Memorial 5a
1
Monday, July 4, 2011 ❘ the gazette ❘ A5 local rado by partnering with rural hospitals and other providers. Nearly lost amidst the fu- ror over Memorial’s future is what’s going on at the city’s other hospital system, Penrose-St. Francis Health Services, which in recent years has developed joint partnerships to expand or create services, signed agreements with rural hos- pitals and is developing an integrated physician net- work where primary care doctors and specialists will work closely with the hos- pital. Sound familiar? That doesn’t come as a surprise to McEvoy. “When you hear about health care systems all try- ing to do the same things, there’s a reason for that: They are,” McEvoy said. “Everyone is trying to do the same thing.” What’s telling is that Pen- rose-St. Francis, part of the faith-based, nonprofit Cen- tura Health hospital net- work, has seen its admis- sions jump while Memorial’s have fallen: Penrose’s share of the Colorado Springs market has risen from 38 to 42 percent since 2008. Under the leadership of McEvoy and Penrose-St. Francis president and CEO Margaret Sabin, relations between the rival hospital systems have been cordial, and they have worked to- gether on certain initiatives. But Memorial and Penrose are still competitors. Sabin said the 38 percent market share Penrose-St. Francis had when she arrived in 2008 was unacceptable, and she plans to reach par- ity with Memorial in the near future. “I told Larry McEvoy that we need to grow,” Sabin said. “We need to get to 50 percent, and we will.” For its part, Memorial has been consumed with the ownership and governance question, which a citizens committee spent most of 2010 studying before rec- ommending the nonprofit option McEvoy favors and which a City Council task force is now re-examining. The hospital’s uncertain fu- ture has stymied its ability to move forward on strate- gic plans and is contribut- ing to the decline in admis- sions, McEvoy said. “If you’re a physician whose practice economics are un- stable under your feet, you’re looking for long-term stabil- ity,” he said. “As docs look at the conditions their small practices are under, they’re not in a position to wait.” As far as market share goes, however, McEvoy said he’s not worried about Penrose-St. Francis catch- ing up. “Our belief is that it’s healthy to have two rough- ly equivalent systems,” he said. Push to broaden borders The tricky thing, McEvoy and Sabin agree, is that the trends in health care are aimed at reducing the use of hospitals and getting pa- tients treated in less acute, less expensive settings. And a half-empty hospital isn’t a resource, it’s a liability. “Those kinds of changes are happening all over the country,” said Steven Sum- mer, president and CEO of the Colorado Hospital Asso- ciation. “If care is done the right way, there will be less beds filled.” One way to keep beds filled, as well as boosting outpa- tient services and the bot- tom line, is to broaden the hospital’s reach. In addition to her duties at Penrose-St. Francis, Sabin oversees St. Mary Corwin Medical Cen- ter in Pueblo and St. Thomas More Hospital in Cañon City for Centura. One of her pri- orities is getting Centura’s southern Colorado hospitals to run as a unit. Centura is also branch- ing out: It signed affiliation agreements with San Luis Valley Regional Medical Center in Alamosa last year and with Heart of the Rock- ies Regional Medical Center in Salida this year. For an urban hospital such as Penrose-St. Francis or Memorial, along with beds and budget, expand- ing its patient base means bringing in more patients for specialized care, keep- ing surgeons and specialists sharp. For the rural hospi- tals, the partnership means access to resources. For in- stance, Centura sent a team to help San Luis through a trauma certification and is helping to bring a cardiol- ogy practice to the region. “It really says that we will look to each other first to solve our clinical needs and to develop clinical pro- grams,” San Luis Valley CEO Russ Johnson said of the af- filiation agreement. “If (our doctors) need a specialist or a consult, they can call the Centura Connect num- ber and talk to a specialist in their system within five minutes.” Heart of the Rockies CEO Ken Leisher said the alli- ance isn’t an exclusive ar- rangement but makes Cen- tura the preferred partner. Memorial hasn’t forged similar alliances yet. As a city-owned hospital, Mc- Evoy said, signing agree- ments and sending resourc- es outside of the city limits would require City Council approval and could run into legal and logistical snags. If the city makes Memorial an