Corewell Health Will Transition Anesthesia Services to Employed Model

[2021Doctor]

June 28, 2023
In order to better serve patients by aligning the anesthesia team more closely within the health system, Corewell Health East in southeast Michigan will transition anesthesia services to an employed model on Jan. 1, 2024, after a contractual agreement with NorthStar Anesthesia concludes.

“We believe this is the time to move to an employed model for our anesthesiology program,” says Dr. Benjamin Schwartz, president of Corewell Health East. “We now have the skill set and expertise to have our own, world-class anesthesia program. We are doing everything we can to encourage our NorthStar Anesthesia team members to work for Corewell Health.”


Dr. Timothy Lyons, president of Corewell Health’s Beaumont Hospital, Grosse Pointe; and David Warsing, vice president of service line operations, will co-lead the new anesthesia program. Warsing recently was hired to help build the new anesthesia program’s framework.

Corewell Health Will Transition Anesthesia Services to Employed Model - DBusiness Magazine.

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[Arantius]

I see this as a trend all over. A LOT of programs are going to an employed model.

 

[Lecithin5]

If my practice every becomes employed, you can be damn sure that I won’t be hustling between cases; I’ll probably be uber-conservative and cancel more cases; I’ll show up 15-25 minutes late to the OR (after pt has arrived) like the employed surgeons do. Basically, I’ll behave like the rest of the employed OR staff and surgeons.

 

[Guillemot]

If my practice every becomes employed, you can be damn sure that I won’t be hustling between cases; I’ll probably be uber-conservative and cancel more cases; I’ll show up 15-25 minutes late to the OR (after pt has arrived) like the employed surgeons do. Basically, I’ll behave like the rest of the employed OR staff and surgeons.

This can definitely be a problem, and I have personally witnessed it in payment models that are straight salary, shift based or hourly.

Probably best to incorporate some RVU/ productivity incentive into the models to keep people behaving themselves.

 

[rowsdower88]

If my practice every becomes employed, you can be damn sure that I won’t be hustling between cases; I’ll probably be uber-conservative and cancel more cases; I’ll show up 15-25 minutes late to the OR (after pt has arrived) like the employed surgeons do. Basically, I’ll behave like the rest of the employed OR staff and surgeons.

I don't fully get this mentality. I guess I can understand that there would be some frustration if you aren't being compensated fairly, but that isn't the issue in this scenario. Presumably, the guys staying would be getting paid the same amount (if not more to encourage them to stay). It sounds like you're at a pretty malignant place if that's the general attitude the surgeons and staff have.

I have no idea how old you are, but I hope you're not one of those boomers who says all the youngsters are lazy and "lack drive".

Like, the idea that I would cancel a patient's surgery because I don't feel like I'm being compensated in a manor that encourages me to work seems so foreign to me. This is totally independent from the actual $ amount of compensation I would be receiving!

 

[Gasworks]

I dunno.. I got to watch HCA transition to employed model and after the initial disaster they seem to have ironed out the wrinkles and their hospitals in my area are basically fully staffed and running quite well. At the end of the day nothing is worse than working for some POS private equity firm.

 

[Lecithin5]

I don't fully get this mentality. I guess I can understand that there would be some frustration if you aren't being compensated fairly, but that isn't the issue in this scenario. Presumably, the guys staying would be getting paid the same amount (if not more to encourage them to stay). It sounds like you're at a pretty malignant place if that's the general attitude the surgeons and staff have.

I have no idea how old you are, but I hope you're not one of those boomers who says all the youngsters are lazy and "lack drive".

Like, the idea that I would cancel a patient's surgery because I don't feel like I'm being compensated in a manor that encourages me to work seems so foreign to me. This is totally independent from the actual $ amount of compensation I would be receiving!

I’m being a bit facetious/sarcastic/hyperbolic. The point I’m trying to make is that there certainly is some incentive that is lost when you go from a production-based private practice model to an employed model where you “clock in, clock out“. It is frankly just human nature. Case in point: on average, how does an employed surgeon react to an anesthesiologist cancelling a case as compared to a PP surgeon? Of course I would never willfully ‘take it out on the patient’ or abuse the system….

Hospital systems are so shortsighted. They would rather lose millions and millions of dollars to prove a point, and shut down rooms, when in many cases it was just cost them less if they just worked with the PP anesthesia group, and maybe provide a few (necessary) pennies for support.

