USACS loses major contract

[GeneralVeers]

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Finally some non-Corona news, and something that will brighten most of our days.

USACS has officially lost the contract at University Medical Center in Las Vegas. They've had the contract for 28 years, and it's the only Level I trauma center in the state, as well as having the only proper academic EM residency. With over 100K patient visits it was also the busiest ED in the city.

 

[RustedFox]

So, who got the contract?

 

[Brigade4Radiant]

Oh no my ownership!!!!

 

[GeneralVeers]

So, who got the contract?

No one knows yet. Best case is that they get absorbed by the UNLV medical school. For $135/hr and teaching residents, I can't see many docs wanting to work there when it's less than half of market pay.

 

[Fox800]

No one knows yet. Best case is that they get absorbed by the UNLV medical school. For $135/hr and teaching residents, I can't see many docs wanting to work there when it's less than half of market pay.

Oof.

I didn't realize Las Vegas was in Colorado. Because USACS pays their Colorado slaves minions $140 an hour...

 

[alpinism]

They gave the contract to Sound Physicians.

 

[bravotwozero]

Sound Physicians is pretty bad, at least I know they are on the hospitalist side. Though to be worse than USACs, is almost hard to do.

 

[NYEMMED]

Wait, when they lose the entire city of Charlotte, It will be a good day to be an EM Doc around there...

 

[GeneralVeers]

Sound Physicians is pretty bad, at least I know they are on the hospitalist side. Though to be worse than USACs, is almost hard to do.

They were a pretty bad hospitalist group at one place I worked. They have no EM contracts in the area, so it will be interesting to see how they run this. I don't know much about the company on the EM side. I will assume they are equally as bad and incompetent as USACS.

 

[alphaholic06]

Damn! $135/hr, who works at a shop with that rate?

"Adversity introduces a man to himself."

 

[GeneralVeers]

Damn! $135/hr, who works at a shop with that rate?

"Adversity introduces a man to himself."

USACS slav....err physicians. I will try to find out what Sound is paying.

 

[TooMuchResearch]

Seriously, even my first SDG sweat equity year was somewhere in the $185-195/hr range, if I'm doing that math right.

Damn! $135/hr, who works at a shop with that rate?

"Adversity introduces a man to himself."

Sent from my Pixel 3a using SDN mobile

 

[Groove]

I know some peeps who work for Sound. They pay ~$240/hr in this area but I'm not sure what they'd pay in Vegas... They are relatively new to running EM contracts but I haven't heard anything too horrible. My impression has been that they are just like any other CMG, just not as slimy as USACS. Anything other than USACS is an improvement, I say.

 

[thegenius]

Sound Physicians is pretty bad, at least I know they are on the hospitalist side. Though to be worse than USACs, is almost hard to do.

Yea man they are terrible, on the hospitalist side. It must suck being a hospitalist overall. What a thankless job.

 

[RustedFox]

I know some peeps who work for Sound. They pay ~$240/hr in this area but I'm not sure what they'd pay in Vegas... They are relatively new to running EM contracts but I haven't heard anything too horrible. My impression has been that they are just like any other CMG, just not as slimy as USACS. Anything other than USACS is an improvement, I say.

We need "CMG Power Rankings".

For those who don't follow sports, power rankings of (any league) is/are a list of all competitors and how "good/bad" their trend is. They're completely subjective and worthless, but great to read.

 

[thegenius]

Didn't we have a "which CMG sucks the most" thread a few months ago?
I'm too lazy to look and I'm hoping someone else will.

 

[RustedFox]

From worst to "not as bad."

1.) USACS
2.) Envision/EmCare
3.) APP
4.) TEAMHealth
5.) Others.

 

[EctopicFetus]

From worst to "not as bad."

1.) USACS
2.) Envision/EmCare
3.) APP
4.) TEAMHealth
5.) Others.

Have to add shumacher and sound (now).

 

[RustedFox]

Have to add shumacher and sound (now).

