Envision bought by KKR. Meet the new boss; same as the old boss.

[RustedFox]

So like I said in a related thread, I sat in on a conference call at my Envision/HCA jobsite to hear about the new changes in... whatever. Here are the highlights, with my thoughts in italics. NOTE: I am only part-time at this job site, and for good reason. EmCare/HCA/Envision/Whatever has never failed to do the wrong thing in the 6 years that I've been here in Florida.



---------------------------------------------BEGIN COPY/PASTE-------------------------------------------------



Here are the Conference Call/Meeting Highlights:


1. KKR Transaction Completed:

· Given this it is essential for Envision to ensure there are no missed financial targets and that as 4th quarter ensues there is cost mitigation strategies in place.

KKR Transaction Officially Closed

Today, we officially completed the transaction to be acquired by KKR. I want to thank everyone across the organization for your support and patience during this process. I am excited about the partnership with KKR.


KKR is committed to our strategic direction, including continued growth and pursuit of operational excellence. We will continue to deliver high-quality, patient-focused care across the organization. In addition, we remain diligent on ensuring our organization is positioned to meet the changing demands of the healthcare environment. Linked here is a FAQ document that may answer some of your questions.


Thank you again for your continued commitment to doing what we do best – improving the health and well-being of communities across the U.S. Our future is strong, and together we can achieve our goals. If you have any questions, please send them to [email protected]


Meet the new boss; same as the old boss.



2. Further Financial Lean Initiatives:

· Overtime restrictions and justifications
· Termination of Scribe Program - EFFECTIVE (XXX)
· Inability to add provider Coverage until 2.0-2.2 patients per hour (pph) is attained



So, great - you killed the scribe program to save pennies, and just as soon as our snowbird/tourist season begins, you slash hours in a move that will be guaranteed to piss everyone off once the avalanche begins and we go from 1.8 pph to 3-4 pph in a few days time. Predictably, the request for "more doc hours" will be delayed by weeks to months, leading to more frustration as the tide of snowbirds swells and the doc-in-the-box feels abandoned, with the words "I told you so" still on their lips. "Overtime hours" will not be paid (see first line) unless there is either (1) critical care documented, or (2) a procedure being done - but you can bet your ass that you'll be asked to stay just because of the volume surge.


3. Schedule Modifications:


· Despite the holiday Schedules being already released, We cannot increase the physician coverage in Nov and Dec. we will need to maintain the current coverage (existing October)until we start to see an increase in the volumes. We need to be at 2 pph at the direction of HCA corporate and division
· In Effort to meet demand – please refer to attached staffing grid & See below:

[I deleted the grid here to maintain anonymity and because it's just not helpful anyways.]
Those holiday hours that you already had figured on, and planned your schedule around? Gone. Suck on it.


4. Elective On-call List of Providers


· Creation of a provider elective call in roster starting in November
· General O/C 10a-8p, however O/C providers can identify their “o/c hours of availability”
· Google Document forthcoming


- Yep. They actually asked us on the conference call to establish a "call schedule", with the spoken directive being to "sign up" for three days to be "on-call" and come in if volume demands it. You will not be paid to take call; you will just get your hourly rate if you are called in. This is on-top of the unspoken demand of being "available to come in 1-2 hours early for your shift" in case volume demands that as well. Many of our docs and MLPs have said in response "listen; I have child-care scheduled at a firm time - you can't do this to me." Personally? You can't call me 1-2 hours early for a night-shift because... I'm asleep 100% of the time, and if you call me 1-2 hours before a day-shift - I'm generally at the gym and will not pick up my phone. The overwhelming response to this has been: "Uhh, no."


5. Reminder: ED Provider (EDMD & APP)

· Marchment Act Training/Education 12-12:30, Lunch Provided
· ED Provider Meeting to follow

Nobody cared about this anyways.


6. Compliance:

· CIA Compliance
· ELM Compliance-
PLEASE COMPLETE ASAP/ Remember to send copies of completion


Nothing new here, either.


7. Patient Engagement:

· AIDET
· Keeping patients informed
· ED MD’s whenever possible or when requested- SEE THE APP’s Patients
· Change of Shift/Patient Turnovers- Please remember walking rounds/ the off-going provider should introduce the oncoming Provider to the patient
· Manage up the TEAM


It was really harped on during the call that the expectation is for the physician to see most of the MLP patients, because the one thing that kept getting mentioned on the satisfaction surveys was: "I never saw a doctor." So, you cut our hours and take away the scribes, but ask us to do even more unecessary tasks in the name of "satisfaction". Oh, and all charting must be done before the end of your shift, because we won't pay you for that, either.




