#Texas MultiSpecialty

[multispecial]

Implants vs. Augmentation: What's the Real Difference?

When considering breast enhancement, many women find themselves confused by the terms breast implant surgery and breast augmentation surgery. While they are often used interchangeably, there are key differences between the two procedures. At Texas MultiSpecialty Group, we aim to provide clear and accurate information so you can make an informed decision about your body.

Visit : https://multispecialty123.blogspot.com/2025/03/implants-vs-augmentation-whats-real_63.html

Address : Texas MultiSpecialty Group, 12315 Judson Rd., Suite 110, Live Oak, TX 78233

Email Address : info@texasmsc.com

Phone Number : 210-566-8332

[sahraeyll]

Leading 10 Medical Billing Companies: Streamline Your Revenue Cycle in 2024

Top 10​ Medical Billing Companies: Streamline Your Revenue Cycle in 2024

The medical billing landscape⁤ is changing rapidly in 2024. As healthcare providers face increasing demands to optimize their revenue cycle operations, enlisting the help ⁤of a top medical billing company can significantly enhance⁤ your practice’s financial performance. In ‌this ⁢article, we ‌will explore the top 10 medical billing companies that can ‌help your healthcare practice thrive.

Why Medical Billing Companies Matter

Efficient medical billing is crucial for healthcare providers to ensure they receive timely payments. A professional medical billing company can:

Reduce administrative burdens

Enhance revenue cycle management

Minimize claim denials

Improve⁤ cash flow

Top 10‌ Medical Billing ⁤Companies in 2024

Company

Year Founded

Specialty

Website

AdvancedMD

1999

General Practice & Specialties

advancedmd.com

Quest Billing Services

2002

Physician Practices

questbilling.com

Coding Strategies

2005

Emergency Medicine

codingstrategies.com

eCatalyst Healthcare Solutions

2003

Multispecialty Practices

ecatalysthealth.com

Medical Billing Star

2010

Hospital ⁢& Clinics

medicalbillingstar.com

Optimum Outcomes

2004

Behavioral Health

optimumoutcomes.com

MedBillingExperts

2011

Diverse Specialties

medbillingexperts.com

Visionary RCM

2018

Healthcare ‍Systems

visionaryrcm.com

ClaimCare

1998

Dentistry

claimcare.com

MedBilling Solutions

2007

Radiology & ‌Pathology

medbillingsolutions.com

Benefits of Using Medical Billing Companies

By partnering with a medical billing company, healthcare providers ⁢can experience a myriad of benefits:

Increased Efficiency: Specialized teams ⁤streamline the ⁢billing process ⁢using the latest software.

Focus on Patient Care: Providers can allocate‍ more time to patient interaction rather than paperwork.

Fewer Claim Denials: Experts ensure ⁣proper ⁣coding and timely submissions, reducing errors.

Enhanced Revenue Cycle Management: Comprehensive reporting helps track the health of finances.

Case Studies: Success‌ Stories

Many healthcare practices have witnessed a turnaround in their financial health by ‍partnering‍ with medical billing companies. Let’s take a look at a couple of examples:

Case ⁣Study 1: Family Healthcare Clinic

A small clinic in Texas implemented AdvancedMD’s services and saw a 30% increase in collections within six months. They reduced claim denial rates significantly and improved their cash flow.

Case Study 2: Urban Pediatrics

Urban ⁣Pediatrics partnered with Medical Billing Star and achieved a 50% reduction in administrative staffing‍ needs. This enabled‍ them to reinvest those resources back into their patient care programs.

Choosing the Right Medical⁢ Billing Company

When selecting a medical billing company, consider the following factors:

Industry Experience: Opt for a company with a background in your specific healthcare field.

Technology ⁤Implementation: Evaluate their technology solutions for efficiency ⁣and data security.

Reputation: Read ⁤reviews and seek testimonials from other healthcare providers.

Pricing Structure: Understand their fees and what services are‌ included‍ in the pricing.

Practical⁤ Tips for Streamlining Your Revenue Cycle

In addition to hiring a professional billing company, consider implementing these practical tips to enhance your revenue cycle:

Regular training for your team on billing practices and updates.

