Find out more about the true value of a patient by reading Economic Intelligence: What's the Lifetime Value of a Patient? Published July 2019 in Outpatient Surgery.

Are you in the know? Read An Update on the 'Company Model' and Other Anesthesia Kickback Schemes, published in the Winter 2019 issue of Communique.

Love is fleeting, especially relationships involving employment. Check out Anesthesia Alert: In or Out of Love with Your Anesthesia Group? Published October 2018 in Outpatient Surgery.

Mark was quoted in connection with interventional radiology ASCs in Medicare approved 400+ interventional radiology ASC codes - Is it time to invest? Published September 14, 2018 in Becker's ASC Review

You provide great quality medical but just can't make the required business decisions? It's likely that your medical group's governance structure needs a tune up. Read  Is Your Group's Governance Structure Holding You Back? Published September 2018 in Pain Medicine News

Answers are great but sometimes it is better if we ask the right questions. A Self-Diagnostic for High-Performing Anesthesia Group Leaders, published in the Fall 2018 issue of Communique.

Mark was quoted in connection with his concept of The Medical Group Governance Matrix in the piece Becoming a Cheetah and Other Survival Tactics, published in the Summer 2018 issue of Communique.

Some think that the future will be a continuation of the present, or, even worse, a return to an idealized past. They're both wrong. Read Why and How You Must Prepare Your Anesthesia Group for the Future, published in the Summer 2018 issue of Communique.

There's been an explosion in the number of billing codes permitting ASCs to collect for outpatient international services. Read Explosive Growth in ASC Codes Fuels Opportunity, published April/May 2018 on

Learn why RFPs for physician services are ill thought out and replete with cognitive bias. Read Anesthesia Services RFPs: Reality, Unicorns And Cognitive Bias, published in the Spring 2018 edition of Communique.

It's easier (and far more fun) to learn about compliance from others' mistakes. Read How (Others') Stupid Compliance Mistakes Can Save Your Life, published in the Winter 2018 edition of Communique.

A plethora of new interventional radiology ASC billing codes brings new opportunities for facility ownership. Read New Codes Drive Growth for Interventional Surgical Centers, published December 12, 2017 on  

A few upset physicians can cause the downfall of a billion-dollar medical center's CEO. Read The Flea That Killed the Medical Center CEO: A Cautionary Tale, published in the Fall 2017 issue of Communique.

Hospitals, and competitors, are poised to steal your group's physicians. Read How to Prevent Your Medical Group From Getting Robbed of its Staff, published in the Summer 2017 issue of Sentinel.

Read some strategies for the inevitable Hospital CEO turnover in Mark's article Hospital CEO Turnover: What You Must Know and Do to Protect Your Anesthesia Group, published in the Summer 2017 edition of Communique.

Mark was asked to help CPAs working with healthcare clients understand the changes and challenges impacting the industry. His article The Impeding Death of Hospitals: How to Help Your Clients Survive, published in the July/August 2017 issue of Today's CPA.

Are your compliance efforts worthless? Read Why Your Compliance Efforts May Be Worthless, published in the Spring 2017 volume of Communique.
Mark was quoted in the article ASC Regulatory Areas That Developers Need To Pay Attention To, published on November 9, 2016 in The Ambulatory M&A Advisor.

Mark's article A New Strategy To Profit From Interventional Radiology, co-authored with Cecilia Kronawitter, was published in May 23, 2016 online

Finders keepers, losers weepers. Except in connection with overpayments from Medicare, then it's a violation of the federal False Claims Acts leading to significant liability - that is, unless you repay the overpaid sum within 60 days. Read CMS Resets the Clock for Return of Medicare Overpayments, published May 11, 2016 in Anesthesiology News.

Three of Mark’s blog posts were republished as a column entitled Practice Challenges in the Spring 2016 issue of the Pennsylvania Society of Anesthesiologists Newsletter, the Sentinel.

Professional, business, and regulatory paradigm shifts occurring in interventional radiology present a new opportunity for interventional radiologists and their groups: Profiting from ownership of interventional radiology ambulatory surgery centers (“irASCs”). Read Is There An Interventional Radiology ASC (irASC) In Your Future?, published April 19, 2016 in Radiology Business Journal.