----------------------------------------- END COPY/PASTE---------------------------------------------

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[bikERdoc]

Dude, you got some cajones for posting that up in a public forum. But um, ya. Thanks for posting that up. Note to self: never ever take a job with Envision. Cut losses, retire early... Live sanely.

Sent from my Pixel 3 using Tapatalk

 

[bravotwozero]

Seems to me like the new boss is actually WORSE than the old boss...

 

[Psai]

Can't miss those financial targets though. Because then the bosses bonuses won't be as high as they could be

 

[RustedFox]

Dude, you got some cajones for posting that up in a public forum. But um, ya. Thanks for posting that up. Note to self: never ever take a job with Envision. Cut losses, retire early... Live sanely.

Sent from my Pixel 3 using Tapatalk

There's nothing identifying in the text itself.
Those who choose to work with Envision/KKR/Whatever need to know the dirty details behind the scenes.
If I would have known then what I know now.... I would perhaps have taken an entirely different job and approach when I came out of residency.
There's been so many lies handed to me by EmCare/Envision that I can't stand it.
The only way to change things will be to expose the nonsense, and get people to collectively say "No."

 

[miacomet]

EM is a dying field. I really wish students would see this! Don't fool yourself, RF, ALL EM jobs are going this way. There's very little other option.

1. The call thing is INSANE. Is anyone doing this, or is everyone declining?
2. They got rid of scribes? What horrific charting are you using? This is nuts.
3. What happens if you don't finish charting in the requisite time?
4. I don't understand the staying late without getting paid. Can't you just leave?

Thank you for posting. Med students need to see this. I might add that I was at a conference this week and Envision was recruiting like mad. Apparently they have money for that.

 

[bikERdoc]

100% agreed. Just gotta be careful some times about biting the hand that feeds you. I don't trust that these forums are always anonymous. But I think the info is useful and may be the only way to share knowledge of some of the shadiness going on in our field right now.

There's nothing identifying in the text itself.
Those who choose to work with Envision/KKR/Whatever need to know the dirty details behind the scenes.
If I would have known then what I know now.... I would perhaps have taken an entirely different job and approach when I came out of residency.
There's been so many lies handed to me by EmCare/Envision that I can't stand it.
The only way to change things will be to expose the nonsense, and get people to collectively say "No."

Sent from my Pixel 3 using Tapatalk

 

[Brigade4Radiant]

Sending this now to my residency network. My former PD already refuses to let some residents moonlight at certain groups cause their predatory nature. Im also sending this to my friend who is a PD

 

[miacomet]

100% agreed. Just gotta be careful some times about biting the hand that feeds you. I don't trust that these forums are always anonymous. But I think the info is useful and may be the only way to share knowledge of some of the shadiness going on in our field right now.

Sent from my Pixel 3 using Tapatalk

This is the fear that is leading to the downfall of EM, and medicine in general. Be strong and stand up.

 

[Gastrapathy]

The FAQ has one of my favorite rhetorical tricks to make the reader feel weak and whiny. They choose the question and then start their response with “Again...”. As in, you weren’t listening the first time little child.

 

[Brigade4Radiant]

Biting the hand that feeds you but there is no expression about screwing over the people that make you money.

New law should just state hospitals have to hire their docs directly and bam these groups go away.

 

[southerndoc]

I thought Envision used independent contractors? Didn't realize you were employed. Only employed emergency physicians can be required to take call. The IRS is very clear about this. If Envision is requiring you to take call and you are an independent contractor, the IRS is going to have a field day with them. Treasury uses strict criteria to see if a "worker" can be classified as an independent contractor. Failure to maintain control of one's own schedule is an automatic dysqualifier. They cannot dictate what days you will work -- you make yourself available for those days.

 

[miacomet]

I thought Envision used independent contractors? Didn't realize you were employed. Only employed emergency physicians can be required to take call. The IRS is very clear about this. If Envision is requiring you to take call and you are an independent contractor, the IRS is going to have a field day with them. Treasury uses strict criteria to see if a "worker" can be classified as an independent contractor. Failure to maintain control of one's own schedule is an automatic dysqualifier. They cannot dictate what days you will work -- you make yourself available for those days.

