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and the trend keeps going... still wanna do anesthesia? another amc takeover
- Thread starter criticalelement
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criticalelement has got his finger on the pulse.....
Happening at an accelerated pace; just need BladeMDA to post a colorful graph showing the rate of AMC aquisitions over the past ten years.
Happening at an accelerated pace; just need BladeMDA to post a colorful graph showing the rate of AMC aquisitions over the past ten years.
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"Professional Anesthesia Associates, PC, which has provided anesthesia services in the Jackson market for more than 25 years, employs 10 full-time clinicians (9 anesthesiologists and 1 anesthetist). The practice provides services at Jackson Madison County General Hospital (JMCGH), a 635-bed tertiary care center that serves a 17-county area in rural West Tennessee, and is the only tertiary care center between Memphis and Nashville. In addition, the practice provides services at the hospital’s West Tennessee Surgery Center and Skyline Endoscopy Center as well as at Physicians Surgery Center..."
They did all this with just 10 "providers!?" I don't think so....
They did all this with just 10 "providers!?" I don't think so....
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Ha, I interviewed there when I was in fellowship. Nice hospital, but man what a sh**ty town to go with a sh**ty payor mix
BTW, IIRC there were only four Anesthesiologists in this group. I remember there being two groups at the time. Guess they merged so they would have more bargaining power?
BTW, IIRC there were only four Anesthesiologists in this group. I remember there being two groups at the time. Guess they merged so they would have more bargaining power?
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I think they have some weird set up with multiple separate groups in the hospital.
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Maybe there are multiple groups there.
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http://newswatchinternational.com/news/company-shares-of-mednax-inc-nysemd-drops-by-1-71.html
Company Shares of Mednax, Inc (NYSE:MD) Drops by -1.71%
Jan 4, 2016
Mednax, Inc (NYSE:MD) has dropped 1.71% during the past week, however, the bigger picture is still very bullish; the shares have posted positive gains of 0.65% in the last 4 weeks. The shares have underperformed the S&P 500 by 0.89% during the past week but Mednax, Inc (NYSE:MD) has outperformed the index in 4 weeks by 3%.
MEDNAX, Inc. has dropped 6.34% during the last 3-month period . Year-to-Date the stock performance stands at 8.4%.
Shares of Mednax, Inc (NYSE:MD) ended Thursday session in red amid volatile trading. The shares closed down 0.44 points or 0.61% at $71.66 with 618,415 shares getting traded. Post opening the session at $71.98, the shares hit an intraday low of $71.58 and an intraday high of $72.67 and the price vacillated in this range throughout the day. The company has a market cap of $6,739 million and the number of outstanding shares have been calculated to be 94,041,485 shares. The 52-week high of Mednax, Inc (NYSE:MD) is $86.09 and the 52-week low is $64.123.
Currently the company Insiders own 2.4% of Mednax, Inc shares according to the proxy statements. Institutional Investors own 95.77% of Mednax, Inc shares. During last six month period, the net percent change held by insiders has seen a change of -7.95%. On a different note, The Company has disclosed insider buying and selling activities to the Securities Exchange,The director of Mednax, Inc., Goldschmidt, Md Pascal J sold 5,250 shares at $70.99 on December 11, 2015. The Insider selling transaction had a total value worth of $372,698. The Insider information was disclosed with the Securities and Exchange Commission in a Form 4 filing.
Company Shares of Mednax, Inc (NYSE:MD) Drops by -1.71%
Jan 4, 2016
Mednax, Inc (NYSE:MD) has dropped 1.71% during the past week, however, the bigger picture is still very bullish; the shares have posted positive gains of 0.65% in the last 4 weeks. The shares have underperformed the S&P 500 by 0.89% during the past week but Mednax, Inc (NYSE:MD) has outperformed the index in 4 weeks by 3%.
MEDNAX, Inc. has dropped 6.34% during the last 3-month period . Year-to-Date the stock performance stands at 8.4%.