How would you like to know exactly what’s going to happen in the future so that you can prepare for and profit from it? Read Impending Death of Hospitals: Will Your Anesthesia Practice Survive? published in the Winter 2016 volume of Communique.

Mark was quoted in the article Practice Patterns Change While Outcomes Remain Steady Among Older Anesthesiologists, published in December 2015.

The debate between retaining a medical group's independence and selling to a larger entity is of growing concern for Anesthesia practices. Read Anesthesia Group Mergers, Acquisitions and (Importantly) Alternatives, published in the summer 2015 volume of Communique.

Mark was quoted in the article Anesthesiology Acquisition Rate Still at Fevered Pace, published July 2015 in Anesthesiology News

There’s a tremendous cloud of uncertainty resulting from the rapidity of change in radiology and in medicine in general. Read Seeking Certainty In Radiology: Mergers, Acquisitions and Alternatives, published June 19, 2015 on Imagingbiz, by Radiology Business.

No one wants to work with a surgeon whose default setting is bad-mouthing or screaming at his staff, whose idea of "getting his point across" is throwing scalpels into the wall. Read Legal Update: Give Disruptive Docs the Boot, published April 2015 in Outpatient Surgery Magazine Online.

I just read an op-ed piece in which an economist was mystified that a medical procedure cost an insurer differing amounts if performed at one facility over another. Read Do You Make This Mistake Concerning Customer Value?published April 2015 in Anesthesiology News.

Imagine! A “celebrity” economist stymied by the fact that a medical procedure, a hip replacement, for example, costs an insurer $X if performed at one facility, yet $X + $Y if done at another. Read Do You Make This Mistake Concerning Customer Value?, published March 2015 in General Surgery News.

Medical groups lose contracts because they focus on what’s important to them, not on value as determined by their customers. Read McDonald’s and Delivering Anesthesia Group Value
published as a web exclusive December 2014 in Anesthesiology News.

Mark was quoted in the article Top 15 Financial Challenges Facing Physicians In 2015 published in the December 2014 issue of Medical Economics. Read or download here.

Bungled billing: the combination of multiple entities' fees into a single price. What could be wrong with that? A lot, depending on who is doing the bundling. And, in some cases, depending on why they're doing it. Read Bundled Billing or Bungled Billing?, published in the October 2014 issue of Pain Medicine News.

What's your anesthesia group worth? There are a lot of people out there who are happy to fool you with the answer. Read What's Your Anesthesia Group Worth? And Why It Might Not Make Any Difference, published in the summer 2014 issue of Communique.

Mark was quoted in Michael Vlessides's article Does Anesthesia Need Its Own NTSB?, published August 2014 in Anesthesiology News.

On Nov. 12, 2013, the Office of Inspector General (OIG) of the Department of Health and Human Services released Advisory Opinion 13-15 dealing with a situation closely akin to a "company model" deal. Read OIG Opinion Adds Clarity to Illegality of Company Model, published February 2014 in Anesthesiology News.

The Anti-Kickback Statute is fairly straightforward: It prohibits rewards for referrals. Read 
Anesthesia Profits Are Off-Limits, published December 2013 in Outpatient Surgery Magazine Online.

It’s a tough world out there for anesthesiologists. At least, that’s what many anesthesiologists think. Read The Siren Song of Hospital (Un)Employment, published November 2013 in Communique.

Many anesthesiologists are leaving truly private practice for jobs with large national and regional groups and other anesthesia staffing companies. Read Doctors Rush To Corporate Employment … as Corporate America Lays off Workers, published October 2013 in Anesthesiology News.

The predominant relationship between anesthesiologists and hospitals has been through anesthesia groups, which more often than not hold an exclusive contract for all anesthesia services at the hospital. Read Two’s Company, Three’s a Crowd: Company Model Deals in the Hospital Setting, published March 2013 in Anesthesiology News.

Kickbacks disguised as management fees and in the form of the so-called “company model." Read Company Model Kickbacks In The Hospital Setting, published March 7, 2013 in ImagingBiz by Radiology Business.