Absolutely re: call. Not only that, ICs make their own schedules. I don't understand these jobs where there is a required minimum number of shifts, yet docs are considered ICs. ICs, by definition, make their own schedules. Is Envision/KKR employing you? Like W2?

 

[RustedFox]

At some job sites, Envision has W2 "employed" physicians.

 

[namethatsmell]

On the other thread I suggested envision docs quit to stand up to this bulls**t. While I hope they leave in droves, I realize that will be tough for many docs (but easy for me to suggest as some dude on the internet).

Then it occurred to me that most of us have an opportunity to make a point to these VC jokers and maybe, just maybe, help out the docs who can't escape envision:

Instead of ignoring the multiple emails/calls/texts we all get each month from envision recruiters, it's time to respond. Pick your dream rate and then add another 100/hr. Give this rate right up front when communicating and state there's no point in talking further unless they'll offer this rate. Those of us not employed by envision have nothing to loose, it may help our colleagues and field as a whole, and at the very least it'll feel damn good. If enough of us do this perhaps their execs will hear about it and realize the cost of replacing their current docs will be far higher than they budgeted. Perhaps they'll realize that we actually do understand that we create all of their revenue and their company would cease to exist without us.

 

[Alvarez13]

Thank you for posting this and being so transparent. To the new grads that just got done with ACEP that read this forum, pay close attention. I know that trippling and quadrupling your salary is tempting, but you're worth so much more. Don't let the suits convince you that you're not.

 

[NicMouse64]

I'm curious why everyone here sees the whole seeing MLP patients as a bad thing. I know it is extra work and a PITA, but isn't this what we want? Our patients to know the difference between a MLP and a physician? To vex the hospitals on patient satisfaction because they didn't get to see the physician?

The other parts, from my M1 perspective, seem pretty egregious. If anyone wants to slap me silly with why the MLP thing is bad I've prepared myself for a verbal beating .

 

[Rendar5]

I'm curious why everyone here sees the whole seeing MLP patients as a bad thing. I know it is extra work and a PITA, but isn't this what we want? Our patients to know the difference between a MLP and a physician? To vex the hospitals on patient satisfaction because they didn't get to see the physician?

The other parts, from my M1 perspective, seem pretty egregious. If anyone wants to slap me silly with why the MLP thing is bad I've prepared myself for a verbal beating .

It’s doing extra work for free just so that your company can charge the patient 100% instead of 85% of the bill. You don’t paid the difference but they do. So now they get more $$$ and you get to squeeze an extra 30-40 minutes of work into your day when they already want you to get all your charting done in that time, see enough patients or yell at you for lost productivity, etc.

 

[NicMouse64]

It’s doing extra work for free just so that your company can charge the patient 100% instead of 85% of the bill. You don’t paid the difference but they do. So now they get more $$$ and you get to squeeze an extra 30-40 minutes of work into your day when they already want you to get all your charting done in that time, see enough patients or yell at you for lost productivity, etc.

Ah I see, the 100% vs. 85% makes sense. Still can't believe MLPs get to bill 85%. That's crazy.

 

[Rendar5]

They don’t get that 85% though mind you. They get paid a certain amount per hour usually and the rest of that money goes to the boss and to the rest of the group sometimes. Why they like mid levels and can afford to pay the docs more.

 

[gamerEMdoc]

I heavily considered interviewing for a PD job in Florida at one point, but eventually turned down the in person interview even though I was only one of 3 vying for the job. It was an HCA/Envision operation, and honestly, I just couldn't reconcile leaving my job for the risk of working for them. Man, after reading this, I'm so thankful I made that decision.

 

[goodoldalky]

This is why the corporate practice of medicine is f$,&3d up, and it’s mind boggling to me that some states, such as Florida, permit this.

 

[EctopicFetus]

First the 85% thing is only for Medicare. Not Medicaid and private insurance just depends on the state. Most states they get 100% of what the docs make.

I entertain most of the recruiter calls. I always ask for a lot of money. Only once did I come close to working for them.

The issue with residencies popping up like FroYo shops a few years ago there will be a ton of docs who are ingrained in the CMG model happy to work for them.