 

[narcotics999]

I’m being a bit facetious/sarcastic/hyperbolic. The point I’m trying to make is that there certainly is some incentive that is lost when you go from a production-based private practice model to an employed model where you “clock in, clock out“. It is frankly just human nature. Case in point: on average, how does an employed surgeon react to an anesthesiologist cancelling a case as compared to a PP surgeon? Of course I would never willfully ‘take it out on the patient’ or abuse the system….

Hospital systems are so shortsighted. They would rather lose millions and millions of dollars to prove a point, and shut down rooms, when in many cases it was just cost them less if they just worked with the PP anesthesia group, and maybe provide a few (necessary) pennies for support.

Work less and get paid more. Why are you complaining? In addition, if each of us churns out less cases, the hospitals will have to hire more of us. Job security.

 

[aneftp]

Well there is a hospital employed model (same Hospital system) that’s running their employees 1:4 100% of the time

It’s tiring work.

The hospital claims the Private equity group in the area that has many of the same practices (also same hospital system) runs 1:4 as well

It’s monkey see. Monkey due. And worst hospital w2 based are even slower to respond to market conditions with pay raises or extra pay for being short staff

Be careful what you wish for. Not all AMCs are the same. Not all w2 hospital owned anesthesia practices are the same.

 

[narcotics999]

Well there is a hospital employed model (same Hospital system) that’s running their employees 1:4 100% of the time

It’s tiring work.

The hospital claims the Private equity group in the area that has many of the same practices (also same hospital system) runs 1:4 as well

It’s monkey see. Monkey due. And worst hospital w2 based are even slower to respond to market conditions with pay raises or extra pay for being short staff

Be careful what you wish for. Not all AMCs are the same. Not all w2 hospital owned anesthesia practices are the same.

Then the hospital will have problem to acquire and retain anesthesiologists.

 

[rowsdower88]

I’m being a bit facetious/sarcastic/hyperbolic. The point I’m trying to make is that there certainly is some incentive that is lost when you go from a production-based private practice model to an employed model where you “clock in, clock out“. It is frankly just human nature. Case in point: on average, how does an employed surgeon react to an anesthesiologist cancelling a case as compared to an employed surgeon? Of course I would never willfully ‘take it out on the patient’ or abuse the system….

Hospital systems are so shortsighted. They would rather lose millions and millions of dollars to prove a point, and shut down rooms, when in many cases it was just cost them less if they just worked with the PP anesthesia group, and maybe provide a few (necessary) pennies for support.

Would be interesting to see data that supports this. There could be countervailing factors that reduce the "lost incentive". For instance, employed settings may engender a more collaborative approach as opposed to everyone being out for themselves. There could be cultural factors as well that could mitigate it. For instance, if I worked at a place with a "good work culture" I wouldn't want to be the person slowing things down, regardless of my lost productivity incentive.

It isn't crazy to me to suggest that the "lost incentive" could be entirely mitigated by having a good work culture. Those cultural factors are also a part of "human nature".

Of course this is highly speculative, I would be interested to see research on it. It could be the case that there are a lot of "good culture" facilities out there and that SDN posters suffer from a selection bias of "poor work culture" locations.

 

[cchoukal]

Would be interesting to see data that supports this. There could be countervailing factors that reduce the "lost incentive". For instance, employed settings may engender a more collaborative approach as opposed to everyone being out for themselves. There could be cultural factors as well that could mitigate it. For instance, if I worked at a place with a "good work culture" I wouldn't want to be the person slowing things down, regardless of my lost productivity incentive.

It isn't crazy to me to suggest that the "lost incentive" could be entirely mitigated by having a good work culture. Those cultural factors are also a part of "human nature".

Of course this is highly speculative, I would be interested to see research on it. It could be the case that there are a lot of "good culture" facilities out there and that SDN posters suffer from a selection bias of "poor work culture" locations.

This is a very thoughtful point. As it happens, I'm in a FFS practice that, I think, has a very good work culture. It is, in part, because all our incentives are aligned in the sense that the surgeons, the anesthesiologists, and the hospital all do better, at least financially, when we work together to do more cases in less time. What I can't figure out is why the whole rest of the apparatus (the RNs in the rooms, pre-op, post-op, Sterile processing, environmental, etc) generally work so effectively. As hourly employees, they don't have as much skin in the game, and yet, compared to where I've been, delays and slowdowns are very rare. And people seem happy.