independent nonprofit, however, creating those ties would be a top priority, he said. Eighty-seven percent of Me- morial’s patients come from El Paso and Teller counties. That’s a narrow base to draw from, McEvoy said. “The secondary and tertia- ry service areas have a big population that we haven’t tapped into,” he said. Last week, the City Council task force weighing Memo- rial’s future invited Rulon Stacey, CEO of Poudre Valley Health System in Fort Col- lins, to speak. Poudre Valley is a former county-owned hospital that became an in- dependent nonprofit in 1994 and has since grown to one of the state’s largest inde- pendent health systems. Stacey said an independent Memorial could forge part- nerships with physicians and hospitals across southern Colorado and become an eco- nomic engine for the Springs — a formula that he said has been the key to Poudre Val- ley’s success. Forty percent of Poudre Valley’s admissions come from outside its imme- diate service area. There’s no reason Memorial couldn’t do the same, he said. “There are hundreds of millions of dollars and pa- tients waiting to be served if you can figure this thing out,” Stacey said. Doctors inside the tent One area where Memorial may have a head start is in building a physician net- work. While hundreds of doctors have privileges at each of the hospitals, only a handful are directly em- ployed by them. That’s likely to change in the coming years, as changes to reim- bursement for hospitals and doctors are pushing them into closer partnerships. “The new wrinkle that’s happening right now is the changes in reimbursements that have tipped the balance in favor of employment,” said Dr. Jim Reinertsen, a health care consultant and former hospital CEO based in Wyoming. “Doctors are much more valuable inside the tent than outside the tent right now.” Signing up doctors willy- nilly, Reinertsen warned, is likely to be counterproduc- tive. What hospitals need is a shared vision and mission with their physicians. “To me, the successful hos- pitals are going to think that one through very carefully,” he said. “They’re not go- ing to chase every doctor in town.” Memorial launched its Me- morial Physician Network last year and plans to hire as many as 30 doctors this year. It signed its first large practice last month, hir- ing the eight physicians of Associates in General and Vascular Surgery. Those sur- geons were tightly aligned with Memorial — not even their name badges will change with the shift — but Dr. David Corry, who heads the practice, said it’s a sign of things to come. Coming inside the Memorial tent will improve patient care by creating a deeper team of caregivers that work more closely together, he said. “We are not getting any kind of better financial deal” by being employed, Corry said. “What we’re getting is the ability to integrate the care that we provide.” Memorial’s future was a concern, Corry said, but not a deal-breaker. That’s not the case for many local doctors, said Mike Scialdone, Memo- rial’s chief financial officer. There’s too many questions and too much uncertainty for Memorial to be an attrac- tive partner, he said. “Health care is in turbulent times,” Scialdone said. “Our message is, ‘We think we have a great life line for you, but we can’t throw it to you right now or tell you what it’s really going to look like.” Centura has a doctors net- work in Denver that employs more than 300 physicians. At Penrose-St. Francis, an integrated physicians net- work is still in the planning stages, but Sabin expects to move forward aggressively in coming months. They don’t all need to be hired by the hospital for integration to work, she said. “There are four or five dif- ferent ways we could part- ner with doctors, and we’re going to pursue all of them,” Sabin said. In addition to the physician networks, both hospitals hope to pursue joint ven- tures with doctors’ groups on everything from office buildings to new clinics. The high-profile example here is the agreement Penrose-St. Francis and Rocky Mountain Cancer Centers signed in December. Before the agree- ment, Penrose-St. Francis and Rocky Mountain provid- ed competing services, while now Penrose-St. Francis pro- vides radiation oncology ser- vices while Rocky Mountain focuses on medical oncology such as chemotherapy. For its part, Memorial provides both kinds of treatments. Memorial has tried such joint ventures, although they required City Council’s approval. It ended a part- nership for an outpatient surgical center this year and brought the facility in- house. Memorial still has a joint venture with a group of gastroenterologists. Talk of teamwork raises the question: Is this like choosing sides for a pick-up game? If Penrose-St. Francis is doing all the things Me- morial is planning, will all the best players be taken if the city does decide to spin the hospital off ? That’s a concern, McEvoy says, but as a smaller, inde- pendent system, he hopes Memorial will be a more attractive partner for some hospitals and physicians than Centura is. “It hurts Memorial if they’re so good at it so fast that there’s just no room for us,” McEvoy said. “One way you could look at it is, ‘first is best.’ Our goal is to do it better.” However, he said, the clock is ticking and the sooner Memorial moves, the better its long-term chances are. Over at Penrose-St. Francis, Sabin said she is committed to making these changes first — and best. “I think we have shown that we are going to be the preferred partner,” she said. “I have nothing but respect for Memorial, (but) we are better positioned.” Margaret Sabin Larry McEvoy Penrose Hospital’s share of the Colorado Springs market has risen from 38 to 42 percent since 2008. GENNA ORD, THE GAZETTE MeMorial: Penrose is aiming for parity from page 1 — Closings Banks and credit unions: Most banks and credit unions closed today. Check with individual bank or credit union. Buses (Metro Transit): No bus service today. Government offices: Federal, state, city and county office closed today. Libraries: All Pikes Peak District Library branches closed today. Post office: Offices closed and no mail service today. The Gazette: Closed today; newspaper delivery unaffected. Malls: The Citadel and Chapel Hills open 10 a.m. to 6 p.m. today. Major department and grocery stores: Most are open regular hours today. Check with indi- vidual stores for hours. Road conditions Colorado: 1-877-315-7623, www. cotrip.org Arizona: 1-888-411-7623 Kansas: 1-800-585-7623 Nebraska: 1-402-471-4533 New Mexico: 1-800-432-4269 Oklahoma: 1-405-425-2385 Utah: 1-800-492-2400 Wyoming: 1-888-996-7623 Texas: 1-800-452-9292 Events more AT colorAdosprings. com TodAy “TRI-LAKES INDEPENDENCE DAY FESTIVAL”: 7-10 a.m., pancake breakfast, St. Peter Catholic Church, 55 Jefferson St., Monument, call for cost; 964-9770; 10 a.m., parade on Main Street, Monument; 11 a.m. Monument street fair and Palmer Lake festival open with music and activities throughout the day; 9:15 p.m. Palmer Lake Fireworks Extravaganza. For a list of events, go to www.palmer- lakefireworks.com. “FAMILY FOURTH”: Music, games and more, 10 a.m.-5 p.m., Rock Ledge Ranch Historic Site, 30th Street at Gateway Road, $8 for adults, $5 for seniors, $4 for ages 6-17, free for ages 5 and younger; 578-6777 or rockledg- eranch.com. “4TH OF JULY CELEBRATION”: Food, beer garden, live music and fireworks, noon-9:15 p.m., city parking lot along the 300 block of Bennett Avenue, Cripple Creek; www.visitcripplecreek. com. “STATUE OF LIBERTY DEDI- CATION”: Patriotic music and in- stallation of a new time capsule to celebration the Statue of Liberty given to the city in 1950 returning to its original home, 2 p.m., front lawn of City Hall, 107 N. Nevada Ave.; 339-7171. “OLD FASHIONED 4TH OF JULY”: 9 a.m.-5 p.m., with fireworks at dark, Memorial Park, Park Street and Henrietta Avenue, Woodland Park. More at city-woodlandpark.org. “4TH OF JULY CELEBRATION”: Food, game vendors, fly over, music and fireworks, 4 p.m., Air Force Academy Football Stadium, free; www.usafacademyband. af.mil and click on appearances, or call 556-9916. “MANITOU SPARKLE”: Fireworks, dessert bar and live music, 8-10 p.m., behind Manitou Springs High School, 421 El Monte Place, Manitou Springs, $5 per person, $20 maximum per family, to benefit the Manitou Springs High School Band; [email protected]. “FOURTH OF JULY AT CHEY- ENNE MOUNTAIN RESORT”: Music, dinner, fireworks at more, Cheyenne Mountain Resort, 3225 Broadmoor Valley Road. For a list of events, go to www.cheyenne- mountain.com. TUesdAy “31ST ANNUAL SYMPHONY ABOVE THE CLOUDS” CONCERT AND FIREWORKS: 5:30 p.m., Woodland Park Middle School, 600 E. Kelly Road, Woodland Park, free; 687-1304 or www.sym- phony.findwoodlandpark.com. july Fourth inFormation Colorado Springs 719.637.9767 *Results may vary. Products not included. Eat real food • Doctor-developed programs • FREE CONSULTATION No strenuous exercise • One-on-one support • Increased metabolism ASK US ABOUT OUR BODY IN BALANCE® HORMONAL WELLNESS PROGRAM CALL NOW! START LOSING TODAY! www.eMetabolic.com Scan QR code using mobile device
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Transcript of Memorial 5a
Monday, July 4, 2011 ❘ the gazette ❘ A5
local
rado by partnering with rural hospitals and other providers.