Someone else had better add them. I have zero experience or frame of reference with either.

I support my rankings with the following logic:

1. USACS - What has not already been said about this abortion?

2. Envision - Profits above patients, always. Worked for them for seven years (still have my PRN status with them). Will never forget the "sepsis" conference call where I objected to their comparison of "Zosyn" to "Aspirin" only to be actually "shush'ed" by my site medical director. That's right. A grown man actually "shushhhhh'ed" me. I'll elaborate on this if enough people ask. I think I already may have.

3. APP - APP bought my pseudo-SDG and is now going to have to account for the black math that they used to ratchet down our paychecks.

4. TEAMHealth - Honestly, the best of the bunch in my experience. Sure; they're a CMG like all the others, but at least they gave us enough free CME credits every year to satisfy the licensing folks and "let us run our show" locally; to the point where our regional director said (in regards to our untenable MLP situation): "If we need to shoot a hostage (fire a MLP) to make our point, then we need to shoot a hostage to make our point."

 

[miacomet]

Why can't UNLV hire their own doctors directly like a non-corrupt medical school?

 

[Brigade4Radiant]

Why can't UNLV hire their own doctors directly like a non-corrupt medical school?

It depends on the state some states emergency medicine physicians can’t be employees and can’t be employed by the hospital.

 

[miacomet]

It depends on the state some states emergency medicine physicians can’t be employees and can’t be employed by the hospital.

Even California allows it for academic facilities...

 

[GeneralVeers]

It depends on the state some states emergency medicine physicians can’t be employees and can’t be employed by the hospital.

It's legal here. UNLV is likely too new to hire the doctors directly at this point. The other option is corrupt administration that has a back door deal with Sound.

 

[miacomet]

It's legal here. UNLV is likely too new to hire the doctors directly at this point. The other option is corrupt administration that has a back door deal with Sound.

Too new? I don't get why that would matter

 

[namethatsmell]

Why did USACS lose the contract?

While my n is small, I've not seen c-suite dump CMGs and directly employ EM docs unless they'd been badly burned by CMGs or happened to have admin who came from another hospital with an employed model.

If/when Sound botches this perhaps UNLV would consider employing their own.

 

[EctopicFetus]

Too new? I don't get why that would matter

Need a system in place to recruit, retain and train and control docs.

 

[alphaholic06]

2. Envision - Profits above patients, always. Worked for them for seven years (still have my PRN status with them). Will never forget the "sepsis" conference call where I objected to their comparison of "Zosyn" to "Aspirin" only to be actually "shush'ed" by my site medical director. That's right. A grown man actually "shushhhhh'ed" me. I'll elaborate on this if enough people ask. I think I already may have.

Had a very similar experience during a sepsis meeting where we were told Zosyn was as harmless as an Aspirin in chest pain. Must be taught in the Envision management training class. That's when I started to pack my bags.

"Adversity introduces a man to himself."

 

[SeasideDoc]

What is also strange is that Dignity Health (who runs three acute care hospitals in the Las Vegas valley) has an ownership interest in Sound...

 

[EctopicFetus]

The CMGs have wisely sold small chunks to hospitals. USACS sold bits and pieces to some hospital system in NC. Obviously we all know about emcare And hca. What’s taking team so long? Also have to believe app will do something similar. Need congress to explore this crap.

 

[EctopicFetus]

Sound is owned by optum (aka united healthcare). At least between them and summit those are the main owners.

 

[Groove]

The CMGs have wisely sold small chunks to hospitals. USACS sold bits and pieces to some hospital system in NC. Obviously we all know about emcare And hca. What’s taking team so long? Also have to believe app will do something similar. Need congress to explore this crap.

Any change salaries might increase in the next 5 years? All locums are drastically lower than what they were 5 years ago. It's sad. Nobody is offering the kind of money they did back then. I know it's multifactorial but I just keep hoping....

 

[EctopicFetus]

Any change salaries might increase in the next 5 years? All locums are drastically lower than what they were 5 years ago. It's sad. Nobody is offering the kind of money they did back then. I know it's multifactorial but I just keep hoping....