The CMGs have tried to limit their MD need by hiring more MLPs. I work with MLPs and love them. They work for me. I profit from them and they are accountable to me. Thats how it is supposed to be done.

 

[Alvarez13]

I'm curious why everyone here sees the whole seeing MLP patients as a bad thing. I know it is extra work and a PITA, but isn't this what we want? Our patients to know the difference between a MLP and a physician? To vex the hospitals on patient satisfaction because they didn't get to see the physician?

The other parts, from my M1 perspective, seem pretty egregious. If anyone wants to slap me silly with why the MLP thing is bad I've prepared myself for a verbal beating .

Depends on how much you trust your mid-level. I've worked with some that might as well be doctors and some that think TPA is something you use after going to the bathroom. I have to oversee two to three of them at a time and can't possibly see all their patients which means more liability. No one is going to sue a PA when you put a doctor that makes three to four times as much.

It would be one thing if they just saw sprained ankles and medication refills but my shop uses them for high risk chest pain, undifferentiated neurological symptoms and even sepsis as they're trying to cut costs. Furthermore I work in two states with a high malpractice climate. It's just a matter of time.

 

[NicMouse64]

Depends on how much you trust your mid-level. I've worked with some that might as well be doctors and some that think TPA is something you use after going to the bathroom. I have to oversee two to three of them at a time and can't possibly see all their patients which means more liability. No one is going to sue a PA when you put a doctor that makes three to four times as much.

It would be one thing if they just saw sprained ankles and medication refills but my shop uses them for high risk chest pain, undifferentiated neurological symptoms and even sepsis as they're trying to cut costs. Furthermore I work in two states with a high malpractice climate. It's just a matter of time.

That's egregious. After going thru neuroanatomy and the cranial nerves, I would want all the education I could get to see patients like that. Do you do this because you have to or is because of location or other factors? I'd like to be idealistic and say as a physician I will refuse to oversee midlevels if I don't see the pt, but am curious what everyone else's reasoning for dealing with this bs are.

 

[NicMouse64]

First the 85% thing is only for Medicare. Not Medicaid and private insurance just depends on the state. Most states they get 100% of what the docs make.

I entertain most of the recruiter calls. I always ask for a lot of money. Only once did I come close to working for them.

The issue with residencies popping up like FroYo shops a few years ago there will be a ton of docs who are ingrained in the CMG model happy to work for them.

The CMGs have tried to limit their MD need by hiring more MLPs. I work with MLPs and love them. They work for me. I profit from them and they are accountable to me. Thats how it is supposed to be done.

while I understand the mindset, is that really how it's supposed to be done? MLPs have equal responsibility? I hate to say this, but sometimes I fear others will ruin the profession for me before I can pay off my debt, and it's terrifying.

 

[EctopicFetus]

Read up young buck. The profession is being actively ruined. Mlps are but one problem.

Cmgs are the root of the issue. They care 0 about patients. They care 0 about you.

All those groups selling out to them? All the hospitals CEOs picking them. All that is ruining your profession. That mountain of debt will force you to work.

I tell all my young partners. Pay off debt and save. Who knows how long the good times will last.

What I can tell you is no one ever told me they saved too much. There is a balance.

If you can save 100k+/yr you don’t need a ton of time before you have room to breathe.

 

[EctopicFetus]

That's egregious. After going thru neuroanatomy and the cranial nerves, I would want all the education I could get to see patients like that. Do you do this because you have to or is because of location or other factors? I'd like to be idealistic and say as a physician I will refuse to oversee midlevels if I don't see the pt, but am curious what everyone else's reasoning for dealing with this bs are.

You think you have a choice. Lol. You better be willing to move. If you work for a cmg you won’t have a choice. It’s part of your job.

 

[Alvarez13]

That's egregious. After going thru neuroanatomy and the cranial nerves, I would want all the education I could get to see patients like that. Do you do this because you have to or is because of location or other factors? I'd like to be idealistic and say as a physician I will refuse to oversee midlevels if I don't see the pt, but am curious what everyone else's reasoning for dealing with this bs are.

