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Case Study: Struggling Practice Finds Success Through an Innovative Consortium Presented by Kyle Matthews CardioVascular Associates of Mesa, P.C.

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Presentation on theme: "Case Study: Struggling Practice Finds Success Through an Innovative Consortium Presented by Kyle Matthews CardioVascular Associates of Mesa, P.C."— Presentation transcript:

1 Case Study: Struggling Practice Finds Success Through an Innovative Consortium Presented by Kyle Matthews CardioVascular Associates of Mesa, P.C.

2 Objectives Explore a unique perspective on physician and practice cooperation to maintain independence Identify a new way of doing business beyond integration or an accountable care organization model Evaluate whether your organization can succeed using an innovative business model

3 About Your Speaker Kentucky Native Early Volunteer Western Kentucky University Freed-Hardeman University – Accounting – Finance AmSurg Corporation CardioVascular Associates of Mesa

4 About Your Speaker Arizona MGMA President National MGMA Committees – National/State Task Force – Annual Conference Abstract Review MGMA 4Corners Conference Co-Chair

5 Disclaimer This presentation is a case study based on actual events as experienced by a practice administrator. Before beginning any work on any form of cooperative entity, please seek legal, accounting and other professional advice. Your presenter is not a legal nor accounting expert and is not making any recommendations on how to form new entities since all practices are unique.

6 Interact @KMattCHD

7 Do It Yourself Recognize the Problem Find the Solution

8 Practice Background Located in Mesa, Arizona – Phoenix Suburb – 38 th Largest City 8 Physicians 5 NPs/PAs 2 Offices 15,000 Unique Patients Per Year

9 Service Area Intense Competition – “Guys Next Door” – Influx of New Physicians Hospitals/Systems Lack of Integration Snowbirds Housing Market

10 Same Story, Different Place Billing Problems Low Morale Sacred Cows Unfavorable Contracts Operational/Financial Inefficiencies Mounting Debt Embedded Consultant

11 Change Begins New Management Team New Compensation Model New Team Focus Financial-Based Decisions Revamped Committee Structure Restructuring of Existing Contracts

12 New Challenges Arise Reimbursement Economy Competition Hospitals PCP Consolidation Traditional Solutions Were Not Enough

13 Our Future Partners Different Philosophies Different Culture Number 1 vs. Number 2 Heart Hospital Partner Transfer Virtually No Interaction

14 Small Problem -> Huge Opportunity Banner System “Rural” Hospital – No CV Services – No Cardiology Presence – 30 Minutes Each Way – Projected Consults < 5 Per Week

15 It Begins One Phone Call Cheesecake Factory Similar Strategies Similar Issues Common “Foes”

16 Intent Competitors Maintain Independence Exclude Revenue Save Money Exchange Ideas Expand Strategy

17 The Basics Structure – Separate Entity – Low Overhead – Physician Leadership Legal – Operating Agreement – Purchasing Agreement – Master Agreements

18 Priorities Medical Supplies Nuclear Supplies IT

19 Medical/Nuclear RFP Presentations Required Participation – Existing Contracts – On-boarding Tiered Savings Partnerships

20 Medical/Nuclear Benefits Protection against Supply Issues Generics Suggested Uniformity Exchange Ideas $$$

21 IT Optional RFP – Local – National Presentations On-boarding Group Governance

22 IT Benefits Reliability HIPAA/Regulations Compliance Shared Resources – Techs – Network Administration – CIO Shared Purchasing $$$

23 Data Center I/O – Agility – Reliability – Sustainability – Security Ideal for Medical Practices Unaffordable as Individuals

24 Data Center Benefits Financial – Shared Physical Space – Shared Data Storage – Shared Connections – Common Maintenance – Physical Electric A/C Water Damage Lightning

25 Data Center Benefits Operational – Uptime – Speed – Equipment Health – Security Sleep Better Mitigated Additional Costs





30 Twitter Challenge @KMattCHD

31 Health Insurance Optional Partially Self-Funded – TPA – Stop-Loss – Reserves Individual Plan Documents Individual Loss Ratios Centrally Administered

32 Health Insurance Benefits Wellness Plan Narrow Networks Plan Design ACA Protection Premium Protection Group Governance Group Strategy Shared Consulting $$$


34 Other Projects Office Supplies Statements Shredding Echo Reading Answering Service Collections Phone Maintenance Venous Ablation Packs ICD-10

35 How It Works Physician Led Physician Owned Practice Administrator Executive Physician Meetings Administrator Meetings – Health Plan – Wellness – IT – Vendor-Partners Superior Communication

36 Operating Parameters Management Fees Low Overhead Reimbursements for Services Budget Approval Levels Check Signatures Buy-In K-1

37 Challenges Legal Restrictions Individual Practice Buy-In “What Have You Done For Me Lately” Varying Needs All Groups; All Sizes Vendor Compliance

38 What Is Next HR Credentialing Compliance Shared Personnel Nuc/Echo Maintenance Billing

39 Possible Destinations One Tax ID – Financial Integration Clinical Integration Internal Consolidation Maintain Current Structure

40 Lessons Learned Share the Work Talk, Talk, Talk Establish A Team Administrator Relationships – Ideas – Problem-Solving – Best Practices – Sanity

41 Why It Works Cost-Savings Options Independence Harmony Intelligent Decisions Survival

42 Practice Today Line of Credit Repaid/No Short-Term Debt Strong Financial Health Competitive Staff Compensation Morale High; Turnover Low Excellent Patient Satisfaction Firm Partnerships Enhanced Operational Efficiencies

43 Questions

44 Kyle Matthews @KMattCHD

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