 

[rowsdower88]

This is a very thoughtful point. As it happens, I'm in a FFS practice that, I think, has a very good work culture. It is, in part, because all our incentives are aligned in the sense that the surgeons, the anesthesiologists, and the hospital all do better, at least financially, when we work together to do more cases in less time. What I can't figure out is why the whole rest of the apparatus (the RNs in the rooms, pre-op, post-op, Sterile processing, environmental, etc) generally work so effectively. As hourly employees, they don't have as much skin in the game, and yet, compared to where I've been, delays and slowdowns are very rare. And people seem happy.

Could be work culture is independent or only partially dependent on compensation structure?

I'm just shooting in the dark here, really need data to make better inferences.

 

[Lecithin5]

This is a very thoughtful point. As it happens, I'm in a FFS practice that, I think, has a very good work culture. It is, in part, because all our incentives are aligned in the sense that the surgeons, the anesthesiologists, and the hospital all do better, at least financially, when we work together to do more cases in less time. What I can't figure out is why the whole rest of the apparatus (the RNs in the rooms, pre-op, post-op, Sterile processing, environmental, etc) generally work so effectively. As hourly employees, they don't have as much skin in the game, and yet, compared to where I've been, delays and slowdowns are very rare. And people seem happy.

Consider yourself very lucky. The amount of times I’ve heard preop or OR or pacu nurses flippantly say “well I’m here until 3” or “just a few more hours” have been numerous.

 

[DesiredMemberName?]

Every system creates the behavior it incentivizes. In the many systems I’ve been through, I’ve never seen salaried anesthesiologists hustle the way they do in a productivity model.

Maybe if you knew for sure you’d get to go home when your room finishes, you might hustle to try to finish early. But more often than not, your hard work is rewarded with an extra addon for no more compensation. People aren’t that stupid.

The only places I’ve seen salaried folks hustle to get cases done ASAP is the surgery center where there are no addons.

 

[CubsDynasty]

Just because you are not RVU incentivized, doesn't mean it immediately turns into the VA. You still need to keep your anesthesia group happy so they don't fire you, and you still need to keep the surgeons and hospitals happy so they don't fire your group. In an employed model, the latter doesn't apply, but the former gets amplified.

 

[DocMcCoy]

Every system creates the behavior it incentivizes. In the many systems I’ve been through, I’ve never seen salaried anesthesiologists hustle the way they do in a productivity model.

Maybe if you knew for sure you’d get to go home when your room finishes, you might hustle to try to finish early. But more often than not, your hard work is rewarded with an extra addon for no more compensation. People aren’t that stupid.

The only places I’ve seen salaried folks hustle to get cases done ASAP is the surgery center where there are no addons.

Curiously, I’ve worked in both models and though I prefer and was happier with a production based set up, I’ve noticed an unintended benefit?. Lot of questionable blocks and lines aren’t getting done anymore since it doesn’t pay anything. Less cowboy stuff, APPROPRIATE cancellation of cases and more strict adherence to guidelines and recommendations like NPO status. Might be a good thing for patients when we aren’t chasing the dollar. I honestly feel it’s safer for the patient though obviously hurts the bottom line if you care about that.

 

[TexBlazer2106]

I dunno.. I got to watch HCA transition to employed model and after the initial disaster they seem to have ironed out the wrinkles and their hospitals in my area are basically fully staffed and running quite well. At the end of the day nothing is worse than working for some POS private equity firm.

Which HCA if you don't mind sharing? I was under the impression that HCA didn't like to take anesthesia practices over as a general rule.

 

[itwasalladream]

It looks like Corewell is the new name of Beaumont Health that recently outed the private anesthesia group in favor of Northstar. Around that time there were some news stories concerning staffing issues, quality, and patient harm that got discussed on this board. I think this was around 2020. Is that right or am I mixed up on the changing names?

 

[BoogieAndGroove]

It looks like Corewell is the new name of Beaumont Health that recently outed the private anesthesia group in favor of Northstar. Around that time there were some news stories concerning staffing issues, quality, and patient harm that got discussed on this board. I think this was around 2020. Is that right or am I mixed up on the changing names?

Correct. Corewell is Beaumont + Spectrum. Spectrum is the big system on the west side of the state in Grand Rapids. Spectrum, to my knowledge, had a private group of anesthesiologists that did everything.

Not sure what this means for the different sites for the system. Would like to hear about the difference in pay/benefits between the east and west side of the state and how that’ll shake out when everyone is employed.

 

[IlDestriero]

Every system creates the behavior it incentivizes. In the many systems I’ve been through, I’ve never seen salaried anesthesiologists hustle the way they do in a productivity model.

Maybe if you knew for sure you’d get to go home when your room finishes, you might hustle to try to finish early. But more often than not, your hard work is rewarded with an extra addon for no more compensation. People aren’t that stupid.