I'm credentialed in 4 systems. All but one were small democratic groups that have been bought out by Envision, TH, USACS. For a facility that sees 70000 patients a year, the goal for these contract groups will be to have four to five PAs on at a time and an MD that signs charts, consults, and puts their license on the line. Envision's mouth is watering at the idea of billing insurance at 100% and paying their workforce 75% less. Sadly, patients aren't your family / friends / coworkers to them, they're sacks of money. This is the direction we're heading as more and more groups continue to sell out for their short term gains.

You got to remember, Envision was the company that got sued 30 million dollars for falsifying medical charts by the Department of Justice: Two Physician Groups Pay Over $33 Million to Resolve Claims Involving HMA Hospitals. Profit above all for these CMGs.

 

[Angry Birds]

Can someone TL;DR this for me?

 

[deleted547339]

Being on call for now pay!?!? Lolz.

 

[Tenk]

Bro you need to get a new job. 8(

You are too much of a nice guy to be beaten down like this.

 

[KGflyboy]

Thanks for sharing. I'm currently considering 2 jobs. One is envision, other is SDG. Also some respectable hospital employed jobs in my region. After reading this, I can't seriously consider envision no matter how much money they offer in my area.

 

[EctopicFetus]

Thanks for sharing. I'm currently considering 2 jobs. One is envision, other is SDG. Also some respectable hospital employed jobs in my region. After reading this, I can't seriously consider envision no matter how much money they offer in my area.

It will continue to get worse and worse. They have no loyalty to their docs.

 

[VA Hopeful Dr]

What I can tell you is no one ever told me they saved too much. There is a balance.

True, but what I have seen is people die young-ish and not get to enjoy the money they worked hard to save.

You don't want to be broke at retirement or stuck in a job because you can't afford a few months of finding a new job, but you also don't want to deprive yourself of good life experiences because you're going crazy saving.

 

[EctopicFetus]

True, but what I have seen is people die young-ish and not get to enjoy the money they worked hard to save.

You don't want to be broke at retirement or stuck in a job because you can't afford a few months of finding a new job, but you also don't want to deprive yourself of good life experiences because you're going crazy saving.

I aim for all of it. It’s why I found a unicorn job. I put away a lot. My family travels and we have a nice home. When you don’t work for hca/envision/th/usacs and know your worth there is hope.

 

[Jlaw]

good god....we really need to find a way to stop this as a profession. Only going to get worse now that an envision guy runs acep. I’m an ex Wall Street guy, I guarantee that part of the sell envision had to like was that the docs don’t understand the business, won’t fight back, and offer a revenue stream that can be exploited from multiple angles. We need to wake up, we are the revenue generators, everyone else, admin included, are expenses.

 

[hundreddaysoff]

good god....we really need to find a way to stop this as a profession. Only going to get worse now that an envision guy runs acep. I’m an ex Wall Street guy, I guarantee that part of the sell envision had to like was that the docs don’t understand the business, won’t fight back, and offer a revenue stream that can be exploited from multiple angles. We need to wake up, we are the revenue generators, everyone else, admin included, are expenses.

FWIW, my buddy works at the Envision shop across town and never got this memo. He still has scribes as far as he knows. RF, could this memo be local to your shop/region rather than a national thing?

 

[EctopicFetus]

FWIW, my buddy works at the Envision shop across town and never got this memo. He still has scribes as far as he knows. RF, could this memo be local to your shop/region rather than a national thing?

It is regional, shop by shop. Other friends of mine got a different message.

 

[Dr Mantis Toboggan]

Being a nephrologist used to be quite lucrative, when they all owned their own dialysis centers. Seems as though now though the field is dominated by DaVita, etc. Compensation is way down. Will the same happen to us?

It is regional, shop by shop. Other friends of mine got a different message.

 

[EctopicFetus]

Being a nephrologist used to be quite lucrative, when they all owned their own dialysis centers. Seems as though now though the field is dominated by DaVita, etc. Compensation is way down. Will the same happen to us?

We are in the midst of it. See how few sdg jobs are out there.

 

[thegenius]

This thread makes me want to vomit. We are trying to get rid of our CMG at our current shop, but it's gonna take time. It's really terrible how these CMGs manage to take 20-30% of everything we make, so they can make millions of dollars. Then they say you have to see >= 2 pph, no matter what.

Thankfully we don't have such punitive rules at our CMG...but they still take a lot of money. It's not worth the ROI they give back.

