Compliance Issues Related To Acquisitions Of Physician Practices Case Study

Employee Relations: As could have been projected by the public’s negative perception, Sister Mary Theresa’s style of leadership was not well received by many employees at Abbott Hospital. Despite warnings from Dr. John Coletti (Abbott administrator under MEDICO), Sister Mary Theresa implanted her authoritative managerial style into the new satellite hospital. First, she requested all Abbott staff members to be interviewed by Mt. Mercy personnel. They were given a three-month probationary period (at the end of which permanent appointment could be discussed). Also, both staffs were informed they could be transferred between hospitals at administrative discretion. Sister Mary Theresa stuck to her bureaucratic plan – causing Dr. John Coletti to resign.

The state healthcare marketplaces have increased new insurance companies in their markets and many of these state healthcare marketplaces will increase new health plans as well. These additional physician opportunities will be imperative for them to understand how the contracting process affects their practices.

Managing a physician practice business involves careful financial planning and setting of organizational goals. Unlike other industries where operations can be executed with fixed budgets, most medical practices typically adapts a flexible budget system – one that can be changed easily within a fiscal period (Borglum, 2014).

First, we would perform a thorough stakeholder analysis and define the roles and responsibilities of each. Secondly, we would engage these stakeholders (e.g. patients, board members, employee, physician, local community leaders) in constructing the vision and strategic goals of the merged entity. Thirdly, the deployment of specific human capital management strategies would be a

The medical foundation model is an arrangement in which independent physicians vend their practices to a medical establishment. The physician will then be under a contractual agreement to provide medical treatment services at the foundation’s sites. Under this model, hospitals and health systems are able to create legal nonprofit organizations to directly employ physicians. It also gives physicians more independence and strengthens physician and hospital affairs. Hospital-owned group practices are medical practices that have been contracted under a hospital network. This model can be advantageous because it can improve integration, increase access to care and nurture better relationships with the patient’s physician. Joint ventures are when two businesses create a legal entity to share its profits (Harrison,

Mergers have become normal practice in the health care industry by creating a larger hospital system that provides broader services with the focus on lowering healthcare cost and being economically profitable with keeping in line with regulatory guidance. A merger happens when two or more organizations agree to join together and become one organization. One or more organizations essentially must dissolve for this to happen. Sometimes both organizations dissolve and take on a completely new name as in this case of the merging of the two competing hospitals. (McClure, n.d.) Hospitals along with health systems are following the same trend to merge with other hospitals, this movement has continue to gain momentum and appears to be the future trend in the health care industry due to high operating hospital cost. In a survey done in 2012 regarding hospital maintaining independence only 13% plan not to align with other hospitals or health care systems, while the other 87% plan some type of merger with another hospital or health care system. (Hospital Mergers and Acquisitions, 2013)

In summary, the presentation outlined the goals incorporated in the development a sustainable process to the physician contracting. In addition, the report described the structure for efficiently processing materials and data pertaining to physician contracting. Furthermore, the report described the daily management system and daily tracking of contracts to ensure ongoing performance improvement.

Understanding the forces affecting physicians discusses the extreme struggles private practice physicians have obtained. The increase in malpractice insurance and benefit costs, horizontal or declining revenue, and the extreme requirements to obtain EHR are contributing factors. Private practice physicians have looked for ways to work with hospitals and other health organizations. There are three offerings that were designed to meet the needs of physicians: “independent physician programs, employed

Despite of increased pressure to reduce health care spending, enhance quality of care, and prepare for changes associated with the federal health reforms, most of the players in the industry are venturing into new grounds. These players are usually distorting the difference between businesses that have conventionally been varying. Many health care facilities are mainly using enormous systems, combining with each other, and creating extensive new doctor work forces. These facilities are exploring setups that are insurance-like such as the direct initiatives to workers that lessen the

This option is flexible, can be set up relatively quickly, and be managed short- or long-term. However, with this type of physician alignment arrangement, hospitals may have limited ability to influence physician behavior, clinical quality, and costs. And despite requiring less capital than a physician acquisition model , this option still demands that the health care organization dedicate enough resources to ongoing monitoring and performance improvement across the network. 2) Employed physician

The success of the sale hinges on working with an experienced medical broker specializing in the healthcare business organizing and arranging a smooth transition of ownership. Something to keep in mind, not all medical practices are the same, they do however share common obligations to the industry requirements and they have similar business functions for determining the value of the business when establishing the sales price.

Merger of Hospital A and B and its consolidation into PRMC was essential as Hospital A was crippled with losses for 3 previous years and was also forecasting losses in the coming year. Hospital B was struggling with an aging facility. Furthermore, given that both the hospitals were in the same community and therefore essentially serving the same community, they were competing both: for the same patients, as well as, the clinical staff. The merger, allowed the new PRMC to reduce the healthcare costs, address the shortage of healthcare personnel and improve the delivery of healthcare by reducing the duplication of services and providing wide variety of services to the small community of 60,000 in southeastern part of Idaho.

Hospitals and health care systems take strategies to update their infrastructure like technological upgradation, operating room services etc. in contrary due to the concept of supply and demand and less competition in specialty services force the physicians to pursue further.

In early 1990’s, physician-hospital organizations (PHO), legal in the United States, developed to provide attractive one-stop shopping for consumers, employers and managed care payors, by bonding the medical staff to the hospitals within an organization (Daniels 2011). As with the majority of healthcare decisions, legal issues surfaced among the formation of PHOs, forcing the Federal Trade Commission (FTC) to closely examine multiple alliances and networks.

This case study looks at the challenges faced by Matt Hayes, executive director of Riverview Regional Medical Center (RRMC). Previously named as “The Holy Name of Jesus Hospital”, the facility was owned and operated by Catholic nuns. The Hospital Management Associates (HMA) bought the facility in August 1991 and modify the name to Riverview Regional Medical Center. Hospitals that were taken over by HMA upgraded to state-of-the-art facilities that provided high quality medical care. RRMC run numerous private practices throughout the city and shared common medical staff with their chief opponent, Gadsden Regional Medical Center (GRMC). However, the common staff from the Emergency and Radiology department were not shared. Over the past years, RRMC has been facing multiple challenges concerning the different services provided by the facility (Swayne, Duncan, & Ginter, 2013).