Nearly lost amidst the fu-ror over Memorial’s future is what’s going on at the city’s other hospital system, Penrose-St. Francis Health Services, which in recent years has developed joint partnerships to expand or create services, signed agreements with rural hos-pitals and is developing an integrated physician net-work where primary care doctors and specialists will work closely with the hos-pital.
Sound familiar?That doesn’t come as a
surprise to McEvoy.“When you hear about
health care systems all try-ing to do the same things, there’s a reason for that: They are,” McEvoy said. “Everyone is trying to do the same thing.”
What’s telling is that Pen-rose-St. Francis, part of the faith-based, nonprofit Cen-tura Health hospital net-work, has seen its admis-sions jump while Memorial’s have fallen: Penrose’s share of the Colorado Springs market has risen from 38 to 42 percent since 2008.
Under the leadership of McEvoy and Penrose-St. Francis president and CEO Margaret Sabin, relations between the rival hospital systems have been cordial, and they have worked to-gether on certain initiatives. But Memorial and Penrose are still competitors. Sabin said the 38 percent market share Penrose-St. Francis had when she arrived in 2008 was unacceptable, and she plans to reach par-ity with Memorial in the near future.
“I told Larry McEvoy that we need to grow,” Sabin said. “We need to get to 50 percent, and we will.”
For its part, Memorial has been consumed with the ownership and governance question, which a citizens committee spent most of 2010 studying before rec-ommending the nonprofit option McEvoy favors and which a City Council task force is now re-examining. The hospital’s uncertain fu-ture has stymied its ability to move forward on strate-gic plans and is contribut-ing to the decline in admis-sions, McEvoy said.
“If you’re a physician whose practice economics are un-stable under your feet, you’re looking for long-term stabil-ity,” he said. “As docs look at the conditions their small practices are under, they’re not in a position to wait.”
As far as market share goes, however, McEvoy said he’s not worried about Penrose-St. Francis catch-ing up.
“Our belief is that it’s healthy to have two rough-ly equivalent systems,” he said.
Push to broaden bordersThe tricky thing, McEvoy
and Sabin agree, is that the trends in health care are aimed at reducing the use of hospitals and getting pa-tients treated in less acute, less expensive settings. And a half-empty hospital isn’t a resource, it’s a liability.
“Those kinds of changes are happening all over the country,” said Steven Sum-mer, president and CEO of the Colorado Hospital Asso-ciation. “If care is done the right way, there will be less
beds filled.”One way to keep beds filled,
as well as boosting outpa-tient services and the bot-tom line, is to broaden the hospital’s reach. In addition to her duties at Penrose-St. Francis, Sabin oversees St. Mary Corwin Medical Cen-ter in Pueblo and St. Thomas More Hospital in Cañon City for Centura. One of her pri-orities is getting Centura’s southern Colorado hospitals to run as a unit.
Centura is also branch-ing out: It signed affiliation agreements with San Luis Valley Regional Medical Center in Alamosa last year and with Heart of the Rock-ies Regional Medical Center in Salida this year.
For an urban hospital such as Penrose-St. Francis or Memorial, along with beds and budget, expand-ing its patient base means bringing in more patients for specialized care, keep-ing surgeons and specialists sharp. For the rural hospi-tals, the partnership means access to resources. For in-stance, Centura sent a team to help San Luis through a trauma certification and is helping to bring a cardiol-ogy practice to the region.
“It really says that we will look to each other first to solve our clinical needs and to develop clinical pro-grams,” San Luis Valley CEO Russ Johnson said of the af-filiation agreement. “If (our doctors) need a specialist or a consult, they can call the Centura Connect num-ber and talk to a specialist in their system within five minutes.”
Heart of the Rockies CEO Ken Leisher said the alli-ance isn’t an exclusive ar-rangement but makes Cen-tura the preferred partner.
Memorial hasn’t forged similar alliances yet. As a city-owned hospital, Mc-Evoy said, signing agree-ments and sending resourc-es outside of the city limits would require City Council approval and could run into legal and logistical snags. If the city makes Memorial an independent nonprofit, however, creating those ties would be a top priority, he said.
Eighty-seven percent of Me-morial’s patients come from El Paso and Teller counties. That’s a narrow base to draw from, McEvoy said.
