Another One Bites The Dust

[kidthor]

MEDNAX Announces Acquisition of Anesthesiology Practice in New York

http://www.businesswire.com/news/ho...nces-Acquisition-Anesthesiology-Practice-York

“Our group has provided the highest quality of anesthesia care to our surrounding community for more than 30 years, and we expect to continue that legacy as we partner with MEDNAX to support and guide us through this new and complex era of health care,” said Mitchell Reuben, M.D., who will serve as medical director for the practice. “MEDNAX’s well-developed infrastructure will help us not only provide value added services to our hospital, facilities and patients but also further enhance the care we deliver through leading-edge data collection as well as research, education and quality initiatives and outcomes.”

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So an AMC is going to provide "value added services" that weren't there before? The acquired group needed support and guidance though new and complex aspects of healthcare?

Oops - I suppose 4:1 supervision is the added value (to the the AMC), and what's new and complex is a business structure designed to leech profits while offloading risk on the physicians. My mistake.

Shameless...

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Members don't see this ad.

 

[Psai]

"leading-edge data collection as well as research, education and quality initiatives and outcomes"

roll my eyes

 

[PainDrain]

It honestly seems like these private equity owned AMCs are drinking the cool aide of the service industry and tech. It's all about data and service but they fail to realize we are dealing with humans; not computers.

 

[risnwb]

They were working on this sale for a while. Stopped taking new partners a few years back and just hired employed people who they worked to the bone. Interviewed there and was warned by a mommy track doc to run away haha.


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[Scotty_G]

Lol I was talking about this with somebody the other day

 

[GravelRider]

I believe they were an all doctor group.

My theory is everyone knows we are marching slowly toward a single payer system like the Canadians and Europeans. Shrewd businessmen know this and see healthcare as a quick way to make a bunch of money until that happens. It's almost like they are short selling the healthcare industry. The bubble will burst, so might as well make a few bucks.

 

[Psai]

I believe they were an all doctor group.

My theory is everyone knows we're are marching slowly toward a single payer system like the Canadians and Europeans. Shrewd businessmen know this and see healthcare as a quick way to make a bunch of money until that happens. It's almost like they are short selling the healthcare industry. The bubble will burst, so might as well make a few bucks.

Sounds about right to me but no one has a crystal ball. We don't know what it will look like in 10 years

 

[BLADEMDA]

Sheridan/Amsurg are now part of Envision:

Envision Healthcare’s Physician Services Business Acquires Desert Mountain Consultants in Anesthesia, Inc.

http://www.businesswire.com/news/ho...s-Physician-Services-Business-Acquires-Desert

 

[BLADEMDA]

http://www.businesswire.com/news/ho...-Expands-Physician-Services-Arizona-Acquiring

Envision Healthcare Expands Physician Services in Arizona by Acquiring Tucson-Area Anesthesia Group

 

[Scotty_G]

Looks like Arizona is the new hotspot for AMC takeovers!

 

[Consigliere]

Predictable.

"We will all eventually be employees of a hospital or AMC."

- me 5 years ago

 

[BLADEMDA]

25 anesthesia mergers & acquisitions in the past year
Written by Laura Dyrda | February 08, 2017 | " rel="nofollow" style="color: rgb(0, 57, 116); font-size: 1em;">Print | Email




Here are 25 anesthesia group mergers, acquisitions and partnerships over the past year.

Vancouver, Canada-based CRH Medical Corp. acquired majority stake in Decatur, Ga.-based gastroenterology-facing anesthesia practice.

Bedford (N.Y.) Anesthesia physicians joined Westchester, N.Y.-based CareMount Medical, forming a large full service practice in Hudson Valley, N.Y.

Las Vegas-based Anesthesia Consultants and East Texas Anesthesiology Associates in Tyler entered into a partnership with Ft. Lauderdale, Fla.-based U.S. Anesthesia Partners for anesthesia care.

