Poach a contract from an AMC?

[cerev]

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I know this goes against the current trend, but does anyone know of instances when this has been done? There is a small hospital using an AMC in an area of BFE I am interested in, but my interest in working for the man is waning. My only experience is as an employee, and while I really have no idea how I would go about securing a contract, I am curious to hear any stories out there.

 

[PainDrain]

I have heard of it happening but it's rare. The instances I have heard are where an AMC came in, gutted a dept, brought in horrible new staff, then it all hit the fan. You should contact a consultant, draw up a practice plan, present this to the hospital management and then hope for the best. Worst you can do is put the AMC on notice.

 

[Mman]

I know this goes against the current trend, but does anyone know of instances when this has been done? There is a small hospital using an AMC in an area of BFE I am interested in, but my interest in working for the man is waning. My only experience is as an employee, and while I really have no idea how I would go about securing a contract, I am curious to hear any stories out there.

The first step is directly contacting suits at the hospital and determining whether or not they would consider looking for a new contract for anesthesia services. If the AMC has another 2-3 years on their contract with an expensive buyout, you have no chance of taking it right now.

If the hospital is amenable, then you need to request data on their surgical volume, case mix, and payer mix and present a plan for how you can cover all those services. It's possible that their case volume and payer mix is so crappy that you could take the job but you wouldn't make any money doing so. I'm assuming you'd like to actually make money, right? Also gotta figure out the nights and weekends and how often you are coming in on those.


It's a complicated process.

 

[cerev]

The first step is directly contacting suits at the hospital and determining whether or not they would consider looking for a new contract for anesthesia services. If the AMC has another 2-3 years on their contract with an expensive buyout, you have no chance of taking it right now.

If the hospital is amenable, then you need to request data on their surgical volume, case mix, and payer mix and present a plan for how you can cover all those services. It's possible that their case volume and payer mix is so crappy that you could take the job but you wouldn't make any money doing so. I'm assuming you'd like to actually make money, right? Also gotta figure out the nights and weekends and how often you are coming in on those.


It's a complicated process.

Yeah, I don't imagine that this will be easy, and yes, charity would not be my intention. At this point it is mostly a thought experiment to see how feasible it is. Even if their contract is up soon, I imagine that it will be difficult to:

1) Convince the hospital admins to hand over info on volume and payer mix to some random person they don't know. If I were in their shoes, I would be reluctant to open my books...

2) Figure out how much the group is worth. My only guess as to how much this group is making is based upon the average salary of the docs in their adverts * # of docs + AMC profit (~20%?). I could be way off, any insight would be appreciated.

3) Recruit a whole new set of docs to this group in BFE. There must be a non-compete clause in the current docs' contract, so that will make it more difficult. I have been bouncing this idea around with a few colleagues who sound interested in theory, but certainly not enough people to make an entirely new group. At least not initially.

 

[pgg]

4) Since AMCs are big and can negotiate better rates with insurers while you (the little guy) can't, figure out how you can underbid the AMC and forgo a hospital subsidy when the AMC can bill and collect more than you for the same work.

 

[BuzzPhreed]

You (and whomever you recruit to join you) will likely have to be willing to take a huge pay cut and/or make less than you would elsewhere for the reasons stated.

First thing is to see if the hospital is seeking or willing to entertain an RFP.

Go for it, though! I hope you succeed.

 

[urge]

I'm curious about the wording choice for the thread title. "Poach", as if it were illegal. It's a bidding process where the hospital chooses whomever they want.

I would start by taking all the practice management courses the ASA has and probably taking the business course also.

I suspect the hardest part will be to portray to administration that you are up to date with all regulation involved. The second hardest will be to figure out if you will be profitable. Let's say they do a few cases a week and all are medicare but you have 3 anesthesiologists making bfe salaries; you will go broke unless you ask for a stipend. Lastly, will be to recruit quality personnel.

There are consultants for this stuff but I'm sure it will cost you a fortune, and if you lose the contract you are SOL.