Shares of Mednax, Inc (NYSE:MD) ended Thursday session in red amid volatile trading. The shares closed down 0.44 points or 0.61% at $71.66 with 618,415 shares getting traded. Post opening the session at $71.98, the shares hit an intraday low of $71.58 and an intraday high of $72.67 and the price vacillated in this range throughout the day. The company has a market cap of $6,739 million and the number of outstanding shares have been calculated to be 94,041,485 shares. The 52-week high of Mednax, Inc (NYSE:MD) is $86.09 and the 52-week low is $64.123.
Currently the company Insiders own 2.4% of Mednax, Inc shares according to the proxy statements. Institutional Investors own 95.77% of Mednax, Inc shares. During last six month period, the net percent change held by insiders has seen a change of -7.95%. On a different note, The Company has disclosed insider buying and selling activities to the Securities Exchange,The director of Mednax, Inc., Goldschmidt, Md Pascal J sold 5,250 shares at $70.99 on December 11, 2015. The Insider selling transaction had a total value worth of $372,698. The Insider information was disclosed with the Securities and Exchange Commission in a Form 4 filing.
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- Joined
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I got this from a blog which is referenced at the end of the post.
Getting beyond the “bubble” really changes things around. The question becomes an individual one rather than a macroeconomic one. Is the price someone is willing to pay for my practice high enough now that I am willing to accept future risk to my practice? What are the opportunity costs of not selling now?
What are the future practice risks? This is somewhat nebulous. Let’s look at one scenario. The large entity you sell to may be better at managing expenses and risk in an era of health reform. For some time, you may benefit from practice efficiency, technology and income stability/repair that the new entity provides (see previous articles for more details). Is there a point at which they maximize efficiency? What point will growth cease to impress the capital markets and multiples (price above earnings the market will pay) start to come down? What affect will that have on operations? When companies leave the rapid growth cycle, it creates pressure to decrease costs. Salaries and staff are reduced.
In our past articles, we argued that corporations are buying practices at earnings multiples of 3-9 and “reselling” them to the capital markets at multiples of 15-30. They use the money raised to purchase more practices. As corporate valuations go up, they can easily fund more practice acquisitions (of note, they also use the free cash flow of the practices to fund acquisitions as well). This means that practice valuations can be subject to the whims of Wall Street. Here is the 52-week chart of Envision Healthcare (EVHC), Team Health Holdings (TMH) and Mednax (MD). Notice the volatility. If their access to capital is decreased due to a declining valuation, that could mean decreased prices for practice acquisitions in the future.
The recent buyout offer by Amsurg for TeamHealth underscores that this is a dynamic marketplace. Consolidation will reduce the number of potential acquirers.
We must also consider macroeconomic pressures. Eventually, rising interest rates will make acquisitions more costly and reduce prices. The lending market is still tight because of the financial crisis of 2008.
The uncertainty raised in the previous paragraphs explains the dilemma but also points to the solution for those worried about a bubble. Our best guess is that most providers/owners are better off now with the investment and efficiency of a large entity. If the underlying business of anesthesia deteriorates, the smaller groups will be hurt more than the bigger ones. Even if the business falls apart, you will likely have fared better in a large company than on your own during a downturn (“popped bubble”).
In the end, I cannot say with certainty that we are in a practice valuation bubble. Bubbles tend to be impossible to predict. Are we saying you should sell now? Not necessarily. Just that you should think about it systematically and not run away because of fear. Start with a practice and risk assessment. Then you can choose among several options, which may or may not involve a sale of your practice.
http://www.anesthesiastat.com/2015/12/24/medical-practice-buyouts-are-we-in-a-bubble/
Getting beyond the “bubble” really changes things around. The question becomes an individual one rather than a macroeconomic one. Is the price someone is willing to pay for my practice high enough now that I am willing to accept future risk to my practice? What are the opportunity costs of not selling now?
