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Not sure if this has been posted yet:
http://www.acepnow.com/article/summa-transition-directly-principals/
KK: The program has a great reputation and provides great training. What really happened, from your perspective, with this transition?
JW: Basically, our most recent contract [with Summa Health System] was a three-year contract started in 2013. At that time, there was an RFP because Summa wanted one group for six emergency departments. One has since closed, so now it’s five emergency departments. It was us and many other groups vying for that contract. We won the contract in 2013 and picked up three other emergency departments within the system.
KK: Was this negotiation in 2016 different?
JW: We had dealt with similar administrations for multiple years. Some members of the new team have been here for one to three years. The negotiations didn’t get started, unfortunately, until mid to late November. We saw the first contract on Nov. 26. It was about an 80-page contract. The biggest issue was that it was never about quality, timeliness of service, or meeting any metrics. We do fantastic on the metrics. The residency does very well on the medical education side. When we won the RFP three years ago, we picked up three new emergency departments within Summa. All three are underperforming either financially and/or by volume.
Two weeks before we took over the Wadsworth contract, the hospital decided to get rid of inpatient beds; it took out 36 percent of the volume within that ER. The groups that were in there before us had asked for stipends or assistance. We did those contracts for three years, and lost between $8 million and $9 million. It cost us more to staff them, bill them, and malpractice them than we were receiving in revenue. There was nothing to cut from our end. We offset the losses with other departments that we run.
Five senior residents this year wanted to stay with the group. All five had to sign with competitors because I could not offer them the type of package needed for them to pay back the $350,000 in medical student loans.
KK: So the math is simple. You can’t compensate people and pay your bills if they’re more than you can bring in in revenue.
JW: Correct. I’ve been head of our group for 15 years, and even before I was president of the group we never had any financial assistance from the hospital, but those in residency roles got graduate medical education money. In our counter proposal to Summa, we didn’t even ask for financial assistance. We said, “Can we get out of two of these three ERs? Can we close them? Can we make them urgent cares?”
KK: Was there anything extraordinary beyond meeting your losses with the stipend you were looking for?
JW: No. Initially, we didn’t even want a stipend, but when it was discussed, it was actually significantly less than what we were losing. Basically, our group, doctors, and corporation were giving them [Summa] a stipend the last three years and my doctors were taking less....
KK: In effect, you were subsidizing the hospital. Did you decide to withdraw or did they terminate your contract?
JW: The contract was over Dec. 31 at 11:59 p.m. I had requested face-to-face meetings with emails saying, “Guys, let’s get together and get this worked out.” We got the contract on Nov. 26 or 28. Our first and only face-to-face meeting was Dec. 26.....
KK: It sounds like they may have had a backup plan in place?
JW: Well, they had actually talked to US Acute Care Solutions on Dec. 24 before we had our face-to-face meeting on Dec. 26.....
The residents (only those on an ED rotation) did not work for two or three days. They were put on administrative elective, basically a study month for their in-service exam. They have since gone back to their normal routine.
KK: Who told them to come back to work?
JW: They were pressured by [two members of Summa Health System’s senior leadership]. They were told that they could potentially lose their jobs if they didn’t come back into work.
KK: Did you have concerns that there was any undue influence over the negotiation process by those who might have had a conflict of interest?
JW: Absolutely that was one of our biggest concerns. The initial hospital contract team was the COO, who was new to her position within the last year or two. The biggest concern was the CMO of the hospital, who is the wife of the USACS CEO. She was directly involved with contract negotiations.
KK: So, from your perspective, she was involved with the negotiation? It’s not just that she works there?
JW: No, no, no. She was directly on the hospital’s contract negotiations team. The first conversation we had about the contract took place in November, and included me and the [Summa Health System] CMO and COO, about two to three weeks before we got the contract [Nov. 26]. We turned in our counterproposal on Dec. 12. They reviewed it on Dec. 14, and she was directly involved with that meeting.
