AllCare (formerly Asheville Anesthesia Associates) has provided anesthesia services at Mission for over 40 years. The docs and CRNA's love their job and where they work, but do NOT want to become hospital employees for a number of reasons (The administration treats staff very poorly and freezes PTO hospital wide on several occasions while CEO makes his paltry $900K base salary. The new OR manager is not well liked by her staff and has gained a reputation of being difficult to work with. OR management have done away with RN's "no call" positions earned after 20+ years of service. There has been greater than 75% of faculty turnover due to such a bad work environment, then mandatory overtime is enforced because OR's are so understaffed that it is the only way to get cases done...etc.)
Anyhow AllCare (AC) sold to Surgery Partners (SP) in a deal that would allow AC to stay in tact in Asheville and continue to run the same model that allows them to succeed in area with a terrible payer mix (numbers quoted earlier seem pretty accurate). Surgery Partners benefits by getting the billing office and its model for anesthesia services that was highlighted by MGMA best practices. SP's goal is to implement that anesthesia billing model throughout their many surgery centers while leaving AllCare as its own entity to continue at its current practice sites. SP also gets to use AllCare's NC tax ID for their 2 centers in NC giving them an immediate return on their investment.
So Mission would be dealing with the SAME anesthesia practice that it had been for 40+ years, but now is backed by publicly traded company. What would this mean for Mission? Lower stipend to AllCare (quoted as likely lowering the stipend by 25% in 1-2 years) while working with the same anesthesiologists and CRNA's! Win- win, right?
Not when the Mission CEO, though he stated otherwise, had plans to take over AllCare and "bring the anesthesia services in-house". Now his future plan that was to be implemented over the next several years is ruined. So what does he do? Goes NUCLEAR and decides to try to do it all in 4 months instead! He would not even listen to AllCare's and Surgery Partners' plans to reduce the stipend while maintaining the same AllCare group that they currently work with! He would not even listen!!!
Within days his staff places the signs (see above in the original post for an actual picture) posting the jobs of the entire anesthesia department IN THE WORKPLACE...OUTSIDE OF ORs...IN THE HALLWAYS...AT THE OR CONTROL BOARD!!! They also posted the jobs on gaswork.com and other job websites. It was so bad that there were literally people crying. Keep in mind that this all happened three days before Christmas! (Gee I wonder why none of the anesthesia personnel want to be directly employed by this organization)
So currently the plan is for Mission to take over all anesthesia services on May 1. The problem is that the anesthesiologists have non-compete clauses. Surgery Partners is enforcing them. That means Mission can't bring those anesthesiologists in-house as planned and has to REPLACE all 25 of them (brutal way to treat a group that has served the community for the past 45 years). CRNA's don't have non-competes, but many have decided not to sign with Mission (see facebook.com "Asheville CRNA" page or #Asheville96 on twitter). Now surgeons are starting to realize that if Mission carries out their plan, there will be a brand new anesthesia team on the other side of the blood-brain barrier. They are not happy about the disruption in patient care that this would cause and are now starting to let Mission administration know how they feel. At the same time Mission is realizing that it will be harder than expected to hire 25 MDA's and greater than 50 CRNA's in a four month (now down to three month) span, since their plan for all of the AllCare employees to jump ship is not working.
AllCare is still engaging Mission in negotiations. It is very unclear what the outcome will be.
My personal advice is to stay very far away from the operating rooms (as a patient or a provider) at Mission Hospital on May 1 if AllCare is not providing the anesthesia care. The likelihood is that the newly created toxic work environment will carry on for at least several months or more likely a year or more as the revolving door of MDAs and CRNAs and locums providers scramble to cover all the cases. Mission's response will obviously be long hours for low pay (remember that whole payer mix thing) and probably that same mandatory overtime that Mission has already forced on its OR staff (I'll bet you that the Mission MDA package is straight salary with no call or OT hourly pay).
If you have any questions about AllCare, Mission Hospital or Asheville please feel free to PM me. Thank you.