Anesthesiology Group Improves Thanks to RCM for Physician Practices

Anesthesiology medical group increased profitability, efficiency, and stability thanks to Change Healthcare RCM for physician practices: practice management, financial management, and billing services.

Customer

Orlando Anesthesia Consultants in Orlando, Florida

Challenge

The independent anesthesia group was looking to refine its business strategy and evaluate growth opportunities. In addition, they wanted to renegotiate payer contracts, and apply for pandemic-related loans and HHS Provider relief funds while improving employee compensation, reducing turnover, and cutting labor costs during the pandemic.

Products

Physician Group Management Services

Results

  • Improved financial stability, resulting in less employee turnover and improved working conditions. 
  • Boosted efficiency, with business focused on profitable endeavors.
  • Increased reimbursements from payers. 
  • Received pandemic-related loans and HHS Provider Relief Funds.
  • Lowered labor costs during the pandemic by furloughing certain employees.

The Customer:

Orlando Anesthesia Consultants (OAC) is an independent anesthesia group with several practice locations in the Orlando, Florida area. OAC practitioners include anesthesiologists and certified registered nurse anesthetists.

The Challenge: Creating Clean Claims

In early 2018, OAC was providing anesthesia services at one acute-care facility and several outpatient centers, including three ambulatory surgery centers (ASCs).

The group elected not to respond to a request for proposal (RFP) from its sole hospital site (which was unprofitable for them). OAC also realized it needed to improve its overall financial condition and devise a business strategy for continued success. Although it was working with a billing company, it realized this vendor would not be able to provide them with the required guidance and support.

Meanwhile, physician turnover was high, due to below-market compensation packages and work demands at the hospital site. OAC determined the importance of improving its compensation and benefit package to be able to attract and retain high-quality anesthesia providers. To accomplish this transformation, it required assistance from a skilled and experienced vendor.

The Solution:

OAC began working with Change Healthcare’s Revenue Cycle Management (RCM) team for billing, practice, and financial management services in February 2018. Since then, Change Healthcare has been providing many key practice and financial management services to OAC.

“Change Healthcare has helped us modernize our group and make it more efficient and competitive. With their assistance, we’ve grown from a financial and stability point of view and made numerous sound business decisions. It would have been very hard to make these changes without them.”

Mark Addonizio, M.D

Orlando Anesthesia Consultants

1. Change Healthcare has been advising OAC on whether to pursue various business opportunities.
Thanks to their input, OAC has avoided some possible service sites that would have proven unprofitable.

One case in point: A new hospital requested OAC be its exclusive anesthesia provider. On guidance from Change Healthcare, OAC indicated it would only move forward if the hospital agreed to OAC’s proposed subsidy mechanism. The hospital did not agree to this proposal, which ended up being fortunate since projected case volumes have not materialized.

Secondly, Change Healthcare advised OAC to terminate its relationship with one of its ASCs due to it being unprofitable.

On the other hand, Change Healthcare helped OAC respond to RFPs from other ASCs. It was also instrumental in negotiating the terms and conditions of service agreements with these sites. 

2. Change Healthcare has been continually negotiating payer contracts to seek higher rates of reimbursement. For example, in anticipation of the No Surprises Act (which would enable payers to pay much lower rates to out-of-network providers), Change Healthcare proactively negotiated a new payer contract. The result: OAC is now in network and benefits from favorable rates. Additionally, due to Change Healthcare’s sage advice, OAC avoided a proposed significant decrease from a major commercial payer, who felt OAC should be paid less since the group was working in ASC settings only (and no longer in an acute-care facility). 

3. Change Healthcare has helped OAC improve anesthesiologist compensation packages. “The younger workforce doesn’t want to take calls and work weekends. They want to work more predictable, daytime hours,” says Dr. Mark Addonizio. The updated employee compensation and working conditions reflect these preferences.

4. Change Healthcare provided critical assistance during COVID-19. Change Healthcare helped OAC apply for, and secure, PPP loans and several rounds of Provider Relief Funds. It also helped OAC receive funds from the Employee Retention Credit program and put employee furloughs in place, reducing labor costs. “When COVID hit, all our case volumes went down 10%–20%, so we had to figure out what to do,” says Dr. Addonizio. “Those loans really saved us.”

The Results:

Thanks to Change Healthcare’s vital assistance, OAC is growing and on solid financial footing.

Successfully navigated COVID. Thanks to employee furloughs and governmental assistance, OAC was able to withstand pandemic pressures.

Fixed the turnover problem. “The anesthesiologists are now being paid more, consistent with market levels,” says Dr. Addonizio. “Their lifestyle has also improved since service sites don’t require on-call hours and weekend and holiday staffing. This has contributed to group stability.”

Increased profitability. By concentrating on profitable ASCs (rather than hospitals), OAC has flourished financially. Thanks to Change Healthcare’s renegotiation of payer contracts, OAC has also been receiving higher terms of reimbursement.

To continue viewing this Insight, please fill out your information below

Go Back

Like this case study or need to read it later?

Related Insights

View all Insights