NorthStar Anesthesia, based in Irving, Texas, acquired several anesthesia practices, including:

• Square Waveform Anesthesiology in Marshalltown, Iowa
• River Cities Anesthesia in Huntington, W.Va.
• Continental Anesthesia in Chicago

Mednax acquired several practices last year, including:

• Central New York Anesthesia Group in Syracuse, N.Y.
• Medical Anesthesia Consultants in Florence, S.C.
• Anesthesia Associates of Naples (Fla.)
• Associated Anesthesiologists in Reno, Nev.
• Northwest Anesthesia in Minneapolis
• Lighthouse Anesthesia in Savannah, Ga.


Sheridan, AmSurg's physician services division acquired multiple practices, including:

• Ambulatory Anesthesia Associates in Torrance, Calif.
• Genesis Anesthesia Services in Los Angeles
• South Lake Anesthesia Services in Claremont, Fla.
• Resolute Anesthesia and Pain Solutions in Boca Raton, Fla.
• Jandee Anesthesiology Partners in Ramsey, N.J.
• Karadan Anesthesiology and Pain Management in Ramsey, N.J.
• North Florida Anesthesia Consultants in Jacksonville

Knoxville, Tenn.-based physician services organization TeamHealth acquired Anesthesia Associates of Cincinnati.

North American Partners in Anesthesia acquired Nashua (N.H.) Anesthesia Partners and Manchester, N.H.-based Anesthesia Care Group.

National anesthesia provider Epix Anesthesia acquired PhySynergy, an anesthesia and hospital medicine management company.

Lodi, Calif.-based Morpheus Anesthesia physicians joined CEP America.

 

[Consigliere]

See post #11

 

[Scotty_G]

Nice post Blade :/

 

[BLADEMDA]

Nice post Blade :/

I want Residents to be aware the acquisitions are still continuing in 2017. Management companies are paying even more money now to acquire good groups than just 1-2 years ago. That new job you are taking may end up becoming an AMC so do your homework and make sure they include you for a portion of the money if/when they sell out.

The are worse things than starting out in life at age 31-32 with a 7 figure check in your bank account. AMCs can and do pay $400K plus benefits to the better groups in some locations.

 

[Consigliere]

I want Residents to be aware the acquisitions are still continuing in 2017. Management companies are paying even more money now to acquire good groups than just 1-2 years ago. That new job you are taking may end up becoming an AMC so do your homework and make sure they include you for a portion of the money if/when they sell out.

The are worse things than starting out in life at age 31-32 with a 7 figure check in your bank account. AMCs can and do pay $400K plus benefits to the better groups in some locations.

To whom does this apply?

 

[BLADEMDA]

To whom does this apply?

To a new grad who joins a group with a contractual clause including them for a 1/2 or 3/4 share of any buyout money if the group were to be acquired by an AMC prior to them becoming a full partner.

 

[Consigliere]

To a new grad who joins a group with a contractual clause including them for a 1/2 or 3/4 share of any buyout money if the group were to be acquired by an AMC prior to them becoming a full partner.

Thank you for the reply. I just don't see that happening though. I can't think a new grad would be saavy enough to ask for it nor would a group be stupid enough to put such a clause in their contract. If you hear of anyone in their early 30's hitting the AMC lottery though, please let us know.

 

[nimbus]

To a new grad who joins a group with a contractual clause including them for a 1/2 or 3/4 share of any buyout money if the group were to be acquired by an AMC prior to them becoming a full partner.

Realistically new grads have no leverage to do this unless they join a practice that has extreme recruiting problems.

 

[Shimmy8]

I declined to join a group that IMO will be selling out in the next 5-8 years. Wondering if I threw a lot of $$$ away there. Oh well.

 

[Scotty_G]

I think you can ask it sure but few groups would honor that. However a new grad can work for a few years and then respectfully command that in a contract.

 

[deleted162650]

Thank you for the reply. I just don't see that happening though. I can't think a new grad would be saavy enough to ask for it nor would a group be stupid enough to put such a clause in their contract. If you hear of anyone in their early 30's hitting the AMC lottery though, please let us know.