The only places I’ve seen salaried folks hustle to get cases done ASAP is the surgery center where there are no addons.

Amen. I hustle at the ASCs, skip a lunch pause, and GTFO!

 

[siednarb]

The issue with Corewell East (to my knowledge Corewell West - ie Spectrum - will remain with their private practice group - also reimbursement in MI is much better on the west side of the state) - but regarding Corewell East (what was Beaumont) that private group sold out to Median 8 years ago? Most of the docs from that group are long gone - from what I hear there is maybe 5-10% of the original physicians left. 2-3 years ago Mednax sold off their anesthesia contracts to NAPA but then Beaumont ditched NAPA and entered into a contract with Northstar - which that itself caused further anesthesiologists and CRNAs to bolt from Beaumont leading Northstar to hire locums aggressively. The Northstar contract was due to be renewed and as we all now know - Northstar is leaving effective 1/1/24 and Corewell is going to employ the physicians along with the CRNAs. The issue in reforming a private practice group would be daunting - especially for 70+ physicians. All the physicians there are used to a market level salary for the area - no existing partnership has existed for 8+ years - so there is no tier - so reforming a private group with 70 physicians all at the same level of salary they are currently used to would be difficult. Moreover - a newly formed private practice group would have to go 3-4 months without any salary since all the collections from say mid-September through December will come in January through March of 2024 and all that money will go to Northstar. A new group starting on 1/1/24 wouldn't collect any money until March/April 2024 - so option B is take out a loan to pay some semblance of a salary - but interest rates right now are very high. While I wish they could reform a private practice group - it makes sense that the only option here really is for Corewell to employ the physicians even though I'm sure other health systems around the area and around the country will be taking notice.

 

[Lecithin5]

The issue with Corewell East (to my knowledge Corewell West - ie Spectrum - will remain with their private practice group - also reimbursement in MI is much better on the west side of the state) - but regarding Corewell East (what was Beaumont) that private group sold out to Median 8 years ago? Most of the docs from that group are long gone - from what I hear there is maybe 5-10% of the original physicians left. 2-3 years ago Mednax sold off their anesthesia contracts to NAPA but then Beaumont ditched NAPA and entered into a contract with Northstar - which that itself caused further anesthesiologists and CRNAs to bolt from Beaumont leading Northstar to hire locums aggressively. The Northstar contract was due to be renewed and as we all now know - Northstar is leaving effective 1/1/24 and Corewell is going to employ the physicians along with the CRNAs. The issue in reforming a private practice group would be daunting - especially for 70+ physicians. All the physicians there are used to a market level salary for the area - no existing partnership has existed for 8+ years - so there is no tier - so reforming a private group with 70 physicians all at the same level of salary they are currently used to would be difficult. Moreover - a newly formed private practice group would have to go 3-4 months without any salary since all the collections from say mid-September through December will come in January through March of 2024 and all that money will go to Northstar. A new group starting on 1/1/24 wouldn't collect any money until March/April 2024 - so option B is take out a loan to pay some semblance of a salary - but interest rates right now are very high. While I wish they could reform a private practice group - it makes sense that the only option here really is for Corewell to employ the physicians even though I'm sure other health systems around the area and around the country will be taking notice.

Incorrect. The ‘only option’ isn’t employment. Very simplistic way of looking at things. Get a line of credit like any other practice on the face of the earth does (or partner with another group! Perhaps the one on the west side!), and suck it up for a few months. A few months of transition for (potentially) long term happiness and prosperity is worth it. If folks can’t see that, that’s truly sad.

Or, just give up and sign with the behemoth where I’m sure you’ll be treated just absolutely amazingly.

 

[NumTacos]

Would be interesting to see data that supports this. There could be countervailing factors that reduce the "lost incentive". For instance, employed settings may engender a more collaborative approach as opposed to everyone being out for themselves. There could be cultural factors as well that could mitigate it. For instance, if I worked at a place with a "good work culture" I wouldn't want to be the person slowing things down, regardless of my lost productivity incentive.

It isn't crazy to me to suggest that the "lost incentive" could be entirely mitigated by having a good work culture. Those cultural factors are also a part of "human nature".

Of course this is highly speculative, I would be interested to see research on it. It could be the case that there are a lot of "good culture" facilities out there and that SDN posters suffer from a selection bias of "poor work culture" locations.