Society's shift toward communal values dictates medical groups adopt coherent strategies. Read Why Society’s Shift Means Your Group Needs a New Strategy, published December 7, 2012 in ImagingBiz by Radiology Business.

Just as the tides come in and out, society cycles round and round from an emphasis on and worship of rugged individualism, to an emphasis on and lauding of community and cooperation. Read The Profit Center: Part 26 -- Radiology and the 'me-we' cycle, published November 14, 2012 on

Like a neutron bomb, national or large regional groups wants to take over your facility contract. Read Inoculate Your Group Against A National Group Takeover, published October 15, 2012 in ImagingBiz by Radiology Business.
Inspector General Weighs In On Free Shipping, published August 2012 in Anesthesiology News.

The OIG has declined to give a free pass two popular structures to extract money from specialists.. Read OIG Disapproves Two Referral Arrangements as Kickbackspublished August 8, 2012 in ImagingBiz by Radiology Business.

Many believe that hospital employment is the panacea: the new "safe" career option. Is it? Read The Profit Center: Part 25. How Safe is Hospital Employment?, published on May 11, 2012 on
CRNAs clear hurdle to totally independent practice in California. Read Calif. Ruling on CRNA Practice Promises Nationwide Tremors, published May 12, 2012 in Anesthesiology News.

In an organization we tend to be judged for what we do, not for the decisions we make not to do something. Read The Error Of Measuring Success Only By Action, published May 14, 2012 in ImagingBiz by Radiology Business.

The ABCs of ACO Economics, published May 14, 2012 in ImagingBiz by Radiology Business.

Healthcare is at the Great Junction: One route leading to completely commoditized healthcare and the other, the road far less traveled, leading to high touch, high-quality care, to an Experience Monopoly. Which route is your group on?  Read Commodity Practice or Experience Monopoly?, published March 2012 in Radiology Business Journal.

Learn how pretending to compete with your own group drives massive improvement. Read Shadow Your Competition, published February 17, 2012 on

The Super Bowl of Radiology Success, published February 22, 2012 in ImagingBiz by Radiology Business.

In these turbulent times in which the pace of creative destruction is quickening, it is more important than ever to take a strategic approach to the way in which exclusive contracting, group structure, and group functions are intertwined. Read Strategies For Exclusive Contracting, published January 
30, 2012 on

Currently, our society is heavily motivated by a “we” mindset, focusing on shared sacrifice, paying your fair share and giving back. Hospitals seek to take advantage of this trend to gain economic control over physicians. Learn what you must do.  Read Protecting Traditional Practice in Today’s ‘We’ Society, published January 2012 in Pain Medicine News, and March 2012 in Anesthesiology News.

In order to thrive in the “We” society sweeping through healthcare, medical groups must adopt a different focus. 
Read  Physicians: Action Required to Thrive in Today's "We" Societypublished December 23, 2011 on

Planning is less effective than strategy and strategy is most effective when strengthened through the Scenario Survey Process. 
Read How Scenario Surveys Strengthen Strategy, published October 2011 in Anesthesiology News.

Radiology groups must engage in the Scenario Survey Process to identify potential trends and threats in order to shape a strong strategy. 
Read  Scenarios Can Shape Group Strategypublished August 24, 2011 on

The way that fair market valuation works in connection with coverage stipends and physician work agreements is leading to lower and lower physician compensation. Read Fair Market Valuation: The Death Spiral of Physician Compensation, published July 2011 in Anesthesiology News.

The fair market valuation process is often unfair, blind to value and generally ignores the true market.  That’s the good part.  Now read about its negative impact on physician compensation. Read The Pitfalls of Fair Market Valuation, published June 3, 2011 on

Your group’s held the exclusive anesthesia contract for 20 years. Instead of entering into renewal talks, the hospital issues an RFP designed to get you to undercut your position. What to do? Read How To Navigate the Rising Tide of Aggressive RFPs, published April 2011 in Anesthesiology News.

How to apply psychological pressure during your next negotiation session.  Read Harnessing the Effects of Group Pressure in Hospital Negotiations: Find Your Buddy, published March 2011 in Anesthesiology News.