Utilize automation tools for claim submission and tracking.

Monitor performance metrics to identify any trends⁢ or areas‍ for improvement.

Conclusion

As we move into 2024, partnering with one⁢ of the top medical billing companies is essential for healthcare providers looking to optimize their revenue cycle. From reducing claim denials to improving cash flow, the right billing partner can make all the difference in your practice’s financial health. Make informed choices and invest in your practice’s future by selecting a company that ​not only understands your needs but also empowers you to ‍focus on what truly matters—patient care.

Explore the options, and streamline your revenue cycle effectively!

https://medicalbillingcertificationprograms.org/leading-10-medical-billing-companies-streamline-your-revenue-cycle-in-2024/

[market-insider]

Telemedicine in Acute Care: Market Dynamics and Growth Prospects

The global acute care telemedicine market is expected to reach USD 60.2 billion by 2030, based on a new report by Grand View Research, Inc. The market is expected to expand at a CAGR of 14.8% from 2022 to 2030. Technological development in the healthcare sector, increasing demand for immediate access to medical care, and shortage of specialty physicians especially in developing countries are some factors driving telemedicine growth in an acute care setting.

Acute Care Telemedicine Market Report Highlights

Based on delivery, the clinician-to-patient segment accounted for the largest market share of 62.5% in 2021 as it provides easy access to medical professionals through chat or video conferencing and reduces long waiting and travel times to get treatment.

The telepsychiatry segment is expected to witness the fastest CAGR of 15.5% over the forecast period. The sector is witnessing significant growth as it holds the potential to become a better option to traditional in-person psychiatric facilities.

Based on the end-use, the hospitals and clinics segment dominated the market with a revenue share of 75.5% and is likely to grow at the fastest growth rate from 2022 to 2030. This is owing to the shortage of specialist physicians, especially in developing countries, and increased demand for better healthcare access among the people.

North America accounted for the largest revenue share of nearly 42.4% in 2021. Due to a favorable reimbursement structure and the availability of telemedicine services. For instance, In January 2021, The American Telemedicine Association (ATA) and the Digital Medicine Society (DiMe) launched “IMPACT” a new program for virtual healthcare.

The Europe market is anticipated to witness rapid growth over the forecast period with a CAGR of 15.2%. The increase in the elderly population and increased development in the healthcare infrastructure is driving the regional market expansion

Gain deeper insights on the market and receive your free copy with TOC now @: Acute Care Telemedicine Market Report

The COVID-19 pandemic caused the healthcare system to encounter various challenges. The swift adoption of various technologies across countries, driven by the necessity to provide continued medical care in the era of social distancing, has increased the penetration of telemedicine in acute care. In addition, the Centers for Medicare & Medicaid Services (CMS) increased the coverage of telehealth services through temporary waivers soon after the declaration of COVID-19 as a public health emergency in early 2020 to make it convenient for people to receive medical care while reducing their exposure to the virus in public settings such as hospitals and health care facilities.

Furthermore, the World Health Organization and the International Telecommunication Union (ITU) collaborated to produce a universal standard for the usage of telehealth services to address the problem on an international scale. This guideline describes the technological criteria that a telehealth platform must fulfill to deliver accessible telehealth services.

In December 2021, Five Ascension Texas facilities collaborated with the nation’s major multispecialty telemedicine group to offer teleneurology services to their patients. The collaboration was intended to ensure 24/7 access to special neurology care. It will also strengthen on-site neurology treatment by offering doctors, nurses, and other professionals high-definition video consultations with neurologists on demand.

[multispecial]

Live Oak Primary Care: How to Stay Healthy in 2025

A fulfilling life is built on a foundation of good health. As we enter 2025, prioritizing wellness has never been more critical.

