Medical Group and Healthcare
Zone Or Continued Existence, Your
Most of us
seek comfort. We want the usual.
hang on too long. Like to that sweater or college T shirt. You know,
with the frayed edges.
beyond the harmless totems of the past, the problem is that we
huge efforts to protect what’s become usual in our greater
what’s become comfortable, what’s become “the way
Hospitals are an example. Home to infections, unions, and to the
administrative bloat that is the unspoken of driver of though the roof costs,
they’ve become the center of the healthcare universe. On the hospital
payment mechanisms promote what is essentially the bundling of
professional and facility fees. On the physician side, billions of dollars have
invested in preserving this status quo through the acquisition of groups
upon hospital contracts.
all of this is akin to making a train locomotive more efficient
tracks themselves are falling apart and headed off a cliff.
technology is fast enabling diagnosis and care outside of the
The ultimate customers, the patients, no matter who is paying the
increasingly demand to receive care and treatment in a manner they
they can diagnose at home, they will. If they can receive care at
Everything that can be delivered, and is wanted to be obtained,
the hospital, and even outside of the physician office setting, will
delivered there, with or without you.
we’re not talking about next Tuesday or even December 7,
that’s the clear direction that we’re headed in and to
makes you increasingly irrelevant.
When I wrote years back that there is no such thing as a healthcare
just a healthcare market, I was supposedly proven wrong. But the
that those who argued that healthcare was a system were simply
reactionaries, tying to hold on to the equivalent of their 20 year old sweater.
grasping at preserving a way of business life that never was and is
increasingly becoming even more so. Healthcare is a market and what the buyers
isn’t usually sold in the “system’s” store.
you have a choice. You can jump cold turkey into the future of
severing all ties to the hospital-centric model and perhaps even to
you can hedge your bet and begin to put a foot into both
will you remain relevant in a world in which patients monitor and
via apps? How will you fit into a situation in which every procedure
that can be
delivered outside of a hospital will be delivered outside of it if
can complain about the future. Physicians can lobby to have apps
“arrested” for practicing medicine without a license. Hospitals can
buy up all
of the urgent care centers in their “catchment area” and
down. But people won’t be denied their future.
can read this and head for the comfort of that sweater. Or you
can see the
huge upside for those who are proactive in taking advantage of the
opportunities that now and will soon exist. We’re working with clients on
Wisdom. Applied. 106 - What's A Medical
Compensation Plan For?
A compensation plan is the largest part
a medical group's system for driving behavior.
I was headed down the escalator at
Immediately ahead of me, six or
steps below, was a woman in a red top and blue jeans, holding a small
When they got to the bottom of the
escalator, instead of turning left or right or even moving straight
I was getting closer. And closer.
closer. Until, finally, I yelled, "excuse me!," and they moved on.
turned and glared at me. I muttered something under my breath.
We've all seen people like this,
completely situationally unaware. You, too, have seen them on
You've seen them on elevators, blocking others from exiting. You've
chatting and chatting and chatting with the cashier at the market as
of customers behind them gets longer and longer and longer.
Laugh at them as we will. Cry
as we will. Elevate our blood pressure over them as we will. But are we
just a bit of the same in the context of being blind to the
the threats facing us on a regular basis in our business?
We devote our focus to the task at
even toward implementing a true, well thought out strategy. In doing
so, do we
become blind to changes in the environment around us?
Yes, we're headed in the right
direction. Yes we're on track. But we might also be on a metaphorical
about to crash into a woman in a red top and blue jeans, holding a
by his hand.
Focus is required, but so, too, is
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Success. Even more success. It’s
what you want. Welcome to the
club, which appears to be getting more exclusive
every day, not due to
evolution but to self-selection. Of course, sometimes we
get stuck, or at least
delayed, by the problems that pop up, blocking the way.
But for many, the problem is
that they don’t know what the problem is.
I’ve been working with
medical group leaders with the aim of increasing
their group’s profits
and managing their risk of loss for over 30 years.
Does that mean that I have
all of the answers? No. But what I do have is a
point of view, a way of
thinking about your success. So go ahead and start
reading now. No one is going
to do it for you. Which, by the way, is thinking
tool number one.
Having fallen for the fallacy that
profit in market share, hospitals have gorged on acquisitions and
on employment and
alignment of physicians. Many physicians have been willing
through practice sales and in the belief that there’s safety
employment. But it’s becoming evident that physician
employment leads to
losses and that integrated care delivers neither better
care nor lower
costs. And now, technology is about to moot many of the reasons
hospital’s existence. How can your practice survive and even thrive
Some days, it seems as if
anesthesia groups to vascular surgery practices, is talking
about selling their
practice to a larger group, to private equity investors, or
to a hospital.
The reality is that some practices can
be sold, some can
never be sold, and some have nothing to sell. The reality also is that there are a number of
alternatives to a practice sale.
A perfect storm of factors is
market for hospital-based medical group mergers and
The healthcare market is changing
bringing new sets of problems. How
can you find a solution, how can you engage in the right
strategy, and how can you to plan your, or your group’s,
tools to help clarify your thinking?
Directions is a collection of thoughts
tools, each intended to instruct, inform, and even more so, cause
you to give
pause to instruct and inform yourself.
If you're an
independent learner or need a refresher on a current
topic, click here to find out about our growing list of
Recent Interviews and Published
Mark's article, How to
Medical Group From Getting Robbed of its Staff, was
published in the
Summer 2017 issue of the Pennsylvania Society of
Anesthesiologists' magazine, Sentinel. Read or
Read some strategies for the inevitable
turnover in Mark's article Hospital CEO Turnover:
What You Must
Know and Do to Protect Your Anesthesia
Group featured in the summer edition of Communique. Read or download here.
Mark covers the trend of hospital based
care an article
entitled The Impeding Death of Hospitals: How to
Clients Survive featured in Today's CPA. Read or download here.
Mark's article Why Your Compliance Efforts May Be
was published in the Spring 2017 volume of Communique. Read or download here.
was quoted in
the article ASC Regulatory Areas That Developers Need To
To published on Nov. 9, 2016 in The Ambulatory M&A
or download here.
Mark's article OIG Advisory Opinion
Strategies was published in the Summer 2016 volume
of Communique. Read or download here.
losers weepers. Except in connection with overpayments from
it’s a violation of the federal False Claims Act leading
liability—that is, unless you repay the overpaid sum
within 60 days.
Read CMS Resets the Clock for Return Of Medicare
Overpayments published on AnesthesiologyNews.com in May 2016. Read or download here.
Mark's article A New Strategy
From Interventional Radiology, co-authored with Cecilia
was published on AuntMinne.com on May 23, 2016. Read or download here.
Three of Mark’s blog posts were
as a column entitled Practice Challenges in the
issue of the Pennsylvania Society of Anesthesiologists Newsletter,
the Sentinel. Read or download here.
Mark's article Is There An
Interventional Radiology ASC (irASC) In Your Future? was
the April/May 2016 volume of Radiology
Journal. Read or download here.