Hospitals are disrupting their longstanding radiology group relationships as they seek to cut stipends and get more for nothing. The favored tool? A "weaponized" form of the request for proposal. Read How To Shield Against “Weaponized” RFPs, published March 17, 2011 on
The so-called “Company Model” of providing anesthesia services at an ASC presents serious kickback concerns. Read The Company Model: Is Taking Less Money To Work at a Surgicenter Worth Jail Time?, published January 11, 2011 in Anesthesiology News.

Turning A Mandatory Compliance Program Into a Strategic Advantage, published December 2010 in Anesthesiology News.

Anesthesiologists should think twice, or even thrice, about ASC deals. Read Will You Pay the Price for an ASC Deal Gone Wrong?, published October 2010 in Anesthesiology News.

Learn how to increase your chances of a favorable negotiation by gaining leverage in countering, or harnessing, the effects of group pressure. Read Countering Pressure in Face to Face Negotiation, published October 8, 2010 on

How will physicians fit within the bureaucratically envisioned healthcare system of the future? Read The Health Care Con-Vergence?, published September 2010 in Pain Medicine News.

Physicians interested in controlling their own future need to steer clear of, or get hold of the steering wheel, of hospital moves to create ACOs – accountable care organizations. Read Escape the Carnage of the ACO, published August 2010, in Pain Medicine News.

Manage Risk: Required For Success , published August 13, 2010 on

The talking heads of healthcare are at it again:  A new acronym to save healthcare has arrived, the ACO, an "accountable care organization."  But to whom is an ACO accountable? Read Accountable Care Organizations: Accountable to Whom?, published June 10, 2010 on

Are you headed to the Anesthesia Factory to deliver more commodity service, or are you creating an experience monopoly? Read Are You Headed to the Anesthesia Factory?, published May 10, 2010 in Anesthesiology News.

Learn how political challenges to exclusive agreements impact on pain medicine practices. Read Politician Challenges Exclusive Contract and Stipend Support: Impact on Pain Practice, published March 10, 2010 in Pain Medicine News.

Like Your Exclusive Anesthesia Pact? Better Learn to Defend It, published March 2010 in Anesthesiology News.

If you like your exclusive anesthesia agreement, you’d better learn how to defend it from political, yes, political, attack. Learn what arguments are being made and what you have to do to counter them. Read Exclusive Contracts and Hospital Stipends Under Attack, published February 13, 2010 on

No matter what “healthcare reform” law is imposed, the steps that you need to take, right now, to thrive in the face of this looming future are the same. Read Thriving Despite (so-called) Healthcare Reform, January 13, 2010 on

Negotiation doesn’t take place in a vacuum, it takes place within a context.  So why not control the context? Read To Control the Contract, Control the Context, published January 10, 2010 in Anesthesiology News.

If your hospital-based group is in the "medical business," why is it highly likely that it's also in the insurance business, in fact, as an insurer of the hospital's risk? Read Taking On Risk With Dubious Reward, published January 4, 2010 on

Stop kidding yourself that the delivery of expert, even world-class, medical care is sufficient to guarantee your group's future.  Understand how to identify and incentivize high level customer service. Read Securing Customer Satisfaction, published November 11, 2009 on

Maximize your group’s negotiating power by carefully choosing the message. Read Deploy the Power of Persuasion, published October 30, 2009 on

Physician groups can greatly increase their negotiating power by controlling context. Read Increase Negotiating Power, published September 11, 2009 on
Let other anesthesiologists worry about surviving the down economy:  Take these steps now in order to thrive. Read Opportunities Knocking In Market Flux, published September 9, 2009 in Anesthesiology News.

Hospital based groups need to take simple steps in defense of their business. Read Imaging Advantage: Much ado about the same old thing?, published August 8, 2009 on

Many radiology groups mistake the fair market valuation process for a viable stipend negotiation strategy. Read Negotiating Your Group's Stipend, published July 31, 2009 on

Hospital based physicians need to develop an experience monopoly for their referring physicians, patients and hospitals. Read Creating an Experience Monopoly, published July 3, 2009 on

Anesthesiologists and other hospital based physicians can learn a valuable lesson from a False Claims Act case involving Stark law violations. Read Anesthesiologists Should Heed Stark Law Ruling, published June 9, 2009 in Anesthesiology News.