Visit : https://multispecialty123.blogspot.com/2025/03/live-oak-primary-care-how-to-stay.html

Address : Texas MultiSpecialty Group, 12315 Judson Rd., Suite 110, Live Oak, TX 78233

Email Address: info@texasmsc.com

Phone Number: 210-566-8332

[texasheartnvein]

PAD Diagnosis & Treatment in Texas

Contact our Peripheral artery disease medical center

Between 8 and also 12 million Americans are impacted by Outer Artery Disease (PAD), and although there are many PAD individuals, numerous stay undiagnosed.

PAD can be frightening, yet even though it can't be cured, there are ways of living changes as well as therapies to quit the progression. Depending on your problem and also health danger aspects, a specialist will certainly select one or several approaches to detect PAD.

The best area you can go to for PAD medical diagnosis and also therapy is Texas Heart and Vein Multispecialty Group if you're in Texas. At our facility, you'll find professionals that have actually dedicated over thirty years of consolidated experience in treating heart diseases like Peripheral Artery Disease.

[multispecial]

Hand and Microsurgery Services Live Oak

Get expert Hand and Microsurgery Services Live Oak at Texas MultiSpecialty Group. Our skilled surgeons specialise in restoring function and precision to injured hands. Schedule your consultation today!

Visit : https://texasmsc.com/service/hand-and-microsurgery-services/

Address : Texas MultiSpecialty Group, 12315 Judson Rd., Suite 110, Live Oak, TX 78233

Email Address : info@texasmsc.com

Phone Number : 210-566-8332

[drsusanlegrand]

Susan B. LeGrand, MD, FACP, FAAHPM, is an Established Oncologist and Hospice and Palliative Medicine Physician with Cleveland Clinic in Cleveland, Ohio

                    Susan B. LeGrand, MD, FACP, FAAHPM, is a remarkable oncologist and hospice and palliative medicine physician who sees patients at Cleveland Clinic in Cleveland, Ohio. Cleveland Clinic is a nonprofit multispecialty academic medical center that integrates clinical and hospital care with research and education. Today, with more than 1,400 beds on Cleveland Clinic main campus and 4,450 beds system-wide, Cleveland Clinic is one of the largest and most respected hospitals in the country. Prior to joining Cleveland Clinic's pioneering Palliative Medicine program in 1998, Dr. LeGrand maintained a solo oncology practice in North Carolina. Furthermore, she is Director of Education at The Harry R. Horvitz Center for Palliative Medicine/Cleveland Clinic Taussig Cancer Center in Cleveland, Ohio. She has been elected Fellow of the American College of Physicians in 2002 and Fellow of the American Academy of Hospice and Palliative Medicine in 2009. “Dr. LeGrand has been a leader in palliative medicine fellowship education, co-chairing a workgroup to develop standards for fellowship training. She spearheaded the development of a Forum for Program Directors under the auspices of the American Academy of Hospice and Palliative Medicine and chaired that group through its infancy. She is a Master Facilitator for the Education in Palliative and End of Life Care program and was the palliative medicine representative on the Robert Wood Johnson Workgroup to improve end-of-life care for amyotrophic lateral sclerosis”, states the official website of Cleveland Clinic. Furthermore, Dr. LeGrand is often found engaging in guest lecturing and presenting at national and international meetings on subjects related to palliative medicine and supportive care in cancer. She has authored or co-authored numerous articles and chapters on these topics. Dr. LeGrand has 29 years in her field and her expertise covers areas such as palliative medicine, breast cancer, myeloma, cancer, cancer anorexia and cachexia, cancer fatigue, cancer symptoms, and chemotherapy related symptoms. For more information about Susan B. LeGrand, MD, FACP, FAAHPM, please visit http://my.clevelandclinic.org/staff_directory/staff_display?DoctorID=2889.