No. More consolidation and until congress sacks up we docs are screwed. More graduating residents etc.

 

[RustedFox]

Okay, maybe I can be dead-ass wrong, but if I am a hospital CEO, direct employment seems to be the preferred method of staffing my ER.
Why pay a middleman when you can cut costs and exert control thru direct employment?

 

[EctopicFetus]

Okay, maybe I can be dead-ass wrong, but if I am a hospital CEO, direct employment seems to be the preferred method of staffing my ER.
Why pay a middleman when you can cut costs and exert control thru direct employment?

Cause you have to negotiate insurance contracts and hospitals
Do a terrible
Job in general.

 

[RustedFox]

Cause you have to negotiate insurance contracts and hospitals
Do a terrible
Job in general.

Problem would be solved if insurers would be honest, clear, and deliver on what they promise.

But... noooh-ohhhh....

 

[EctopicFetus]

Problem would be solved if insurers would be honest, clear, and deliver on what they promise.

But... noooh-ohhhh....

If insurers gave away all their leverage and weren’t scum ? Lest not plan for that.

 

[RustedFox]

If insurers gave away all their leverage and weren’t scum ? Lest not plan for that.

Riiiight?

It's almost like we asked them to do what they said they would do!

 

[thegenius]

Cause you have to negotiate insurance contracts and hospitals
Do a terrible
Job in general.

You can hire someone to negotiate on your behalf

 

[EctopicFetus]

You can hire someone to negotiate on your behalf

I’m aware but hospital contracts are broad. They generally only get good rates where they care. Depending on where you work the hospitals can be negotiating outpt clinics, operating rooms etc.

They can outsource a lot but most have bought into value based care. So they jump into crappy money losing contracts whereby they try to get their docs to do something in hopes that they save insurance companies money and then they get to keep a sliver.
Then what happens is docs don’t care, they think whatever metric they are trying to hit is dumb, hospital puts few time or $$$ resources into it or fixing it then takes a financial bath.

managing physicians and mlps is hard work and people won’t respect the hospital as task master. There are a ton of reasons but many hospital systems
can’t control other docs and em docs are incredibly hard to maintain given how easy it is to find a job and how it’s no big deal (relatively) to job hop.

 

[Alvarez13]

Sound is owned by optum (aka united healthcare). At least between them and summit those are the main owners.

This is what I remember reading. The last people I want to be working for is United. That company needs to die in hell.

 

[EctopicFetus]

This is what I remember reading. The last people I want to be working for is United. That company needs to die in hell.

Its coming to be the main show in healthcare and not backing down from anyone. Physicians are like an afterthought. Did you see how they tried to block one of their old execs from joining the JV with Berkshire, amazon and JP MOrgan. They don't F around.

 

[deleted547339]

Its coming to be the main show in healthcare and not backing down from anyone. Physicians are like an afterthought. Did you see how they tried to block one of their old execs from joining the JV with Berkshire, amazon and JP MOrgan. They don't F around.

Elaborate.

 

[EctopicFetus]

Elaborate.

There was an article (would have to google it) Atul Gawande is leaving as CEO of Haven. In the article there is mention how they sued in order to try to to have one of their former execs not join the JV.

 

[sum dude]

Although I'm sure everyone here loves some USACS Schadenfreude, you do realize an Optum-owned group (sound) is 10x worse than any PE group is?

 

[EctopicFetus]

Although I'm sure everyone here loves some USACS Schadenfreude, you do realize an Optum-owned group (sound) is 10x worse than any PE group is?

F em both... see thats not hard..

 

[GeneralVeers]

Although I'm sure everyone here loves some USACS Schadenfreude, you do realize an Optum-owned group (sound) is 10x worse than any PE group is?

It's more fun for me, as I know most of these guys personally. One of the local groups here got a call from one of the (now unemployed) regional directors looking for a job. Too bad our market is saturated.....