 

[deleted836128]

As a PA who formerly worked for Envision I can attest to the bullsh*t. It was the worst company I had ever worked for. There was no security. We were expected to make last minute schedule changes like you guys described above. Any pay for time staying late was taken away. Scribes were cut. As PAs we formerly got time and a half, and that was taken away as well because they put us on a salary, while paying us a bonus for each extra shift beyond our salaried hours. Just a sneaky way to get out of overtime when for all intents and purposes we were hourly and not salaried employees. More PA shifts were demanded and we were expected to just fill them when doc hours were cut - huge mistake. I think we PAs should be used as support staff to offset some of the work load rather than run the ER. Dangerous the other way around. We were also asked to implement a call schedule which we as a former independent group said HELL NO to.
When their stock dropped it was a huge panic - schedules were cut and people were fighting for hours. The worst part of it was our contracts constantly changed - so WTF is the point of a contract? I had so much anxiety working for this group as I knew there was always huge change lurking around the corner.

 

[EctopicFetus]

Got an email for one of their local contracts. 50k volume 42 physician hours daily and 40 mlp hours.

How does one define insane? The locums pay was $220/hr. Base there is $205. I laughed at the recruiter.

She said they could take back an offer because they are desperate. I told her $500. Non negotiable. Oh and no scribes at that site.

 

[miacomet]

One of our local SDGs (victim of poor management and bad internal battles) is about to sell to USACS for a pittance of 200k per doc. Nuts. Physicians just aren't that bright or savvy, and we overestimate our intelligence. When they come for my job, I'm out. If they offer us money, I'll stay a year and then move on to something- anything- else.

I'm so glad I front-loaded my savings. It's still not enough for what I want, but we can only control what we can control. Primary care is currently paying more than EM in several areas I've looked, which is nuts and a harbinger, IMHO, of things to com. So many new grads flooding the field- it's a bubble.

This is how we destroy ourselves.

 

[EctopicFetus]

One of our local SDGs (victim of poor management and bad internal battles) is about to sell to USACS for a pittance of 200k per doc. Nuts. Physicians just aren't that bright or savvy, and we overestimate our intelligence. When they come for my job, I'm out. If they offer us money, I'll stay a year and then move on to something- anything- else.

I'm so glad I front-loaded my savings. It's still not enough for what I want, but we can only control what we can control. Primary care is currently paying more than EM in several areas I've looked, which is nuts and a harbinger, IMHO, of things to com. So many new grads flooding the field- it's a bubble.

This is how we destroy ourselves.

HOly cow. thats terrible. A group in Arizona who lost their contract got over 500k just to stay on and as good will from Envision. 200k must be a bunch of fools running the show. Might as well go to the open market. Hard to imagine you couldnt get more than 200k from someone else.

As I said the bubble is the CMG bubble. If you are an SDG no matter how many new grads flood the field I am unsure why it matters to me except if I am greedy I can make the buy in ever more steep (which I wont as I oppose it).

 

[thegenius]

Just curious ectopic, do you guys have any buyin at all? Our group is proposing a 3 year percentage of RVUs generated, like first 6 months you get 80% of RVU, next 6 is 83%, and so on until you get to 3 yrs.

I did the math...at our normal numbers this will cost someone about 90-100K over three years. Punitive but not terribly so.

 

[EctopicFetus]

Just curious ectopic, do you guys have any buyin at all? Our group is proposing a 3 year percentage of RVUs generated, like first 6 months you get 80% of RVU, next 6 is 83%, and so on until you get to 3 yrs.

I did the math...at our normal numbers this will cost someone about 90-100K over three years. Punitive but not terribly so.

My old group had a super steep buy - in. Roughly 2.1M over 5 years. Thats not a typo. Job was really something.

New job is 15% buy-in over 2 years. You also cover your own expenses. You still make more than any other job in town so its not a risk. My old job was different. I risked a lot. It worked out well for me but the market was different. People weren’t selling at the drop of a hat. I wouldn’t recommend anyone take a job like my old one in this market.

Most groups dont take more than 20% of your money. For most SDGs that still puts you ahead of other jobs in town.

 

[thegenius]

Amazing that a buyin can be about 400K a year at your old job. How much were you guys making there? And in what state?

 

[RoyBasch]

My old group had a super steep buy - in. Roughly 2.1M over 5 years. Thats not a typo. Job was really something.

Holy ****!

How much were the fully vested partners making after that?