This advice has been given many times by many people on this board over the last few years (myself included). I know of one poster here who successfully had such a clause added to his contract (he was a fresh grad).

I think it would be fair to give the group a choice of either giving you a proportion of the buy-out based on how far through the track you are, or return your buy-in amount up to that point. A fair group without a sellout deal on the table should agree to this. If the group refuses then either they already have a deal in the works/shopping for one, or they are an assortment of douchenozzles you don't want to work with anyways.

 

[sevoflurane]

I declined to join a group that IMO will be selling out in the next 5-8 years. Wondering if I threw a lot of $$$ away there. Oh well.

Likely.

 

[sevoflurane]

Maybe not.

 

[sevoflurane]

Make partner and make partner $ for 3-5 years... Then get 2+ mil lump sum + reduced income for 5 years = not too shabby.

 

[Stank811]

http://www.haverfordhealthcare.com/...iology-Practice-Acquisitions-October-2016.pdf

My guess is M and A will continue the trend down. I know of several groups that have turned down big money and have decided to move forward as an independent group. AMC are an unnecessary middleman that just skim a lot of cash off the top for the rest of your career.

 

[facted]

I wonder what the uncertainty with Healthcare reform will do to the acquisition market. How much is a group worth now if the insurance markets are gonna be scrambled significantly?

 

[NightNight]

Thank you for the reply. I just don't see that happening though. I can't think a new grad would be saavy enough to ask for it nor would a group be stupid enough to put such a clause in their contract. If you hear of anyone in their early 30's hitting the AMC lottery though, please let us know.

Savvy enough to ask for it.

Group thought it was fair to provide peace of mind to secure a new grad they thought was the right fit.


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[Scotty_G]

You are very lucky nightnight

 

[Consigliere]

Savvy enough to ask for it.

Group thought it was fair to provide peace of mind to secure a new grad they thought was the right fit.


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Good for you. One in a million.

 

[NightNight]

Yeah, I actually do agree with @Consigliere that it's not necessarily something that all new grads should expect to find. I was very lucky. But you won't get anything you don't ask for. And it's true that a great private practice job opening is a hot commodity and new grads have very little leverage. But I guess you also never know when a group has just interviewed 2 (or 3? 4?) candidates right before you and didn't find what they were looking for.

This is how I look at it. The fact that they were willing to include it in my contract was (to me) a great indicator of how confident they were in their stability as a group (ie no plans to sell anytime soon). If things change and they sell while I'm on track, sure I'll be extremely disappointed and worried, but the 50/75/100% share of a partner buyout would surely soften the blow.


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[BLADEMDA]

Yeah, I actually do agree with @Consigliere that it's not necessarily something that all new grads should expect to find. I was very lucky. But you won't get anything you don't ask for. And it's true that a great private practice job opening is a hot commodity and new grads have very little leverage. But I guess you also never know when a group has just interviewed 2 (or 3? 4?) candidates right before you and didn't find what they were looking for.

This is how I look at it. The fact that they were willing to include it in my contract was (to me) a great indicator of how confident they were in their stability as a group (ie no plans to sell anytime soon). If things change and they sell while I'm on track, sure I'll be extremely disappointed and worried, but the 50/75/100% share of a partner buyout would surely soften the blow.


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FYI, the "honest" groups shouldn't have a problem with offering a buyout to a new grad especially if they have no plans to sell. After all, the new grad is taking a financial hit to join the group so why not include a portion of any potential buyout money after 1 year? If the goal is to acquire great new talent with the intention to be open, honest and fair then a "buyout" clause seems perfectly reasonable to me. The clause itself doesn't cost the group one dime if the hiring process is open and fair.

 

[deleted50478]

Good for you. One in a million.

Yeah except it gives them an incentive to just fire him before selling to avoid sharing the sell out money. They might be willing to offer that deal since it's meaningless.
Hopefully that isn't the case and he'll be treated well in the case of a sell out, but who knows?