Anesthesia Group Achieves Strategic Growth Goals with Practice Management Services
“Change Healthcare brought a vast amount of expertise to the table that helped in the planning and implementation process.”
- Amer Tabba, M.D.
Atlantic Anesthesia, P.C.
Atlantic Anesthesia, P.C.
Prepare a compelling contract bid and efficiently expand anesthesiology services to a hospital setting.
Financial Management, Practice Management, Consulting Services
- Awarded first hospital contract
- Developed airtight professional services agreement with hospital
- Ensured new employees, and billing and collections, were ready at launch
- Identified future revenue improvement opportunities
Atlantic Anesthesia, P.C. (“Atlantic”) is a physician group practicing at Eastern Massachusetts Surgery Center, an ambulatory surgery center in Norwood, Massachusetts.
The Challenge: Fast Turnaround Time on Strategically Important Proposal
Atlantic learned of an opportunity in November 2017 to bid on the exclusive anesthesia services contract at a Massachusetts hospital. A win would grow business volume at least fourfold.
A successful bid would also achieve one of Atlantic’s long-term strategic goals to expand into the acute care market. Atlantic had been providing anesthesia services only to Eastern Massachusetts Surgery Center, less than 30 minutes from the hospital.
But this was a late-breaking opportunity, so Atlantic needed help bidding on the contract. It turned to the trusted experts at Change Healthcare, where Atlantic is a long-term anesthesia revenue cycle management client.
The Solution: Providing Timely, Targeted Insights on Multiple Fronts
The Change Healthcare team, well aware they were working against a tight deadline, immediately went to work on their two main assignments in the bid preparation process.
The first directive was for Change Healthcare’s senior vice president of anesthesia sales and one of its CPAs to prepare a detailed, three-year pro forma. This was to at minimum cover projected revenue, projected staffing (including call responsibilities), local/ regional market data related to compensation and benefits for both anesthesiologists and certified registered nurse anesthetists (CRNAs), other operating expenses, and the likely need for a line of credit.
The second directive was for one of Change Healthcare’s vice presidents of practice management to write a proposal on behalf of Atlantic for the potential new business with Sturdy Memorial Hospital, a 132-bed community hospital in Attleboro, Massachusetts. The proposal was to emphasize how Atlantic could improve overall anesthesia department operations for the facility, notably through more effective operating room management.
“The process of developing the pro forma and helping us prepare overall for this proposal was very comprehensive but also very efficient,” says Amer Tabba, M.D., Atlantic’s president. “This was a very thorough process that started with Change Healthcare helping with the in-depth interviews and discussions regarding all aspects of the new practice. In addition, there was a detailed review of all the cases that the hospital provided, paired with the payer mix, in order to accurately analyze past and future projections.”
After the proposal was submitted, Dr. Tabba worked with the Change Healthcare team to fine-tune the pro forma and develop a one-page summary of proposed compensation and benefits for the anesthesiologists and CRNAs.
“Change Healthcare brought a vast amount of expertise to the table that helped in planning and implementing staffing structures for both anesthesiologists and CRNAs,” says Dr. Tabba. “Knowing the current market conditions, deciding on the right staffing mix, salaries, and benefits offers— it was all important information that we did not have but needed to make the best decisions for our practice and our staff.”
The Results: ‘Perfect Start’ to a New Book of Business
One critical, final step was for Dr. Tabba and two representatives from Change Healthcare to conduct on-site meetings with all prospective employees of Atlantic (anesthesiologists and CRNAs) and the hospital’s chief executive officer.
Within three days of those meetings, Atlantic learned it was awarded the contract, prevailing over at least two other anesthesia practices. The agreement took effect March 1, 2018.
“I truly believe that having these meetings was ultimately one of the most important factors in securing the new contract,” says Dr. Tabba. “It was important to show administration a strong and synchronized team with years of experience in credentialing, billing, accounting, and contract negotiation. It was definitely impressive.”
The Change Healthcare team next worked with attorneys from Atlantic and the hospital on the professional services agreement, using their knowhow in negotiating facility agreements. Talks were productive and included discussion about necessary financial and nonfinancial protections. For example, the agreement addressed a request by Sturdy Memorial Hospital for Atlantic to permanently increase anesthesia staffing levels to accommodate extended hours and additional anesthetizing locations on an as-needed basis.
At the same time, Change Healthcare initiated a series of calls with Atlantic’s implementation team to ensure all key components of the billing and collection processes were in place before the new anesthesia group started providing services at Sturdy Memorial Hospital. This made for a smooth launch, allowing collections to ramp up as quickly as possible, despite the short window between contract award and service startup.
Change Healthcare’s accountants and CPAs made sure Atlantic’s payroll was set up for the new employees and that they were enrolled with the proper benefits, and that needed accounts payable systems and banking relationships were established. The implementation team held weekly calls, first with the client and then with Change Healthcare. Meanwhile, enrollment and credentialing experts from Change Healthcare saw to it that the new employees were credentialed and enrolled in a timely manner with all third-party payers—essential details of the start-up process.
“For a period of more than two months after signing the contract, Change Healthcare conducted weekly phone conferences with more than 15 staff members representing all stakeholders, in addition to countless other ad hoc meetings to ensure a perfect start on the first day of operations,” says Dr. Tabba. “We reviewed everything over and over again: staffing, credentialing, billing, payroll, benefits, transition, etc. We also had multiple inperson discussions and site visits. That made us comfortable from day one. We didn’t have to cancel anything, not even one case. Overall, a job well done on implementation and client management.”
After the hospital contract was executed, Change Healthcare worked with Atlantic’s counsel to develop a stockpile of sample employment agreements for anesthesiologists and CRNAs. The move resulted in significant time and legal fee savings for Atlantic, and the agreements were immediately executed with the new employees.
An important final step in the start-up process was initiating negotiations with several third-party payers, tapping Change Healthcare’s extensive anesthesiarelated experience.
“Again, Change Healthcare worked hand-in-hand with our team to ensure a seamless transition and effective implementation, clarified any misconceptions and provided guidance on future revenue projections and possible third-party payer agreements,” says Dr. Tabba.
Atlantic not only won a contract; it prepared itself for future growth. Working hand in hand with Change Healthcare, Atlantic effectively evaluated a potential new service location, negotiated agreements with a hospital and multiple payers, and prepared airtight employment agreements all while avoiding unnecessary delays in getting billing and collections up and running.