My group is like that (employed model with some productivity). Everyone busts their ass to get cases done on time, including nurses and surgeons. None of us is interested in delaying/cancelling, although the one benefit is that if a case really shouldn’t go, every surgeon I have worked with wholeheartedly agrees, it’s never been an issue. Culture is important.

 

[ERRES2288]

Wow this is huge health system to take everything in house. So all the former Beaumont sites that were staffed by northstar are becoming hospital employee ?

 

[siednarb]

Incorrect. The ‘only option’ isn’t employment. Very simplistic way of looking at things. Get a line of credit like any other practice on the face of the earth does (or partner with another group! Perhaps the one on the west side!), and suck it up for a few months. A few months of transition for (potentially) long term happiness and prosperity is worth it. If folks can’t see that, that’s truly sad.

Or, just give up and sign with the behemoth where I’m sure you’ll be treated just absolutely amazingly.

I don't disagree with you - but practically it's just not going to happen
the group that exists today is not the same that existed back when it was a private group
it's a hodgepodge of maybe 5-8% of the former group - the rest being relatively new graduates, locums, etc...
Put 3 docs in a room you'll get 5 opinions
Put 70 in a room and the opinions near infinity
Perhaps with a strong leadership and management skills it might be doable
But lets be conservative and say each doc needs at least 50,000 over the first 3 months of the year to cover mortgage, tuition for kids, car payments, student loan payments etc... that's a 3.5M loan at probably at least 7% interest
again - doable - and I truly wish there was the ability to do it - but I don't see it happening
(I do not work at Corewell)

 

[siednarb]

Wow this is huge health system to take everything in house. So all the former Beaumont sites that were staffed by northstar are becoming hospital employee ?

All but the Farmington location which used to be Botsford (DO hospital once upon a time)
that group is still private and was also not part of Northstar
I'm told they are leaving them alone as well with the Corewell employment model

 

[IMGASMD]

I don't disagree with you - but practically it's just not going to happen
the group that exists today is not the same that existed back when it was a private group
it's a hodgepodge of maybe 5-8% of the former group - the rest being relatively new graduates, locums, etc...
Put 3 docs in a room you'll get 5 opinions
Put 70 in a room and the opinions near infinity
Perhaps with a strong leadership and management skills it might be doable
But lets be conservative and say each doc needs at least 50,000 over the first 3 months of the year to cover mortgage, tuition for kids, car payments, student loan payments etc... that's a 3.5M loan at probably at least 7% interest
again - doable - and I truly wish there was the ability to do it - but I don't see it happening
(I do not work at Corewell)

That’s about 3000 of interest per physician at the end of the year right?
If I know what I know now, I would gladly pay twice that to stay independent.
Just me though.

Do agree that you’ll have a lot of opinions with that big of a group. A lot of people who would speak their mind without do the actual work.

 

[Lecithin5]

I don't disagree with you - but practically it's just not going to happen
the group that exists today is not the same that existed back when it was a private group
it's a hodgepodge of maybe 5-8% of the former group - the rest being relatively new graduates, locums, etc...
Put 3 docs in a room you'll get 5 opinions
Put 70 in a room and the opinions near infinity
Perhaps with a strong leadership and management skills it might be doable
But lets be conservative and say each doc needs at least 50,000 over the first 3 months of the year to cover mortgage, tuition for kids, car payments, student loan payments etc... that's a 3.5M loan at probably at least 7% interest
again - doable - and I truly wish there was the ability to do it - but I don't see it happening
(I do not work at Corewell)

Of course you’re going to have a multitude of opinions. But so what? I agree with your point about leaders: leaders take the pulse of the group, but ultimately decide what is best for the group at large. That’s just how it works. And a few million dollar line of credit is no big deal, especially in a situation like this. Anyway, I’m sure it’s a stressful situation. Good luck to them.

 

[pgg]

How on earth do you scrounge up 70 physicians to conjure a new private group?

Maybe some fraction of that is already local and wants to work there, and maybe non-competes aren't a problem, but at a minimum you're going to have to recruit a bunch of people. People who'll have to relocate and join this endeavor on faith. In a buyer's market with high wages everywhere you look, someone's going to join a bunch of strangers taking out a loan to cover payroll? Who's going to do that?

Seems absurdly optimistic.

 

[narcotics999]

How on earth do you scrounge up 70 physicians to conjure a new private group?

Maybe some fraction of that is already local and wants to work there, and maybe non-competes aren't a problem, but at a minimum you're going to have to recruit a bunch of people. People who'll have to relocate and join this endeavor on faith. In a buyer's market with high wages everywhere you look, someone's going to join a bunch of strangers taking out a loan to cover payroll? Who's going to do that?