Susan B. LeGrand, MD, FACP, FAAHPM, pursued her Doctor of Medicine degree at the University of South Carolina School of Medicine in Columbia, South Carolina, and graduated cum laude and Phi Beta Kappa in 1983. She then went on to complete her internship and serve her residency at the University of Texas Affiliated Hospitals. Fellowship-trained in medical oncology at The University of Arizona Cancer Center Tucson, Arizona, Dr. LeGrand is also board certified in medical oncology, internal medicine, and hospice and palliative care by the American Board of Internal Medicine. An active member of the American Society of Clinical Oncology, the American Academy of Hospice and Palliative Medicine, the Multinational Association of Supportive Care in Cancer, the American Psychosocial Oncology Society, and the International Psycho-Oncology Society, she likes to keep up-to-date with the latest developments, guidelines, and procedures in her field. As a result of her outstanding performance in the fields of oncology and hospice and palliative medicine, The International Association of HealthCare Professionals (IAHCP) has selected Susan B. LeGrand, MD, FACP, FAAHPM, to be featured in the premier publication of The Leading Physicians of the World. Featuring 27 years of uniquely diversified experience in her areas of expertise, she credits her success to her training and what she has learned from patients. Staying up-to-date and caring for the whole patient physically and emotionally have also allowed her to nurture an impeccable reputation in two highly challenging medical spheres. When she is not treating patients, Dr. LeGrand enjoys reading and playing computer games. Prior to medical school, she obtained her undergraduate degree in psychology at the University of South Carolina. For more information about Susan B. LeGrand, MD, FACP, FAAHPM, please visit https://www.findatopdoc.com/doctor/8135071-Susan-LeGrand-oncologist-Cleveland-Ohio-44195.

[texasheartnvein]

Texas Heart and Vein Center

Contact our medical center for abdominal aortogram

In between, 8 and also 12 million Americans are affected by Peripheral Artery Disease (PAD), as well as although there are numerous PAD individuals, lots of continuing to be undiagnosed.

PAD can be frightening, however, even though it can not be healed, there is a way of life changes and treatments to stop the progression. Depending upon your problem as well as wellness threat variables, an expert will certainly choose one or numerous approaches to identify PAD.

If you're in Texas, the very best location you can check out for PAD diagnosis and also treatment is Texas Heart and Vein Multispecialty Group. At our center, you'll locate experts who have committed over thirty years of mixed experience in treating cardiovascular diseases like Peripheral Artery Disease.

[qyrresearch-blog]

Office-based Lab Market Opportunities, Analysis & Forecasts, 2019–2025

Due to its cost-effective benefits and enhanced outcome of patients, Ambulatory Surgical Centers (ASC) are becoming popular across the world. There are basically three models of ASC and Office-based Labs is one the important amongst others. Freestanding and hospital-associated are the other models of ASC. Office-based labs model is also known as office-based interventional suits which are actually a facility set up by doctors at various office premise where they offer the service of same-day intervention. The surgeries are also performed at an office-based labs, set up by licensed doctors only if all the safety requirements are fulfilled. These safety requirements are well-equipped room and some level of anesthesia and service room.

Key Dynamics Offer Dashboard View of the Global Office-based Lab Market

Higher reimbursement, cost-effective benefits, and patient convenience are the three most important factors which are driving the growth of the global office-based lab market. There is a reduction in the cost of surgeries when they are performed at office-based labs. It has been observed that the cost of surgeries reduced up to 30%-40% when they are performed at office-based labs as it does not need extra cost for the stay in hospital. Apart from this, office-based labs are convenient and have quicker admission process, lesser chance of infection and greater customer satisfaction. All these factors are collectively driving the growth of global office-based lab market.

In terms of treatment, the office-based lab’s greater benefit is- doctors who are seeking autonomy have total control over the administrative aspects of their practice. Physicians’ productivity and efficiency enhance while practicing in office-based labs, while on the other hand for patients it is a comfortable and enhanced experience. These benefits associated with office-based labs are creating a positive impact on the global office-based labs market.

Get PDF template of this report: https://www.qyrconsulting.com/request-sample/11

Market Segmentation

By Modality Type

●   Single Specialty

●   Multispecialty

●   Hybrid Lab

Among modality type segments, multispecialty is foretold to earn a remarkable share of the global office-based lab market. There is a wide array of services offered in multispecialty office-based labs, viz. embolization, thrombectomy, atherectomy, angioplasty and stenting, and diagnostic imaging.