See my response to Letter to the Editor in connection with my article, Establish Surgeon Support Without the Monkey Business. Read Response Letter to the Editor, published March 2009 in Anesthesiology News.

Physicians need to comply with the Red Flags Rule.  Read Readying for the Red Flags Rule, published May 26, 2009 on
Learn some of the not so obvious purposes of employment agreements. Read Crafting Effective Employment Contracts. published April 24, 2009 on

Radiologists can learn how to steer clear of Stark law issues. Read Steering Clear of Stark And False Claims Allegations, published March 31, 2009 on

Tough times underscore the need for a long term strategy. Read Radiology Groups Need New Approaches to Survive in Rough Times, published  in the January 15, 2009 on

It hinders your group's business if its structure makes it difficult or impossible to make quick decisions. Yet this is what many radiology groups do through their processes of fully participatory decision making. Read Radiology Group (un)Governance, published January 2009 in the Journal of the American College of Radiology.

Anesthesiologists need to understand that the way to garner surgeon support is by tying to the surgeons' goals. Read Establish Surgeon Support Without the Monkey Business, published December 2008 in Anesthesiology News.

What action might an anesthesia group take, both pre- and post-operatively, to boost collections? Read Boosting Collections, A Group Effort, published in the July 2008 edition of Anesthesiology News.

The dominant business and financial paradigm for many physicians, especially hospital-based specialists, is that they are a commodity, a valuable one, perhaps, but a commodity nonetheless.  If you are ever to break out of the current paradigm, it will not be by benchmarking to the best practices of other groups headed downward in the same maelstrom. Read Creative Destruction: Changing the Group - Think of Anesthesia Practice
, published in the May 2008 issue of Anesthesiology News.
Radiology groups must adopt business practices that will permit them to succeed in a changing and uncertain future.  If you don’t write the script for your own future, someone else will. Read We Perform Just Like Every Other Radiology Group - So Why Are We Doing So Poorly?, published in the Journal of the American College of Radiology in the March 2008 issue.

Democracy is fine for government; it just doesn’t work for anesthesia groups of more than a few members, at least not on any level past the election of a leader. Read Anesthesia Group (un)Governance, published in the January 2008 edition of Anesthesiology News.

Too many practices operate as a collection of individuals whose purpose is to provide services at a hospital.  From a business and psychological perspective, they have not evolved much during the past 20 years. Read Gain Your Fair Share: Gainsharing Makes A Comeback, published in
 Seminars in Anesthesia Perioperative Medicine and Pain, November 2006.

(Part 1)  Too many practices operate as a collection of individuals whose purpose is to provide services at a hospital.  From a business and psychological perspective, they have not evolved much during the past 20 years. Read Anesthesia Groups Must Confront the Four Fs - Part 1 and then Part 2. Published in October and November 2006 issues of Anesthesiology News.