What are the future practice risks? This is somewhat nebulous. Let’s look at one scenario. The large entity you sell to may be better at managing expenses and risk in an era of health reform. For some time, you may benefit from practice efficiency, technology and income stability/repair that the new entity provides (see previous articles for more details). Is there a point at which they maximize efficiency? What point will growth cease to impress the capital markets and multiples (price above earnings the market will pay) start to come down? What affect will that have on operations? When companies leave the rapid growth cycle, it creates pressure to decrease costs. Salaries and staff are reduced.
In our past articles, we argued that corporations are buying practices at earnings multiples of 3-9 and “reselling” them to the capital markets at multiples of 15-30. They use the money raised to purchase more practices. As corporate valuations go up, they can easily fund more practice acquisitions (of note, they also use the free cash flow of the practices to fund acquisitions as well). This means that practice valuations can be subject to the whims of Wall Street. Here is the 52-week chart of Envision Healthcare (EVHC), Team Health Holdings (TMH) and Mednax (MD). Notice the volatility. If their access to capital is decreased due to a declining valuation, that could mean decreased prices for practice acquisitions in the future.
The recent buyout offer by Amsurg for TeamHealth underscores that this is a dynamic marketplace. Consolidation will reduce the number of potential acquirers.
We must also consider macroeconomic pressures. Eventually, rising interest rates will make acquisitions more costly and reduce prices. The lending market is still tight because of the financial crisis of 2008.
The uncertainty raised in the previous paragraphs explains the dilemma but also points to the solution for those worried about a bubble. Our best guess is that most providers/owners are better off now with the investment and efficiency of a large entity. If the underlying business of anesthesia deteriorates, the smaller groups will be hurt more than the bigger ones. Even if the business falls apart, you will likely have fared better in a large company than on your own during a downturn (“popped bubble”).
In the end, I cannot say with certainty that we are in a practice valuation bubble. Bubbles tend to be impossible to predict. Are we saying you should sell now? Not necessarily. Just that you should think about it systematically and not run away because of fear. Start with a practice and risk assessment. Then you can choose among several options, which may or may not involve a sale of your practice.
http://www.anesthesiastat.com/2015/12/24/medical-practice-buyouts-are-we-in-a-bubble/
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How To Get The Maximum Price For The Sale Of Your Anesthesiology Practice
Posted On November 25, 2015 By Anesthesia Stat In Business, Transactions /
The biggest mistake that anesthesiologists make is that they wait until negative trends or catastrophic events occur in their groups before they decide to sell. In the article, Should I Sell My Anesthesia Practice, I demonstrated that timing is the most important factor when considering whether to sell your anesthesia practice. The first step is to calculate the current and future value of your group; otherwise, you will get the timing wrong and you will be underpaid by a strategic buyer.
Money is one motivating factor why anesthesiologists are selling their practices and Wall Street backed companies are buying these practices. It is not unheard of for partners to earn up $1-2 million each on a transaction and continue working for compensations that exceed the national averages. But the reason why buyers are interested in purchasing your group is because they can make considerably more money than you can while providing the same exact services. You need to know how much before you ever consider selling your group.
Here is an example:
http://www.anesthesiastat.com/2015/...for-the-sale-of-your-anesthesiology-practice/
Posted On November 25, 2015 By Anesthesia Stat In Business, Transactions /
The biggest mistake that anesthesiologists make is that they wait until negative trends or catastrophic events occur in their groups before they decide to sell. In the article, Should I Sell My Anesthesia Practice, I demonstrated that timing is the most important factor when considering whether to sell your anesthesia practice. The first step is to calculate the current and future value of your group; otherwise, you will get the timing wrong and you will be underpaid by a strategic buyer.
Money is one motivating factor why anesthesiologists are selling their practices and Wall Street backed companies are buying these practices. It is not unheard of for partners to earn up $1-2 million each on a transaction and continue working for compensations that exceed the national averages. But the reason why buyers are interested in purchasing your group is because they can make considerably more money than you can while providing the same exact services. You need to know how much before you ever consider selling your group.
Here is an example:
http://www.anesthesiastat.com/2015/...for-the-sale-of-your-anesthesiology-practice/
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I knew you'd come through, Blade! Thanks!