By Region

Regional Outlook of the Market

With an increasing rate every year, North America is presently the largest office-based lab market. A remarkable number of outpatient surgeries are performed in the United States at the doctor’s office. Considering these growing numbers of office-based labs, it is expected that this market is likely to witness noteworthy growth in the years to come.

Key Players in the Market

Riceland Medical Center, Envision Healthcare, Riceland Medical Center, SCA, Texas Regional Medical Centers, Surgery Partners, National Cardiovascular Partners, Tenet Healthcare and HCA are some of the top players functioning in the global office-based lab market.

Lucid Analysis of Market Makes QY Research’s Report an Exclusive One

Taking into consideration the importance of office-based labs in the present era, QY Research has published complete, impartial and insightful research report that offers a crystal clear picture of the global office-based lab market.  

In a bid to make this report a unique one, the team of analysts which is dedicatedly working in the healthcare domain has covered various aspects of global office-based lab market. Furthermore, they have also covered various key market dynamics such as restraints, trends, opportunities and drivers to provide a dashboard view of this highly competitive market.

The expert team of analysts has assessed the available data over various parameters to arrive at a market number. One of the important sections of this report that is known as competitive landscape, which include various key players and their key strategies to sustain in the market has also covered in detail to give a transparent view of the global office-based lab market.

Get Complete Report within 24 hours: https://www.qyrconsulting.com/reports/global-office-based-lab-market

About Us:

We established as a research firm in 2007 and have since grown into a trusted brand amongst many industries. Over the years, we have consistently worked toward delivering high-quality customized solutions for wide range of clients ranging from ICT to healthcare industries. With over 50,000 satisfied clients, spread over 80 countries, we have sincerely strived to deliver the best analytics through exhaustive research methodologies.

[jackincorp]

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[supershadystudentsweetsfan-blog]

Medical Lighting Technology Market - Industry Shares, Market Strategies and Key Players 2025

The demand for the medical lighting system has increased owing to the infrastructural development of multispecialty hospitals across countries. The usage of advanced lighting system is witnessing a rapid growth in hospitals due to the wide adoption of the lighting products in various hospital applications.

 One of the most important and critical parameter in the development and enhancement of hospital infrastructure is the efficient implementation of advanced lighting systems. Proper lighting spectrum in the hospitals significantly impact each level of activities in the hospitals. It provides significant illumination to help the surgical team to perform visual tasks in surgical procedures more efficiently and further helps in reducing the chances of medical errors and maintaining the body's circadian system.

 Detailed Sample Copy of Updated Analysis @ https://www.orbisresearch.com/contacts/request-sample/2350794

 This study categorizes the global Medical Lighting Technology breakdown data by manufacturers, region, type and application, also analyzes the market status, market share, growth rate, future trends, market drivers, opportunities and challenges, risks and entry barriers, sales channels, distributors and Porter's Five Forces Analysis.

This report focuses on the top manufacturers' Medical Lighting Technology capacity, production, value, price and market share of Medical Lighting Technology in global market. The following manufacturers are covered in this report:

·         Dragerwerk

·         Eaton Corporation

·         Excelitas Technologies

·         GE Healthcare

·         Getinge AB

·         Herbert Waldmann

·         Integra Lifesciences Holdings Corporation

·         KLS Martin Group

·         Kenall Manufacturing

·         Merivaara Corporation

·         Nuvo Surgical

·         Simeon Medical

·         Steris

·         Stryker Corporation

·         Surgiris

·     ��   Trilux Medical

·         Trumpf Medical Systems

·         Welch Allyn

 The study objectives of this report are:

·         To analyze and research the global Medical Lighting Technology capacity, production, value, consumption, status and forecast;

·         To focus on the key Medical Lighting Technology manufacturers and study the capacity, production, value, market share and development plans in next few years.

·         To focuses on the global key manufacturers, to define, describe and analyze the market competition landscape, SWOT analysis.

·         To define, describe and forecast the market by type, application and region.

·         To analyze the global and key regions market potential and advantage, opportunity and challenge, restraints and risks.

·         To identify significant trends and factors driving or inhibiting the market growth.

·         To analyze the opportunities in the market for stakeholders by identifying the high growth segments.