“The secondary and tertia-ry service areas have a big population that we haven’t tapped into,” he said.
Last week, the City Council task force weighing Memo-rial’s future invited Rulon Stacey, CEO of Poudre Valley Health System in Fort Col-lins, to speak. Poudre Valley is a former county-owned hospital that became an in-dependent nonprofit in 1994 and has since grown to one of the state’s largest inde-pendent health systems.
Stacey said an independent Memorial could forge part-nerships with physicians and hospitals across southern Colorado and become an eco-nomic engine for the Springs — a formula that he said has been the key to Poudre Val-ley’s success. Forty percent of Poudre Valley’s admissions come from outside its imme-diate service area. There’s no reason Memorial couldn’t do the same, he said.
“There are hundreds of millions of dollars and pa-tients waiting to be served if you can figure this thing out,” Stacey said.
Doctors inside the tentOne area where Memorial
may have a head start is in building a physician net-work. While hundreds of doctors have privileges at each of the hospitals, only a handful are directly em-ployed by them. That’s likely to change in the coming years, as changes to reim-bursement for hospitals and doctors are pushing them into closer partnerships.
“The new wrinkle that’s happening right now is the changes in reimbursements that have tipped the balance in favor of employment,” said Dr. Jim Reinertsen, a health care consultant and former hospital CEO based in Wyoming. “Doctors are much more valuable inside the tent than outside the tent right now.”
Signing up doctors willy-
nilly, Reinertsen warned, is likely to be counterproduc-tive. What hospitals need is a shared vision and mission with their physicians.
“To me, the successful hos-pitals are going to think that one through very carefully,” he said. “They’re not go-ing to chase every doctor in town.”
Memorial launched its Me-morial Physician Network last year and plans to hire as many as 30 doctors this year. It signed its first large practice last month, hir-ing the eight physicians of Associates in General and Vascular Surgery. Those sur-geons were tightly aligned with Memorial — not even their name badges will change with the shift — but Dr. David Corry, who heads the practice, said it’s a sign of things to come. Coming inside the Memorial tent will improve patient care by creating a deeper team of caregivers that work more closely together, he said.
“We are not getting any kind of better financial deal” by being employed, Corry said. “What we’re getting is the ability to integrate the care that we provide.”
Memorial’s future was a concern, Corry said, but not a deal-breaker. That’s not the case for many local doctors, said Mike Scialdone, Memo-rial’s chief financial officer. There’s too many questions and too much uncertainty for Memorial to be an attrac-tive partner, he said.
“Health care is in turbulent times,” Scialdone said. “Our message is, ‘We think we have a great life line for you, but we can’t throw it to you right now or tell you what it’s really going to look like.”
Centura has a doctors net-work in Denver that employs more than 300 physicians. At Penrose-St. Francis, an integrated physicians net-work is still in the planning stages, but Sabin expects to move forward aggressively in coming months. They don’t all need to be hired by the hospital for integration to work, she said.
“There are four or five dif-ferent ways we could part-ner with doctors, and we’re
going to pursue all of them,” Sabin said.
In addition to the physician networks, both hospitals hope to pursue joint ven-tures with doctors’ groups on everything from office buildings to new clinics. The high-profile example here is the agreement Penrose-St. Francis and Rocky Mountain Cancer Centers signed in December. Before the agree-ment, Penrose-St. Francis and Rocky Mountain provid-ed competing services, while now Penrose-St. Francis pro-vides radiation oncology ser-vices while Rocky Mountain focuses on medical oncology such as chemotherapy. For its part, Memorial provides both kinds of treatments.
Memorial has tried such joint ventures, although they required City Council’s approval. It ended a part-nership for an outpatient surgical center this year and brought the facility in-house. Memorial still has a joint venture with a group of gastroenterologists.
Talk of teamwork raises the question: Is this like choosing sides for a pick-up game? If Penrose-St. Francis is doing all the things Me-morial is planning, will all the best players be taken if the city does decide to spin the hospital off?
That’s a concern, McEvoy says, but as a smaller, inde-pendent system, he hopes Memorial will be a more attractive partner for some hospitals and physicians than Centura is.
“It hurts Memorial if they’re so good at it so fast that there’s just no room for us,” McEvoy said. “One way you could look at it is, ‘first is best.’ Our goal is to do it better.”
However, he said, the clock is ticking and the sooner Memorial moves, the better its long-term chances are.
