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This N.J. hospital canceled surgeries over alleged understaffing. Now it’s suing.
The hospital blames its anesthesia services provider for understaffing its OR.
Hospital suing NJ NAPA
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paywall ... copy and paste itThis N.J. hospital canceled surgeries over alleged understaffing. Now it’s suing.
The hospital blames its anesthesia services provider for understaffing its OR.nj.com
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And charts and graphs and corporate people with expense accounts flying business class taking care of “everything else” so the doctors (the sole and only money generator) can focus on “medicine”.
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paywalled. is this different from the other thread about hospital suing napa in NJ?
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Nope is same story. Phymed done. Napa next
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actually one of my partners thinks envision is next... I say napa. what do y'all think?
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Any new developments on this story?
Just a quick Google news search says NAPA has some recently announced acquisitions, including a hospital in the Penn State system. While NAPA faces some trouble with some large and powerful hospital systems, I don’t think they are going anywhere anytime soon…at least as long as the private equity guys can maintain margins that bring in returns on investment.
Just a quick Google news search says NAPA has some recently announced acquisitions, including a hospital in the Penn State system. While NAPA faces some trouble with some large and powerful hospital systems, I don’t think they are going anywhere anytime soon…at least as long as the private equity guys can maintain margins that bring in returns on investment.
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Just keep marching onto the next dummy.
Envision falling will accelerate every other practice that is heavy in debt. KKR financed envision going private with 9 billion in mostly junk bonds. Hoping for a quick 13 billion or so valuation flip.
Envison is worth maybe half of that with KKR kicking the can ( the debt owed ) again in April.
They are basically homeowners circa 2009 underwater and just collecting rent without paying down the mortgage.
Labor cost especially with crnas figuring out they can make 400k easily doing locums are killing Envison and not working more than 45 plus hours.
Napa is more tightly controlled than envision so I don’t think they will fail first.
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Very interesting take - as usual you offer good insight.
What about envision splitting the crap parts into another company, sucking all the money out and then dumping the new company in bankruptcy?
What about envision splitting the crap parts into another company, sucking all the money out and then dumping the new company in bankruptcy?
It’s all a race to the bottom….
I see envision…Napa…Northstar…USAP in that order but will take years and not all at once. Different local groups will fall before whole organization does
No surprises act was the death blow. These companies will not be able to negotiate rates to get the returns private equity wants in the face of ever increasing admin/nurse/non MD costs. Simple math.
Will slowly either reform private groups….or unfortunately, much more likely will become hospital employees as hospitals will be the only entities able to negotiate higher rates
I see this taking 10-15 years to play out with possibly a few local private equity backed practices that have great payer mixes/or utilization hanging on…if they cut loose the bad ones
I see envision…Napa…Northstar…USAP in that order but will take years and not all at once. Different local groups will fall before whole organization does
No surprises act was the death blow. These companies will not be able to negotiate rates to get the returns private equity wants in the face of ever increasing admin/nurse/non MD costs. Simple math.
Will slowly either reform private groups….or unfortunately, much more likely will become hospital employees as hospitals will be the only entities able to negotiate higher rates
I see this taking 10-15 years to play out with possibly a few local private equity backed practices that have great payer mixes/or utilization hanging on…if they cut loose the bad ones
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Envision Healthcare Hits the Skids
Backed into a corner financially, the private equity–owned physician staffing company could put doctors and patients at risk.
prospect.org
Envision Healthcare Probability Of Bankruptcy vs Total Debt | EVHC
Envision Healthcare fundamental comparison: Probability Of Bankruptcy vs Total Debt
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Envision Healthcare Raises $300 Million in Latest Debt Maneuver
Envision Healthcare Corp. closed a deal with lenders Friday to obtain a new $300 million loan slice and cut debt through a swap that gives some lenders less than par, according to a summary of terms reviewed by Bloomberg.
The ratings downgrade reflects the Company's weak liquidity, increase in debt levels, and Moody's expectation that operating performance will continue to deteriorate given labor pressures impacting the industry. Further, the downgrade reflects the risk surrounding the ongoing sustainability of the business, which has continued to be negatively impacted from Covid-19.
Governance risk considerations are material to the rating action. Moody's believes that the change in the security package and the addition of the super senior debt, materially changes the ability of Envision to service its existing debt.
The outlook is stable. Moody's expects the company to remain distressed and there is a heightened risk of default given the weak liquidity and risks surrounding the ongoing sustainability of the business.
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It appears Envision has raised enough Capital and restructured debt, to survive another 2 years. Of course, longer term the business model is doomed to fail as costs rise due to increasing salaries of providers while reimbursement models are not going to be as favorable with the No Surprise ACT. Still, the executives will use all the legal and business laws to survive as long as possible.
$300 million loan!! Time for all the boys in the admin suite and on the “board” to give themselves some major bonuses!! After all, how you gonna retain all these brilliant paper shufflers, if you don’t use some of that loan money to reward all that “strong leadership”????Envision Healthcare Raises $300 Million in Latest Debt Maneuver
Envision Healthcare Corp. closed a deal with lenders Friday to obtain a new $300 million loan slice and cut debt through a swap that gives some lenders less than par, according to a summary of terms reviewed by Bloomberg.news.bloomberglaw.com
The ratings downgrade reflects the Company's weak liquidity, increase in debt levels, and Moody's expectation that operating performance will continue to deteriorate given labor pressures impacting the industry. Further, the downgrade reflects the risk surrounding the ongoing sustainability of the business, which has continued to be negatively impacted from Covid-19.
Governance risk considerations are material to the rating action. Moody's believes that the change in the security package and the addition of the super senior debt, materially changes the ability of Envision to service its existing debt.
The outlook is stable. Moody's expects the company to remain distressed and there is a heightened risk of default given the weak liquidity and risks surrounding the ongoing sustainability of the business.
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This N.J. hospital canceled surgeries over alleged understaffing. Now it’s suing.
The hospital blames its anesthesia services provider for understaffing its OR.
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Theres another hospital in Jersey that is kicking Envision out close to NY. Cant say more at this point. but their docs are going to be brought in house and indemnified. Looks like a snowball effect.
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Fail to see how any private practice anesthesia practice is sustainable with reimbursements decreasing and the no surprises act.
Who do you all see failing first, the local groups or the nat'l groups?
Who do you all see failing first, the local groups or the nat'l groups?
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Insurers are already trying to push rates down to medicare rates, using recent legislative changes as a bludgeon. I foresee pay falling and people trying to make up the difference from the hospital either through increased stipends or direct employment. It will be difficult for the national groups to continue taking their cut while maintaining staffing when they're already in trouble.
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The end game is hospital employment. Rapidly headed toward a single government payer system. Miserable rates with increasing overhead bloat. There’s no way around it. Collect your W2 and enjoy your life.
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Agree with this. We are more valuable to a hospital or surgicenter than we are to any insurance co, government payor, or PE company. Hospitals directly see our value, the others don’t.
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So say no to any buy-in from private group.
Not necessarily. Have to look at total package. Hospital will have to give groups a subsidy if want to maintain the group and adequate staffing should rates tank.