·         To strategically analyze each submarket with respect to individual growth trend and their contribution to the market.

·         To analyze competitive developments such as expansions, agreements, new product launches, and acquisitions in the market.

·         To strategically profile the key players and comprehensively analyze their growth strategies.

 Ask Discount @ https://www.orbisresearch.com/contacts/discount/2350794

 Market Segments:

This report includes the estimation of market size for value (million US$) and volume (K Units). Both top-down and bottom-up approaches have been used to estimate and validate the market size of Medical Lighting Technology market, to estimate the size of various other dependent submarkets in the overall market. Key players in the market have been identified through secondary research, and their market shares have been determined through primary and secondary research. All percentage shares, splits, and breakdowns have been determined using secondary sources and verified primary sources.

Market size by Product

·         LED Lighting Technology

·         Fluroscent Lighting Technology

·         Incandescent & Halogen Lighting Technology

·         Others

 Market size by End User

·         Operation Rooms/Surgical Suites

·         Examination Rooms

·         Intensive Care Units

·         Others

 Medical Lighting Technology Consumption Breakdown Data by Region

·         North America

·         Asia-Pacific

·         Australia

·         Europe

·         Middle East & Africa

 Enquire Before Buy @ https://www.orbisresearch.com/contacts/enquiry-before-buying/2350794

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Orbis Research (orbisresearch.com) is a single point aid for all your market research requirements. We have vast database of reports from the leading publishers and authors across the globe. We specialize in delivering customized reports as per the requirements of our clients. We have complete information about our publishers and hence are sure about the accuracy of the industries and verticals of their specialization. This helps our clients to map their needs and we produce the perfect required market research study for our clients.

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[multispecial]

Hand pain specialist near me, Live Oak | Texas MultiSpecialty Group

Discover how a hand pain specialist near Live Oak can help you avoid surgery using non-invasive treatments. Get expert care and long-term relief today.

Visit Our Website - https://texasmsc.com/

Address - Texas MultiSpecialty Group, 12315 Judson Rd., Suite 110, Live Oak, TX 78233

Contact Us - 210-566-8332

Email Address - info@texasmsc.com

[dreamfreely2-blog]

Advocare And GuideIT Enter Strategic IT Relationship

MARLTON, N.J. and PLANO, Texas, July 12, 2018 /PRNewswire/ -- Advocare, LLC a number one multispecialty follow with nearly 600 suppliers across 181 locations, in New Jersey and Pennsylvania, representing paediatrics, adult medical aid, and specialty practices and GuideIT, a market leader in redefining the delivery of knowledge technology, these days proclaimed a strategic IT relationship targeted on supporting a brand new Electronic Health Record implementation. cheesypickuplineshub.com

In support of its vision to deliver the very best quality and efficient care, Advocare launched a strategic IT transformation project in early 2017. the target is to implement a best-in-class Electronic Health Record and also the supporting structure transformation initiatives.

Guide it had been at first engaged to advise Advocare on its separation from its current IT supplier and to support the acquisition of a brand new Electronic Health Record system.  GuideIT's services have swollen to steer this project for Advocare.

"We ar committed to providing the very best quality attention to the communities we tend to serve," aforementioned Howard Orel, MD, President and business executive for Advocare.  "With technology enjoying AN more and more vital role in patient care, our investment in technology is additionally AN investment in our patients. we tend to ar excited to own GuideIT as our strategic IT partner.  They inspire confidence by being results-oriented, exhibiting an easy approach, and demonstrating the experience required to create this technology transformation successful."

Chuck Lyles, business executive for GuideIT aforementioned, "Advocare has AN exalting vision for the strategic role technology will play in attention.  Our team is devoted to the mission of attention suppliers. we tend to developed the clinical, technological and business experience and supporting processes necessary to power initiatives like Advocare is enterprise. we tend to ar excited to play a task during this vital transformation of AN already winning attention follow."  