Over at Penrose-St. Francis, Sabin said she is committed to making these changes first — and best.
“I think we have shown that we are going to be the preferred partner,” she said. “I have nothing but respect for Memorial, (but) we are better positioned.”
MargaretSabin
LarryMcEvoy
Penrose Hospital’s share of the Colorado Springs market has risen from 38 to 42 percent since 2008.GENNA ORD, THE GAZETTE
MeMorial: Penrose is aiming for parityfrom page 1—
Closings Banks and credit unions: Most banks and credit unions closed today. Check with individual bank or credit union. Buses (Metro Transit): No bus service today. Government offices: Federal, state, city and county office closed today. Libraries: All Pikes Peak District Library branches closed today. Post office: Offices closed and no mail service today. The Gazette: Closed today; newspaper delivery unaffected. Malls: The Citadel and Chapel Hills open 10 a.m. to 6 p.m. today. Major department and grocery stores: Most are open regular hours today. Check with indi-vidual stores for hours.
Road conditionsColorado: 1-877-315-7623, www.cotrip.orgArizona: 1-888-411-7623Kansas: 1-800-585-7623Nebraska: 1-402-471-4533New Mexico: 1-800-432-4269Oklahoma: 1-405-425-2385Utah: 1-800-492-2400Wyoming: 1-888-996-7623Texas: 1-800-452-9292
Eventsmore AT colorAdosprings.com
TodAy “TRI-LAKES INDEPENDENCE DAY FESTIVAL”: 7-10 a.m., pancake breakfast, St. Peter Catholic Church, 55 Jefferson St., Monument, call for cost; 964-9770; 10 a.m., parade on Main Street, Monument; 11 a.m. Monument street fair and Palmer Lake festival open with music and activities throughout the day; 9:15 p.m. Palmer Lake Fireworks Extravaganza. For a list of events, go to www.palmer-lakefireworks.com. “FAMILY FOURTH”: Music, games and more, 10 a.m.-5 p.m., Rock Ledge Ranch Historic Site, 30th Street at Gateway Road, $8 for adults, $5 for seniors, $4 for ages 6-17, free for ages 5 and younger; 578-6777 or rockledg-eranch.com. “4TH OF JULY CELEBRATION”: Food, beer garden, live music and fireworks, noon-9:15 p.m., city parking lot along the 300 block of Bennett Avenue, Cripple Creek; www.visitcripplecreek.com. “STATUE OF LIBERTY DEDI-CATION”: Patriotic music and in-stallation of a new time capsule to celebration the Statue of Liberty given to the city in 1950 returning to its original home , 2 p.m., front lawn of City Hall, 107 N. Nevada Ave.; 339-7171. “OLD FASHIONED 4TH OF JULY”: 9 a.m.-5 p.m., with fireworks at dark, Memorial Park, Park Street and Henrietta Avenue, Woodland Park. More at city-woodlandpark.org. “4TH OF JULY CELEBRATION”: Food, game vendors, fly over, music and fireworks, 4 p.m., Air Force Academy Football Stadium, free; www.usafacademyband.af.mil and click on appearances, or call 556-9916. “MANITOU SPARKLE”: Fireworks, dessert bar and live music, 8-10 p.m., behind Manitou Springs High School, 421 El Monte Place, Manitou Springs, $5 per person, $20 maximum per family, to benefit the Manitou Springs High School Band; [email protected]. “FOURTH OF JULY AT CHEY-ENNE MOUNTAIN RESORT”: Music, dinner, fireworks at more, Cheyenne Mountain Resort, 3225 Broadmoor Valley Road. For a list of events, go to www.cheyenne-mountain.com.
TUesdAy “31ST ANNUAL SYMPHONY ABOVE THE CLOUDS” CONCERT AND FIREWORKS: 5:30 p.m., Woodland Park Middle School, 600 E. Kelly Road, Woodland Park, free; 687-1304 or www.sym-phony.findwoodlandpark.com.
july Fourth inFormation
Colorado Springs
719.637.9767 *Res
ults m
ay va
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oduc
ts no
t inclu
ded.
Eat real food • Doctor-developed programs • FREE CONSULTATION No strenuous exercise • One-on-one support • Increased metabolism
ASK US ABOUT OUR BODY IN BALANCE® HORMONAL WELLNESS PROGRAM
CALL NOW! START LOSING TODAY!
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