Seems absurdly optimistic.

If the price is right, they will find Drs. 20millions credit for 3-4 months is nothing for such a big institution. Interest only 400K at 6% for 4 months. They can probably shuffle $$ from some BS pet projects.

70 people, too many opinions? $$$ will silence most of them. I think they probably need some locums at the beginning. Mercenaries, get the Michigan license ready, lol

BTW, anyone has experiences with the interstate licensure compact? How faster to get your license? If I have fcvs, does the compact make a big difference?

 

[ERRES2288]

I’m not sure how lucrative a private group would even be though to be worth the hassle. Michigan is low reimbursement overall and you would need to employ crnas which is big cost. Employee job will probably be about 475k

 

[GravelRider]

Of course you’re going to have a multitude of opinions. But so what? I agree with your point about leaders: leaders take the pulse of the group, but ultimately decide what is best for the group at large. That’s just how it works. And a few million dollar line of credit is no big deal, especially in a situation like this. Anyway, I’m sure it’s a stressful situation. Good luck to them.

The hospital also has to be on board with your endeavor. Is a hospital who just went through a musical chairs of private equity management companies going to want to give a contract to a rag tag bunch docs who are probably horrendously understaffed and taking out multi-million dollar loans to cover payroll? I don’t know anything about Corewell, but it sounds like a rather large regional entity. These large regional health systems are not going to give exclusive anesthesia contracts to an unknown. If we were talking about a small, local hospital system, I would say give it a go, but not with a gigantic hospital system that is going to have unreasonable expectations on a new group just trying to get its footing.

 

[pgg]

If the price is right, they will find Drs. 20millions credit for 3-4 months is nothing for such a big institution. Interest only 400K at 6% for 4 months. They can probably shuffle $$ from some BS pet projects.

A hospital system can conjure money and pay people to work at a loss for a long time, sure.

70 anesthesiologists cobbling together a group from scratch don't have $millions of BS pet projects to play shell games with.

It's a massive chicken-egg problem. How do you get 70 people to jump in on this, before funding is secure? How do they pay locums to cover shortages during the startup months/years? They'll want cash, not the spirit of adventure of starting a new business. Would YOU ever commit to something like this? I wouldn't. How do you get a huge loan, without an existing group and a contract? Who would lend $millions to a handful of guys who say they're going to start a business, absent a contract and people?

It's seems ludicrously impossible to start something on this scale.

 

[yossarian22]

Why does it have to be one group? Lots of hospitals and surgery centers we are talking about.

 

[USCTrojan11]

If this was my group situation, based on my experience in consulting and contracts, it would be some combination of:

1. Form private group with docs who are staying - keep in mind it doesn't need to be all 70, goal is to establish and ramp up. Hospital allowed to bring in locums to meet sites of service until then. Eventually they will let those locums go in favor of group's docs since it's much cheaper. Remember this is Royal Oak, Michigan not Nashville or Austin. I'm not worried about another non-existent group's bid or another PE backed bid (not 3 other AMCs left since the other 2 failed).

2. Forget the high interest business loan - hospital needs to come with stipend and industry standard is stipends paid in advance monthly or quarterly. While this won't cover salaries from Day 1, it will make the collections lag easier. Remember, the hospital was still doing surgery before your group started. They've been collecting facility fees the whole time. Loan may still be needed but much smaller hit and will also be paid back very quickly with stipend money once collections pick up. 7% is the APR, over 6 months that's 3.5% interest you will pay.

3. For this plan to work, hospital needs to commit to some period of at least 3 years IMO. That gives group stability and confidence for recruits to join

4. To increase margins, have hospital staff vascular with locums anesthesia. Also ban locums from OB

I don't actually have any knowledge of the situation outside of what's posted here

 

[siednarb]

Just to update the little I know - the president of Corewell East (formerly Beaumont) was let go after only 13 months - rumor has it that Corewell is begging Northstar to not leave on 12/31 - the CRNAs jointed the Teamsters but Corewell again reportedly not recognizing the union efforts. The docs are lawyered up talking for the negations with Corewell for direct employment and so far no one has signed.

Corewell parts ways with president of former Beaumont hospitals after a year

Corewell Health has parted ways with the president of its metro Detroit hospitals a year after his hiring. Dr. Ben Schwartz was hired in July last year to lead the eight former Beaumont Health hospitals, now called Corewell Health East, succeeding former president and CEO John Fox, who departed…

www.crainsdetroit.com