About Advocare

Advocare, LLC ("Advocare") could be a medical practitioner-owned and physician ruled multi-specialty medical cluster in operation in New Jersey and also the bigger Philadelphia metropolitan region. based in 1998 as AN alliance of twenty six pediatricians in southern New Jersey, Advocare has big to become widely known and extremely revered jointly of the region's largest, freelance, multi-specialty medical practitioner teams. With nearly 600 suppliers, Advocare serves around 590,000 patients at nearly two hundred locations throughout New Jersey and Pennsylvania. Advocare physicians ar often recognized among the region's high doctors by New Jersey and Pennsylvania by each patients and client magazines.  https://www.advocaredoctors.com/

About GuideIT

While technology is crucial for each business, it is also advanced and ever dynamical, typically creating it tough to manage. due to this complexness, several business leaders realize themselves in want of advisors they will trust... those who will guide them through obtaining the foremost out of technology, relative to their business priorities and also the results they obtain. that is why individuals place their trust in US. www.guideit.com source: https://cheesypickuplineshub.com/

[isaacscrawford]

Médecins sans Hôpitaux (Doctors without Hospitals)

BY IAN MORRISON

There is lots of talk of disruption in healthcare particularly involving new entrants and weird combinations such as the CVS-Aetna merger, CIGNA and Express Scripts, Amazon Berkshire Hathaway and J.P. Morgan, and now Wal-Mart and Humana all claiming to transform healthcare. At the same time, we are seeing continued consolidation in the traditional healthcare industry with hospital systems merging at the local, regional and national level.

The rise of consumerism is affecting healthcare particularly the retail/primary care area where consumers are spending with their own money in a world of high-deductible healthcare.

The growth of digital health offers the opportunity to disrupt traditional care interactions in both the management of chronic conditions and in routine primary care. And there is a whole new set of patient decision-makers such as millennials who bringing with them different sensibilities in terms of access to services.

Doctors: Disruption and Discontent

Where are doctors in all of this change? One megatrend has been the increasing consolidation of physicians into larger group practices on the one hand and increasingly in employed relationships with hospitals on the other. Recently the American Medical Association (AMA) survey shows that approximately a third of physicians are employed directly by hospitals or by practices either owned wholly or in part by hospitals (Table below).

  Source: AMA, 2017

Among the third of physicians that currently work for hospital systems there is strong anecdotal evidence and some survey evidence that there is considerable buyers’ and sellers’ remorse among those hospitals and physician practices. Indeed, there has been a “cooling of ardor” toward hospital owned physician practice by both parties. Some physicians are now realizing they have sold out “to the man” and have reduced autonomy and control.   Conversely, some hospital leaders are realizing they are subsidizing the incomes of the employed physicians to the tune of tens if not hundreds of thousands of dollars per year per physician and experiencing declining productivity among the newly salaried doctors. Nevertheless these employed physicians are a core component of most health systems’ strategy going forward, as we explore below.

In 2011 my colleagues (at Nielsen at the time) developed a segmentation of physicians based on surveys of attitudes of physicians to practice arrangements and industry trends such as electronic health records, payment reform and evidence based medicine. At one extreme was a segment of Blazing Believers, those who had “drunk the Don Berwick Kool-Aid” in that they were willing to be on salary, believed in large group practice, believed in the use of electronic health records (EHRs) and evidence based medicine. Approximately 37% of doctors were in this category by 2016 rising steadily each year from 23% in 2012. At the other extreme were the independent resisters, think “cranky old surgeons from Texas” who were more likely to be in solo practice and less likely to be enthused about groups, salaried employment, EHRs and so forth. Resisters comprised approximately 30% of physicians the remaining third were split almost evenly between what we labeled optimistic intenders (12%) physicians that have not experienced integration but were open to it and a fourth category, reluctant objectors (20%) who had tried integration and did not like the experience.

Changing practice circumstances in combination with payment reform pressures, increased scrutiny of quality, heightened reporting requirements, and angst over the electronic health record have led to rising physician discontent. This is not new.   A similar trend existed in the 1990s as managed-care took hold. The fever broke with the managed-care backlash and physician satisfaction bounced back and was relatively high in the early 2000s. Over the last seven years surveys show continued growing physician dissatisfaction with practice (not a majority of physicians to be sure but a significant plurality (40%) reportedly dissatisfied with practice).

