Aloha Nui Family Practice, LLC
69 Lanihuli Street
Hilo, Hawaii 96720
808.961.1400 (office)
808.96.1300 (fax)
Alohanuifamilypractice@gmail.com
Alohanuifamilypractice.com
"Welcome to our Ohana"
Aloha Nui Family Practice
The Dan Harmeling Health & Wellness Center

Executive Summary
Aloha Nui Family Practice is a family medicine primary care - patient centered medical home offering comprehensive, cost-effective & innovative health care services within our Big Island community of East
Hawaii.
Opening in 2007 as a single employee "micro" medical practice Aloha Nui Family Practice has prospered and grown into a three provider family medicine primary care - patient centered medical home with greater than 5000 client appointments annually.
Aloha Nui Family Practice is committed to offering health care services in an open & friendly environment in respect of each client's age, gender, economics, ethnicity, culture, race, spirituality and sexual orientation.
At Aloha Nui Family Practice we have worked hard to earn designation as a patient centered medical home (PCMH) emphasizing a team approach & healthy balance within our client's whole self which includes their physical, mental and emotional health.
Our emphasis on medical information technology, evidence-based medicine and national standards of medical care improves our client’s health care education & disease prevention.
We continue to attract and hire exceptional employees by using a business model that compliments the employee centric - concept of successful companies by:

Promoting professional & personal balance within the work place

Empowering employees to improve performance to reach defined goals

Encourage critical and analytical thought in problem solving

Company culture of recognition of an employee's value
At Aloha Nui we recognize that when an employee learns a new skill or develops a better strategy to work more efficiently that the benefits are shared company wide.
From our initial investment in electronic health records (EHR), Aloha Nui has continued to adopt health care technology and has improved the process of providing health care, including client enrollment, specialist referrals, as well as, sharing & receiving protected health information (PHI).
A steady and balanced financial growth strategy, built on a dedicated work ethic & regular market analysis, has led us to achieve our objectives for revenue, and to meet our goals.
*see Aloha Nui Family Practice - 2014 Revenue, Accomplishments & Goals
We look forward to further improving the medical health and wellness of our East Hawaii community through the establishment of the The Dan Harmeling Medical and Wellness Center.
Our new medical center will be a primary care, multi-specialty, healthcare facility providing much needed healthcare services to our Hawaii Island residents.

The Dan Harmeling Medical and Wellness Center will help to address the physician shortage and support the improvement of healthcare services from early adolescence into our older years, caring for our
"keiki" to our "kūpuna".
This new and innovative medical & wellness center will allow for Aloha Nui's continued growth and improvement to meet our community’s need for equal access to quality healthcare.
The Dan Harmeling Medical and Wellness Center will be a primary care medical home complex offering the following services:

Family medicine

Women's health

Geriatric care

Pediatrics

Mental health and wellness

Physical therapy and rehabilitation

Diagnostic and cosmetic dermatology

Pharmacy and medical supply services

Domestic violence, child neglect & abuse prevention and education
We are scheduled to begin construction in 2016 and open in January 2017 to start accepting new clients into our "Ohana" (family).
Mission Statement
Aloha Nui Family Practice is a patient centered medical home that can help to manage your individual medical concerns while educating you on your own self improvement in medical health.
Vision Statement
An integrative and holistic primary care medical & wellness center that serves as a premier patient centered medical home offering comprehensive, cost effective & innovative healthcare services to meet our community's need for equal access to quality healthcare.
Values Statement
First, do no harm, neither confounding the persons, nor dividing the substance.
Primum non nocere, neque confundentes personas, neque substantiam separantes (Latin).

Ownership information
Established/Licensed
Business Entity Type
Manager/CEO
Location
Contact
URL
Federal Tax ID
General Excise Tax ID
Commercial Liability Insurance
Malpractice Insurance
Temporary Disability insurance
Life Insurance
Medical Insurance
Umbrella Policy
Company Description
I. Health Care Services
- Adult Healthcare
- Geriatric Medicine
- Women's Health and Gynecology
- Adolescent Medicine
- HIV & AIDS Care
- Sports Medicine & Physicals
- School, Employment & Commercial Driver
License (CDL) physicals
February 1st 2006
Manager-Managed Limited-Liability Company
Stefan Carl Harmeling, MD
69 Lanihuli Street,
Hilo, Hawaii 96720
808.557.9028 (mobile)
808.96.1400 (office)
808.961.1300 (fax)
Alohanuifamilypractice@gmail.com www.Alohanuifamilypractice.com
20-4220443
W83141700-01
American Insurance Company ($2/$4mil)
Medical Insurance Exchange of California ($1/$3mil)
Guardian Pacific Life ($10K/mo)
Guardian Pacific Life ($3mil)/Lincoln Benefit Life Co ($1mil)
HMSA HMO (medical/vision/dental)
State Farm ($2mil)
- Health Care Education and Disease Prevention
- Medical Marijuana Certification
- * Physical Therapy Rehabilitation & Sports
Kinesiology
- * Diagnostic + Cosmetic Dermatology
- *Mental Health & Wellness
- *Pharmacy & Medical Supply Services

