Jacksonville FL market for anesthesiologists and CRNAs

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However- lots of these rural places do some shady stuff - like extended supervision ratios. One place had one dr for all the rooms… let crnas do hearts with extended care team, do the echo (couldn’t bill but they did them), had a crna training program. Gave all the drs 20 weeks vacation and only one lived in town. Most were pain management guys who probably wouldn’t be of much help to the crnas running amok anyway. Premier anesthesia site. I heard they do the same thing in Jackson? TN…. 6:1 etc.
if they want decent drs in rural america they need to offer acceptable jobs…
This makes my blood boil. Why are there so many greedy sociopaths in medicine?
I have a friend doing locums in Jackson. Let me see what he says.

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Stark law just says we can’t be paid to refer Medicare and Medicaid patients to a certain facility or be paid to refer those patients to a certain vendor. Since we don’t control or direct where patients go (except maybe friends and family), we are not in danger of violating Stark law.

Because we don’t refer, we’re no different than an X-ray tech or a nurse who keeps the hospital running.
The real issue is hospitals owning physicians practices. Over the years hospitals have carved out their own laws through lobbying that exempts them from stark law. A hospital owned primary care physician is not truly free to referred to an outside surgeon. That’s self referral. And Obamacare strengthens the ACA and that’s why I don’t feel
Sorry how much money I’m making as locums off hospitals. They are making a killing. (The private ones)
 
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The real issue is hospitals owning physicians practices. Over the years hospitals have carved out their own laws through lobbying that exempts them from stark law. A hospital owned primary care physician is not truly free to referred to an outside surgeon. That’s self referral. And Obamacare strengthens the ACA and that’s why I don’t feel
Sorry how much money I’m making as locums off hospitals. They are making a killing. (The private ones)


Agree with that assessment. With large regional hospital systems that basically “own” both primary care doctors and specialists and control all the referral patterns, Stark laws seem like a quaint vestige of the past. So while it still has some relevance (for example Stryker can’t pay an orthopedist to use their hardware or Boston Scientific can’t pay a cardiologist to use their stent or defibrillator), much of its bite has been taken away by the formation of large integrated health systems.
 
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Agree with that assessment. With large regional hospital systems that basically “own” both primary care doctors and specialists and control all the referral patterns, Stark laws seem like a quaint vestige of the past. So while it still has some relevance (for example Stryker can’t pay an orthopedist to use their hardware or Boston Scientific can’t pay a cardiologist to use their stent or defibrillator), much of it bite has been taken away by the formation of large integrated health systems.
Large hospitals systems can easily shave millions off anesthesia subsidies by just transferring acute surgery after 5pm.

If large hospital has 4-6 hospitals within a 30 mile radius. Like advent or Baptist in Orlando or Jacksonville. I’d just shut down the non essential hospitals(finish surgery by 5pm) and ship everything that requires after hours surgery to their main tertiary care centers and run 3-4 rooms 24/7 through the night. That’s the most efficient model.

You end up paying for expensive call teams at these smaller hospitals to be on beeper. And when the beeper rate isn’t enough you struggle to find staff to cover and staff ( nursing will quit if they are on call too much for little compensation)
 
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Large hospitals systems can easily shave millions off anesthesia subsidies by just transferring acute surgery after 5pm.

If large hospital has 4-6 hospitals within a 30 mile radius. Like advent or Baptist in Orlando or Jacksonville. I’d just shut down the non essential hospitals(finish surgery by 5pm) and ship everything that requires after hours surgery to their main tertiary care centers and run 3-4 rooms 24/7 through the night. That’s the most efficient model.

You end up paying for expensive call teams at these smaller hospitals to be on beeper. And when the beeper rate isn’t enough you struggle to find staff to cover and staff ( nursing will quit if they are on call too much for little compensation)
Agree - this is the model… ship to a hloc and pay those people well to run the or 24/7.
lol or tell surgeons no but you know that’s not happening w most admins
 
Envision’s envoy USAP’s anesthesia on call division and Napa Bridgecare division. All said by Sept 1 2024. They will want hotel receipts for travel and lodging.

Envision even asking for drivers license so using fake business address won’t help.

Many are really local in Florida. Especially the crna locums. Taking the tax free $4000/month subsidy it’s like adding $25 (tax free) equivalent of $34/35/hr to their locums pay.
 
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Envision’s envoy USAP’s anesthesia on call division and Napa Bridgecare division. All said by Sept 1 2024. They will want hotel receipts for travel and lodging.

Envision even asking for drivers license so using fake business address won’t help.

Many are really local in Florida. Especially the crna locums. Taking the tax free $4000/month subsidy it’s like adding $25 (tax free) equivalent of $34/35/hr to their locums pay.
Wait so what if where I live isn’t my DL address?
 
Wait so what if where I live isn’t my DL address?
They use ur drivers license address to determine where they want to pay you 1099 or w2

So if you are really local. You won’t get paid 1099

So a few things going on
1. Location
2. Physical address
3. Tax free housing subsidy.

Envoy has a 50 miles radius rule for 1099 work vs w2 work as well. That’s where they will determine if they will pay u w2 or 1099. That’s where your drivers license comes into play.

Now you can own 2 homes. Have two electric bills. That may work for address verification. But most travelers who abuse the tax free housing games are in for a rude awakening.

Or we just move towards all inclusive hourly billing rates.

That’s why many professional out of state locums think Florida pays too low. But there is a reason. Because many of the locums are local and get tax free housing.
 
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