Faculty Opinion

It’s not hard to match Shelly Boyce with the profile of a typical entrepreneur.

Boyce is founder and CEO of MedRisk, a specialized medical management company focused on the treatment and management of musculoskeletal injuries for workers’ compensation.

The hardest thing about her job is “never being able to let go. You eat this, drink this, wake up at 3 a.m. and feed the baby with it,” says Boyce, who has three children, 4, 3 and two months. “And I tend not to celebrate the successes long enough. As soon as we accomplish something, I’m thinking yes, but what else, what’s next. It’s important to acknowledge achievement with your colleagues. They need to feel rewarded and appreciated for their efforts.”

MedRisk, which began in 1994 with 10 employees and covered two states, now has 60 employees covering 15 states. And while it started as a provider network of physical therapy centers, it has recently evolved to offer more managed care services for musculoskeletal injuries, including medical management, peer view and bill review. Its primary clients are insurance companies and large managed care organizations. This year its physical therapy network includes more than 6,000 providers in more than 2,000 locations.

Much of MedRisk’s success is attributable to Jerry Poole, also WG’95, whom Boyce met while they were both students in Wharton’s executive MBA program. Poole, who is MedRisk’s COO and CIO, oversees day-to-day operations and developed and designed Medrisk’s proprietary software program. This program, which Boyce describes as the company’s “competitive advantage” and a “barrier to entry” for would-be competitors, monitors treatment outcomes and provider results by integrating the clinical and financial aspects of care.

The two graduates appear to complement each other. Boyce, who worked for 10 years for a small entrepreneurial medical company before and during her two years at Wharton, describes herself as someone who “likes to create and innovate, think out of the box, who is easily bored and therefore impatient to move on. Jerry,” she says, “worked for Boeing before coming to Wharton. He is very detailed, analytical, well thought out, the kind of person who will take a concept and create a sustainable operating structure for it.”

MedRisk’s success is based on “a new approach” to the medical management of musculoskeletal injuries, says Boyce. “We looked at how our market segment — musculoskeletal injuries — was managed and reimbursed in workers’ compensation, and we created a new approach that holds the providers accountable for results. Our contractual relationship with our providers establishes a maximum reimbursement by diagnosis to treat each individual. The system is similar to the DRG (Diagnosis Related Group) system for Medicare. It cuts off payment, not coverage.”

MedRisk, based in King of Prussia, Pa., can claim its share of ups and downs. “One of the most difficult things we have faced was the loss of two major clients,” says Boyce, who grew up in Richmond, Va., and graduated from the University of Virginia with a BSN in nursing. “Neither client was lost because of us — we were a subcontractor under another contract. But one client was 50 percent of our business in 1995 and the other was 30 percent a year later. Those weren’t insignificant hurdles for us to overcome, especially because we are a small company and I didn’t want to downsize. We did it but it was challenging. And now we’re in a much more secure position than we were.”