II.
III.
Company Goals & Objectives
1.
Continue to earn a reputation of exceptional client service to maintain a loyal customer base, as well as, persistently increasing new clients by offering patient centered medical care with comprehensive, cost-effective & technologically advanced health care services.
2.
Continue to support and invest in an "earth first" utilization of resources with the use of green technology whenever feasible, i.e. photovoltaic (PV) solar panels, low energy HVAC building air units & biodegradable cleaning supplies.
3.
Attract and hire exceptional employees by using a business model that compliments the employee centric - concept of successful companies by promoting professional & personal balance, empowering employees to improve and having a company culture of recognition of employee value
4.
Maximize social media resources to increase exposure, improve communication. Maintain loyalty and attract new clients.
5.
Continually improve the patient center medical home (PCMH) model and development a coalition of medical providers & business leaders to support an Accountable Care Organization
(ACO) health care structure to reduce cost & improve access.
6.
Secure funding for Phase II of the Aloha Nui Family Practice - Dan Harmeling Health & Wellness
Center construction
7.
Maintain the highest standards of medical care using evidence-based health care which is sensitive to our client's unique medical concerns.
Company Strengths & Keys to Success
1.
Friendly & competent medical staff emphasizing customer service
2.
Promoting employee growth and professional development to continually improve efficiency
3.
Accessibility of exceptional medical providers & staff
4.
Comprehensive & efficient medical diagnosis and treatment
5.
Emphasis on health care education & disease prevention
6.
Client assistance in navigating their individual health insurance carrier services
7.
Affordable pricing with 20% discount for uninsured clients
8.
Involvement in physician networking to improve client access to specialist consultation services
9.
Creating relationship with business leaders to support the improvement in health care of our larger community
10.
Partnering with large businesses to offer comprehensive primary care medical services to their employees
11.
Encouraging employee volunteer activities within their local communities
12.
Close proximity to Hilo Medical Center within a 10min drive for emergency services
13.
Convenient location with adequate parking within Hilo town
14.
Use of advanced health care technology

15.
Completion of Phase II construction of the Aloha Nui Family Practice - Dan Harmeling
Health & Wellness Center thereby increasing medical care capacity and company profitability
Organization & Management
I. Ownership Information & Management Profile
CEO - Profile
Aloha Nui Family Practice is a manager-managed, limited-liability company 100% owned and operated by Stefan Carl Harmeling, MD.
Dr. Harmeling has fourteen years of professional experience having developed a keen interest in and a unique perspective of the health care industry based on a diverse professional medical background, as well as, special interests in medical technology and business management.
Dr. Harmeling is a family physician practicing in Hawai'i since March 2005. He completed medical school at the University of Florida - College of Medicine in 1999 with his medical doctorate degree. His undergraduate education was at Florida State University graduating in 1995 with a BS - biology.
Born in Reston, Virginia but raised in Florida first on his grandmother's farm in Jonesville, Florida and later completing high school in Gainesville, Florida in 1990. Dr. Harmeling grew up quickly as the youngest of four brothers and divorced parents.
Patience, perseverance and dedication have defined Dr. Harmeling's work ethic as a driven small business owner, family physician, husband and father of three young children.
Dr. Harmeling's work experience within a large inner city urban hospital during residency training at
White Memorial Medical Center in East Los Angeles, free clinic serving homeless & undocumented residents of Venice, California to a secluded rural underserved area as a family physician at the Bay
Clinic - Pahoa facility has prepared him well for the challenges of medicine. Since moving to Hilo, HI Dr.
Harmeling has continued to gain valuable medical & business experience working within a local urgent care, as well as, a hospitalist setting at Hilo Medical Center prior to dedicating himself to the full time roll of CEO to promote the growth & success of Aloha Nui Family Practice.
Professional experiences also include the past chair of the Department of Family Medicine - Hilo Medical
Center to a current board membership of the East Hawaii - Independent Physician Association (EHI -
IPA), as well as, chair of the EHI - IPA Business Development & Payment Reform committee.
Dr. Harmeling continues to be active within the community working to continually improve the patient center medical home (PCMH) model and development a coalition of medical providers & business leaders to support an Accountable Care Organization (ACO) health care structure to reduce cost & improve access.

II. Organizational Structure & Culture
Employee centric business model
Medical
Providers
Manager/
CEO
Nursing
Nursing
Admin/
CHO
Admin
Assistants
Office
Admin/
CFO
1. Employee centric business model a.
Utilizing companywide decision making tools employing the concepts of critical thinking including reasoning, evaluating, problem solving, decision making and analyzing information. b.
Promoting professional & personal balance, empowering employees to improve and having a company culture of recognition of employee value.
Market Analysis
1. Market Demographics and Economics:
Hawaii total resident population is currently estimated to be 1.4 million with 14% or approximately
190,000 living on the Big Island of Hawaii. The Hawaii State Dept of Business, Economic Development and Tourism (DBEDT) project continued growth of approximately 140,000 every ten years between
2000- 2030. Approximately 42% of projected growth will occur on the neighbor islands of Kauai, Maui and Hawaii Island. As a result, the Neighbor Island population as the share of the state total will increase from 29.9 percent in 2010 to 36.4 percent in 2040. Hawaii Island having the fastest growth rate averaging 1.8% per year with state average being 0.8% growth per year. Hawaii Island's population growth by 2040 is projected to be 296,300 which is a 32% increase over next 25 yrs.
Although Hawaii ranks 9th in US states - primary care physicians per 100,000 population (Hawaii -
83.89%) approximately 72% are currently concentrated on the main island on Oahu. Physician shortages within the neighbor islands continue to challenge healthcare outcomes. Hawaii Island has approximately
138 primary care physicians (PCPs) or 12% of state population leading to an average of 1 PCP per 1,353