We're in the process of uploading the following articles. Until they appear here, we'd be pleased to email to you copies of any that you request:
We Do Exactly What Every Other Anesthesia Group Does -- So Why Are We Doing So Poorly?
Seminars in Anesthesia Perioperative Medicine and Pain
Elsevier, Inc.
December 2005
Medical Directorship of Anesthesia Services:  Are You a Player or Just Being Played?
Seminars in Anesthesia Perioperative Medicine and Pain
Elsevier, Inc.
September 2005
The Future of Anesthesia Practice: Hedge Your Practice's Chances of Being on, Not Under, the Leading Edge of the Wave
Seminars in Anesthesia Perioperative Medicine and Pain
Elsevier, Inc.
June 2005
Exclusive Anesthesia Contracts:  History, Theory, Nuts and Bolts
Seminars in Anesthesia Perioperative Medicine and Pain
Elsevier, Inc.
March 2005
Exclusive Anesthesia Contract or Medical Directorship Pact?
Anesthesiology News
April 2004
Good Faith is the Key to Complying With HIPAA's Notice of Privacy Practices Requirement
Anesthesiology News
December 2002
Get What You Aimed For:   
How to Forge Bulletproof Employment Agreements
General Surgery News
November 2002
Preserve the Deal You Expect:  How to Forge Bulletproof Employment Agreements
Anesthesiology News
July 2002
Guest Editorial:  Liability Arising From Consultant-Prepared Compliance Plans
Orthopedic Technology Review
May/June 2002
Maximize Protection and Profit Through Careful Entity Planning
Radiology Business Management Association Bulletin
March -- April 2002
Liability Arising From Consultant-Prepared Compliance Plans
CSA Bulletin
California Society of Anesthesiologists, Inc.
January – March, 2002 Issue (Vol. 51, No. 1)
Structuring Practice Entities For Maximum Profit And Protection
Anesthesiology News
March 2002
OIG Opinion Places Legality of Common Exclusive Contract Provision
in Doubt
Anesthesiology News
January 2002
Lessening the Impact of the Failure of the Medical Group Model
Anesthesiology News
October 2001
Regulatory Compliance Plans are Key to Avoiding Legal Risk (The Online Radiology Forum)
October 24, 2001
Physician Liability to Debtor Patients … Courtesy of Your Billing Service
Anesthesiology News
September 2001
High Crimes and Misdemeanors:  Avoiding Medical Group Liability as a Result of Billing Service Errors
Radiology Business Management Association Bulletin
September 2001
Physician Leaders Must Manage the Billing and
Collection Process ... or Suffer the Consequences
CSA Bulletin
California Society of Anesthesiologists, Inc.
April – June, 2001 Issue (Vol. 50, No. 2)
The Time is Now:  Providers Must Adopt Prudent
Business Practices in Anticipation of the Failure of  
the Medical Group Model
CSA Bulletin
California Society of Anesthesiologists, Inc.
January - February, 2000 Issue (Vol. 49, No. 1)
Are Percentage-Based Management Services Deals
Illegal?  OIG Opinion Raises Serious Concerns
Group Practice Journal
American Medical Group Association
May, 1999 Issue (Vol. 48, No. 5)
Compliance Audits:  Save Money and (Jail) Time
LACMA Physician
Los Angeles County Medical Association
January, 1998 Issue (Vol. 128, No. 1)
Antifraud Aspects of the Health Insurance
Portability & Accountability Act of 1996
LACMA Physician
Los Angeles County Medical Association
October 7, 1996 Issue (Vol. 126, No. 16)
Reprinted, Solano Physician,
Solano County California Medical Society,
December, 1996 Issue (Vol. 96, No. 11)
Reprinted, Coastal Bend Medicine,
Nueces County Texas Medical Society,
June/July, 1997 Issue (Vol. 37, No. 4)
Physician Recruiting Packages
LACMA Physician
Los Angeles County Medical Association
June 17, 1996 Issue (Vol. 126, No. 11)
Reprinted, CSA Bulletin, California Society of Anesthesiologists, Inc., 
November - December, 1996 Issue (Vol. 45, No. 6) 
Sure I'll Agree to Arbitrate
"I Just Don't Want to Waive Any of My Rights
(and Other Fairy Tales)"
CSA Bulletin
California Society of Anesthesiologists, Inc.
January - February, 1996 Issue (Vol. 45, No. 1)
Beware of "Standard" Contract Provisions
LACMA Physician
Los Angeles County Medical Association
November 6, 1995 Issue (Vol. 125, No. 18)
Reprinted, Solano Physician, December, 1995
(Vol. 95, No. 1)
Assign of the Times:  The Prohibition Against the
Reassignment of Medicare and Medi-Cal Claims
CSA Bulletin
California Society of Anesthesiologists, Inc.
September - October, 1995 Issue (Vol. 44, No. 5)
Does Your Hospital's MSO Owe You
a Fiduciary Duty?
LACMA Physician
Los Angeles County Medical Association
September 18, 1995 Issue (Vol. 125, No. 15)
Specialists and Managed Care:
Strategies for Maximizing Opportunity
Hispanic Physician
California Hispanic American Medical Association
Volume V
Kickbacks:  Extracting A Price For Your Right  
To Treat Patients
CSA Bulletin
California Society of Anesthesiologists, Inc.
May-June, 1994 Issue (Vol. 43, No. 3)