern Association of Therapeutic Radiation Oncology (SATRO)
  • The Arizona Clinical Oncology Society (TACOS)
Ron-Howrigon-cr

Ron Howrigon

President and Founder

Here is a list of our current speaking topics:

  • Dancing with the Devil: Negotiating with Managed Care Companies
  • Healthcare Evolution...or Revolution? Exploring the Shift from Fee for Service to Value-Based Approaches
  • Patient-Centered Healthcare: Improving the Patient Experience
  • Reimbursement Trends in a Post-Healthcare-Reform World
  • Accountable Care Organizations
  • Population Health Management
  • To Be Par or Not to Be Par, That Is The Question
  • Strategic and Tactical Practice Management
  • Physicians vs. Managed Care
  • Pay-for-Performance and Tiered Networks

Upcoming Speaking Engagements for 2017. View our FS Speaking Packet.

Here’s what others are saying about Ron Howrigon and his presentations:

"Ron Howrigon has presented at the ACEP Reimbursement Conference for the past three years, earning exceptional evaluations. He is an excellent speaker, offering the payer side perspective in contract negotiations that is very helpful for emergency physicians in understanding that process."

David McKenzie, Reimbursement Director, American College of Emergency Physicians

Read More on our Testimonials page

Contract Negotiation

Managed care companies come to the negotiation table with highly skilled negotiators who are trained to make sure that physicians are paid as little as possible for the services they provide. They know that physicians and practice managers simply don’t have the time to fully understand the intricacies of the contracts they are signing. At Fulcrum Strategies, our goal is to help physicians to succeed in the business of healthcare. We can determine if you are getting fairly reimbursed from the payers, or if there is potential for better rates and contract language. Our team, skilled in contract negotiation strategies, will handle all of your managed care contract negotiations. You maintain complete decision-making control throughout the entire process while we do all of the work.

Before we take on a new client, we want to get a realistic picture of the group’s situation. We look at things that could help or hurt future negotiations – for example; local competition, any unique aspects of the group, and contract language and rates. If we don’t think we can help a particular practice, we don’t want to take their money. To determine if we can help, we will perform a complimentary data analysis of your contract rates. We will ask you to provide us with a utilization report of your top codes with volume and fee by payer, along with the contracts themselves. From the hard data, and our knowledge of the various payers’ practices, we will normalize your contracts to a single year of Medicare so they can be compared accurately to each other, and allow us to identify which contracts can be improved. From there, we will determine how much money could be available if you were to engage Fulcrum Strategies to renegotiate your contracts.

“You don’t get what you deserve – you get what you negotiate!”

When a group decides to become a client, we’ll draft up Consulting Agreement for your review. Once signed, we begin the negotiation process. We use the previous analysis we performed to organize a “plan of attack.” We recommend which contracts should be negotiated first and predict what the likely outcomes will be. This is a collaborative process and we always defer to the client's wishes. As negotiations proceed, the client is updated as often as they wish. Once the documents are finalized, we keep images of all contracts in our database for future reference. For our clients’ peace of mind, we maintain a calendar of all contractual renewals for as long as the client remains with us.

Alternative Payment Negotiations

The healthcare landscape is changing – especially with regard to how physicians are paid and who pays them. Today, healthcare professionals are being bombarded with new terms like: Accountable Care Organizations, Patient Centered Medical Home, Tiered Networks, Episode of Care, Shared Savings and Pay for Performance, to name a few. Physicians and medical practice managers who don’t fully understand these new payment models could unknowingly sign unfavorable contracts and incur substantial revenue losses.

Now more than ever, you need a trusted ally at your side – someone who has your best interest in mind and who understands these new approaches to reimbursement methods. Fulcrum Strategies is uniquely suited to be your best advocate in these difficult and complex negotiations. At Fulcrum Strategies, our team of former insurance professionals will make sure you are protected before you enter into one of these new agreements. We can help you to understand the frequent changes that are taking place, how they will impact your practice, and how these changes can be tailored to actually benefit your practice.

Contact us today to discuss how we can help with contract negotiation services.

Strategic and Financial Planning


Strategic & Financial Planning 

In the book Art of War, Sun Tzu wrote: "Strategy without tactics is the slowest route to victory. Tactics without strategy is the noise before defeat." Unfortunately, this is true of most medical practices. Without a well-defined, researched and developed strategy, they are just creating the noise before defeat.

For most people, including physicians, it's very hard to devote time and energy to something today that may not pay off for a year or more. Understanding the importance of having a strategic plan is one thing, but the bigger issue is how to get it done. Typically, very few people inside the practice have the time or experience necessary to complete this process. With the addition of our newest team member, Cindy Nyberg, Fulcrum Strategies is ready to assist you, protect your business, and prepare for your future.

Cindy comes to Fulcrum with a wealth of experience in the financial and operational management of medical practices. Most recently, Cindy served as Chief Financial Officer for one of the largest private neurology practices in the country. In addition to overseeing Accounting and Finance, Business Office, Compliance, Information Technology and EMR, Financial Services, Pre-Authorization, and MRI Departments, Cindy also managed strategic projects including: improved access with same day appointments and improved utilization of midlevel capacity, EMR implementation, improved departmental and cost accounting, and new patient collections workflows. A certified public accountant with CMPE credentials, Cindy brings real world experience in EMR implementation, strategic planning, expense management, and operational efficiencies to the Fulcrum team.

We realize that no two practices are alike, so we are able to tailor our services to meet your needs and bring value to your organization.

Does your practice need ongoing assistance and consultation for your business operations and financial planning and reporting? 

Fulcrum Strategies can do the following: 

  • Assist with overall management consultation.
  • Develop and deliver ongoing management reporting and communication with physicians, including: calculation, tracking and communication of key performance indicators.
  • Perform specific project-related data analysis.
  • Assist with cash management and debt reduction strategies.
  • Review physician's compensation.
  • Assist with operational reviews and project management.

Is your practice operating towards future success or only reacting to the daily challenge?

Fulcrum Strategies can assist in developing a comprehensive strategic plan for your practice. 

  • Comprehensive analysis of your group's financial data.
  • Formal report outlining what your business will look like over the next five years.
  • Projections for each partner's income of the next five years.
  • Full analysis of your group's strengths, weaknesses, opportunities, threats, financial projections, and evaluations.
  • Detailed strategic plan with suggestions for improving operational efficiency, ancillary income, and overall business success.

Is your practice ready for shared savings or value based reimbursements? Do you know the cost of services provided?

Fulcrum Strategies can assist in developing and maintaining an activity based costing system. 

  • Develop a general ledger accounting system that provides accurate cost data.
  • Analysis of the cost of providing services from overall practice expense down to a specific service such as an office visit.
  • Report and communicate with physicians and administration.

At Fulcrum Strategies, we understand your day-to-day challenges of running a practice, and our goal is to come alongside and assist you with a forward-thinking approach. We are confident that our team has the knowledge, depth, expertise, and vision to support your practice in planning for the future and operating in this ever-changing healthcare environment.

For more information, please contact us today. We will setup a call to learn more about your practice and discuss your specific needs, and we will provide you with a detailed proposal for our strategic and financial planning services.