65 doctors and USACS couldn't get any of them to stay. What does that say about your company? I'll be curious to see what the RRC thinks about this transition where every faculty member in the residency was replaced.
http://www.acepnow.com/article/summa-transition-directly-principals/
KK: The program has a great reputation and provides great training. What really happened, from your perspective, with this transition?
JW: Basically, our most recent contract [with Summa Health System] was a three-year contract started in 2013. At that time, there was an RFP because Summa wanted one group for six emergency departments. One has since closed, so now it’s five emergency departments. It was us and many other groups vying for that contract. We won the contract in 2013 and picked up three other emergency departments within the system.
KK: Was this negotiation in 2016 different?
JW: We had dealt with similar administrations for multiple years. Some members of the new team have been here for one to three years. The negotiations didn’t get started, unfortunately, until mid to late November. We saw the first contract on Nov. 26. It was about an 80-page contract. The biggest issue was that it was never about quality, timeliness of service, or meeting any metrics. We do fantastic on the metrics. The residency does very well on the medical education side. When we won the RFP three years ago, we picked up three new emergency departments within Summa. All three are underperforming either financially and/or by volume.
Two weeks before we took over the Wadsworth contract, the hospital decided to get rid of inpatient beds; it took out 36 percent of the volume within that ER. The groups that were in there before us had asked for stipends or assistance. We did those contracts for three years, and lost between $8 million and $9 million. It cost us more to staff them, bill them, and malpractice them than we were receiving in revenue. There was nothing to cut from our end. We offset the losses with other departments that we run.
Five senior residents this year wanted to stay with the group. All five had to sign with competitors because I could not offer them the type of package needed for them to pay back the $350,000 in medical student loans.
KK: So the math is simple. You can’t compensate people and pay your bills if they’re more than you can bring in in revenue.
JW: Correct. I’ve been head of our group for 15 years, and even before I was president of the group we never had any financial assistance from the hospital, but those in residency roles got graduate medical education money. In our counter proposal to Summa, we didn’t even ask for financial assistance. We said, “Can we get out of two of these three ERs? Can we close them? Can we make them urgent cares?”
KK: Was there anything extraordinary beyond meeting your losses with the stipend you were looking for?
JW: No. Initially, we didn’t even want a stipend, but when it was discussed, it was actually significantly less than what we were losing. Basically, our group, doctors, and corporation were giving them [Summa] a stipend the last three years and my doctors were taking less....
KK: In effect, you were subsidizing the hospital. Did you decide to withdraw or did they terminate your contract?
JW: The contract was over Dec. 31 at 11:59 p.m. I had requested face-to-face meetings with emails saying, “Guys, let’s get together and get this worked out.” We got the contract on Nov. 26 or 28. Our first and only face-to-face meeting was Dec. 26.....
KK: It sounds like they may have had a backup plan in place?
JW: Well, they had actually talked to US Acute Care Solutions on Dec. 24 before we had our face-to-face meeting on Dec. 26.....
The residents (only those on an ED rotation) did not work for two or three days. They were put on administrative elective, basically a study month for their in-service exam. They have since gone back to their normal routine.
KK: Who told them to come back to work?
JW: They were pressured by [two members of Summa Health System’s senior leadership]. They were told that they could potentially lose their jobs if they didn’t come back into work.
KK: Did you have concerns that there was any undue influence over the negotiation process by those who might have had a conflict of interest?
JW: Absolutely that was one of our biggest concerns. The initial hospital contract team was the COO, who was new to her position within the last year or two. The biggest concern was the CMO of the hospital, who is the wife of the USACS CEO. She was directly involved with contract negotiations.
KK: So, from your perspective, she was involved with the negotiation? It’s not just that she works there?
JW: No, no, no. She was directly on the hospital’s contract negotiations team. The first conversation we had about the contract took place in November, and included me and the [Summa Health System] CMO and COO, about two to three weeks before we got the contract [Nov. 26]. We turned in our counterproposal on Dec. 12. They reviewed it on Dec. 14, and she was directly involved with that meeting.
65 doctors and USACS couldn't get any of them to stay. What does that say about your company? I'll be curious to see what the RRC thinks about this transition where every faculty member in the residency was replaced.