residents or only 72 PCPs per 100,000 resident population. In comparison the US national avg is 75 PCPs per 100,000 residents and Oahu averaging 84 PCPs per 100,000 residents.
Population growth on Hawaii Island will continue to drive demand for health care services. Hawaii reflects the national trend of continued population growth as a result of decreased mortality and increasing life expectancy with Hawaii 1st in nation at 81.3yrs compared to national avg. of 78.9 yrs.
The passage of the Affordable Care Act (ACA) has lead to improving access to health insurance decreasing our uninsured population. The implementation of Primary Care Medical Home (PCMH) standards has helped to support medical providers to increase emphasis on the importance of health education, illness prevention and early treatment of disease. Accountable Care Organizations (ACOs) have the potential to further transform medical care by organizing the local healthcare community to address and reduce their most costly medical issues.
Hawaii Island is a unique environment to provide primary care medical services. While Hawaii Island is faced with a rapidly growing population the total numbers of primary care providers has not kept pace creating an economic environment of significant demand with limited supply. While there is a national trend of decreasing access to primary care providers Hawaii island's large percentage of residents with access to health insurance is 90.1%, compared to US national average of 85.1%, which increases the demand for medical services that Aloha Nui Family Practice has and will continue to supply.
Hawaii's health care coverage is one of the nation's highest due in part to Hawaii's Prepaid Health Care
Act (PHCA) which mandates that employers provide health insurance coverage for their employees working 20 hours or more per week. In addition, a large population of Medicare seniors currently comprising 16.8% of total Hawaii Island residents is projected to increase to 23.6% by 2040. Hawaii's
Medicaid - Quest health insurance program also covers large numbers of Hawaii Island's population with
42,000 residents covered or 25% of total insured population. The remaining 59% of health insured
Hawaii residents have either PPO or HMO insurance plans via employer sponsored or individually purchased in health care market.
Within this market of high demand and limited supply Aloha Nui Family Practice from 2009 - 2014 has increased revenue by 61% while increasing primary care visits by 26% up to 5017 per year. Aloha Nui's goals & objectives supported by proven market & sales strategies have allowed for continued success in accomplishing growth goals, as well as, setting new standard to achieve.
* see Aloha Nui Family Practice - 2014 Revenue, Accomplishments & Goals
The market within Hawaii island for health care is in high demand with limited supply. Aloha Nui Family
Practice has set a standard to customer care creating a demand for services that is being suppled by a friendly, efficient & professional staff.

Marketing & Sales Strategies
1. Market Strategy:

Understanding & predicting changes within healthcare market to quickly adapt and implement.

Employee centric business model recognizing balance, education, empowerment & value to promote employee development and retention.

Exceptional customer service creating a reputation of excellence to build trust & establish customer loyalty.

Use of advanced medical information technology to increase access, improve communication & reduce error.

Emphasizing our social media presence to attract & educate new clients.

Leadership roles within healthcare community to advance policy & implementation.
2. Sales Strategy

Obtaining > 90% of all preventative health measure goals to maximize P4Q (pay for quality) health insurance reimbursement.

Health insurance FFS (fee for service) reimbursement collections of > 95% in accounts receivable.

Increase client's co-pay collection > 98% with convenient online payment options.

Maintaining missed or no-show appointments < 5% of daily total clients seen.

Improving appointment compliance with access to online booking.

Regularly discussing and improving company efficiency in all aspects of primary care including, but not limited to, superior customer service, competent medical care, adaption of enhanced technology, employing training and cost control.
Project Costs
Soft costs $58,000
Hard costs $2,000,000
Building construction $1,181,000
Interior construction
$100,000
Staffing $180,000
+
+

Soft costs => $ 58,000 include architectural, engineering, utility, county & permitting costs
*completed
Hard costs => $2,000,000 includes the below items:

Building construction => $ 1,181,000 include civil grading, drainage, building & landscaping costs

Interior construction => $ 100,000 include smooth finish & painting, furniture, computer equipment and medical supply costs

Staffing => $ 180,000 include operational expenses hiring & training new staff costs
Funding Resources

Crowdfunding – fundraising campaign on Indiegogo.com
@ The Dan Harmeling Medical and
Wellness Center to raise 10% of total project costs

Small business loan – Hawaii Economic Development Corporation (HEDCO) small business loan of 90% of total construction costs
Below is a rendering of the completed Dan Harmeling Medical & Wellness Center.