except where hospitals fire or non-renew Envisions contracts and indemnify the physicians (AKA NJ). No 'selling' the non-competes there. Also LOL at thinking that selling out the non-competes will cover the cost of their failing business model.
The no surprise bill will kill the management companies slowly. no surprise bill Just like what did the anesthesia company in Richmond in. The hospitals will take over and see how easy or hard it is to maintain an anesthesia practice
Entirely possible that it kills all management companies and private practice, the current process for arbitration takes a lot of time when you're out of network meanwhile you have to continue to float the salaries. This puts all PP groups in a more difficult place than large hospitals and AMCs. The next 2 years will be telling. There is also the option that large hospital groups see the value of buying anesthesia asset and diverting them to their hospitals . Could HCA buy envision and divert its clinicians ? maybe ascension ?
Sure, that requires the clinicians to have a lot of trust with the administration, its my experience that anesthesia groups dont have many friends and these hospitals dont internalize groups to just pay them and give them a good work life balance. They need us, but with the financial pressure they are facing there is no doubt that most of the hospital groups will be intentionally understaffed and overworked. One look at how they treat the rest of their staff and you should get the picture.
While I agree they need us, they first need to rid themselves of old paradigms. The hospitals that value and respect their providers will excel and the ones that don't will struggle. There is no doubt in my mind there will be some hospitals that wont learn this valuable lesson and try to run their departments at with 30% of the staff needed and drive them into the ground to "get the cases done" .
More pay? more vacay ? hours go up ? do you run your own department ? Do they know how many bodies are required to be fully staffed? Do they want to be fully staffed? Did they consider a supervision or a CRNA only model ?
I fixed it for you.
www.kevinmd.com
www.wsj.com
More pay. Nothing else changed.
The problem is our field (and this probably includes all doctors) have a hard time being "united" against a hospital. Ive seen it and I understand both sides. People have often said it on here. We have kids, we have mortgages, we have IG model spouses so it's not easy to just cut off income to prove a point. We'd be a pretty poor union if we could form one.
Its behind a paywall. Could you copy/paste? Thanks
FTC Probes Market Power of One of Country’s Biggest Anesthesia Providers
The federal antitrust enforcer is investigating U.S. Anesthesia Partners, a private-equity-owned company that has built a large presence in Texas, Colorado and Florida.
Made it to the wsj
Agreed, in a situation where half the group leaves, the people left will be responsible to take over the enormous workload while locums come in get paid well and leave when they want. In that situation and this market doing locums 1-2 years until they have figures it out would likely be a more reasonable way to protect yourself from abuse.
whether the CEO trusts the group and provides high quality care and whether the group trusts the CEO. I would agree that to many short sided CEOs the stipend is a deal breaker but 80 % of groups were subsidized prior to covid. Again only time will tell. A Solution in one market may not work in another.
You are spot on with this statement.
You could see what their business model a mile away. Gain Market share in an area, stay out of network and, if they go in network, negotiate the highest possible fees. Nothing inherently awful about that except the manner in which they go about gaining market share. They took away the out of network fees so now they have nothing
lol Pipeline filed for bankruptcy ( hospital group) , ascension 1.8 billion loss, mass gen 1 billion loss , common spirit 600 million, etc etc most major hospitals are under enormous financial pressure post pandemic. Health care is a mess in general.
Easy there sport. We're talking about immediate pain relief and hours of babysitting. Given that we're probably the only ones in the hospital that can safely provide that service, I may argue we aren't paid enough, despite it being probably the better reimbursed segment of all of anesthesia.
Not going to happen. They will try to squeeze more blood out of the people doing the actual work.
CRNAs can have ALL the 3 am calls for blocks. ALL. OF. THEM.
Furthermore, I hope you realize, just because the patient is charged 5k for an epidural, doesn't necessarily mean that's what the anesthesiologist was paid.
So true. At the academic hospital I did residency, there was a full time RN who was in charge of handwashing compliance. Her full time job was to observe employees at different locations to see if they were washing their hands before patient interactions. Another example - At my current hospital there are 5 full time RN managers (none involved with patient care) for periop (pre-op, OR and PACU/Phase 2). If there is any objective cost cutting, you'd think these positions would be the first to go.
You are not describing nurses. You are describing low level admin who formerly worked as nurses.
Whenever the Periop/OR nurses have a meltdown about some admin related question (eg what’s the OR policy on X?) I tell them to page the administrator on call and ask them. But they just won’t. They’re terrified of upsetting the admins who’re comfortably sitting at home while we slog away. The OR staff really thinks we should figure it all out on our own and not bother them. They don’t even expect the admins to do their actual jobs… meanwhile we go to BS meetings on their terms mid-day at their convenience. It’s truly a perfect crime on their end.
I wouldn’t accept a buy in with an AMC for sure. A small private practice where you’re an actual shareholder, there’s a argument to be made.
Wouldn't necessarily matter. Neither actually owns any tangible assets.
If you're in a small boutique private practice, the practice ie company, is the asset. The potential future is either the profit sharing of the company or the share of any buyout. That's the risk and potential reward.
seems like only insurance companies are allowed to have monopolies? 1 out of 3 people are insured by blue cross in certain markets but thats ok. This is more government targeting likely lead by insurance companies lobbyists