Surveys also reveal high levels of burnout with the majority of all specialties and 56% of all physicians nationally responding they are burned out. More recently physicians have described to me that the more accurate term is “demoralization” reflecting the compounding effects of these broader changes that undermine the autonomy, authority, independence, and stature of physicians.

It is against this backdrop of change that we are seeing alternative models proliferate in terms of offering physicians new ways to practice.

Three Buckets of Physicians

In my travels I see many hospital systems with three buckets of doctors.   The first bucket is the employed multispecialty medical group (usually split evenly between primary care and specialists) which has grown rapidly over the last few years both organically through recruitment, and through acquisition. In many markets across the country, from Oklahoma to Oregon, from Mississippi to Maine, these groups account for a third or more of all the physicians practicing in the institution and perhaps an even higher proportion of admissions and all clinical activity. A second bucket is the loyal medical staff most of whom practice in traditional solo, small group or single specialty group arrangements. In some cases these physicians are included in the clinical integration organization legal structure that enables activities such as care coordination, managed care contracting, and population health activities but often this second bucket are simply the loyal medical staff who practice exclusively in the health system. The third bucket is the community-based physicians some of whom maybe “splitters” working with competing health systems, some may be in more entrepreneurial mode operating independent surgery centers or in procedural oriented specialties such as orthopedics, ophthalmology, dermatology, or plastic surgery where they do not need to have a close full time relationship with the hospital. Most health systems are trying to drive more of the clinical activity towards the first bucket, but recognize the central importance of the other two buckets as key revenue generators for the foreseeable future.

My friend Daniel Varga M.D. Chief Clinical Officer for Texas Health Resources talks eloquently about the need for THR (and all health systems) to develop “economic docking opportunities” with all three buckets of physicians. And that makes good sense to me. However, increasingly health systems are not the only place that this third bucket or even the second bucket of physicians look for practice opportunities.

Increasingly, we are seeing publicly traded companies, as well as private equity and venture capital backed initiatives that are seeking to organize physicians in different ways then the traditional relationship with independent practitioners, small or large groups or hospital owned practice.

Here are some interesting examples of physician consolidators. Each has a very different approach to the marketplace.

One Medical is a nationally growing member-based primary care practice founded originally by Dr. Tom Lee a pioneering, highly trained physician MBA entrepreneur who created an innovative environment for primary care physicians to practice using high-tech, high touch medical care targeted perfectly to the Uber generation. Well-funded by elite venture capital investors including the prestigious Google Ventures and Benchmark Capital, One Medical is growing rapidly in the San Francisco Bay Area and in other sister markets such as New York, Washington DC, Boston, Chicago, Phoenix, Seattle, Los Angeles and beyond. Their new CEO, Amir Dan Rubin formerly CEO of the Stanford Health Care system and more recently executive vice president at Optum brings vast experience in managing leading edge provider systems at scale. Amir Rubin is building on One Medical’s vision to transform the patient care experience for primary care physicians and their patients leveraging technology and value based care, while growing employer sponsorship for membership for their employees. One Medical will continue to grow as it provide opportunities for young tech savvy physicians to practice the way they really want and for patients to get primary care on their terms.

Amir notes that, “One Medical is focused on transforming health care by delighting consumers with 90% Net Promoter Scores, delivering premier health outcomes, reducing the total cost of care, and engaging providers and technologists within an outstanding environment.”

Oak Street Health is a venture backed primary care service in Illinois and Indiana with growing footprint in the Midwest focused on vulnerable elderly populations. Their model as I understand it, mirrors the pioneering work of CareMore (a medical group that is now part of the Anthem family) that focused on providing coordinated care to frail dual eligible elders on a capitated basis. The revenue flow for such patients is enormous on a Per Member Per Month (PMPM) basis and with prudent management and population health and primary care concierge medical services, has the potential (as CareMore did in its day) to dramatically reduce unnecessary hospitalization and costs.

Core Institute is a private equity backed orthopedic, neurology and spine health practice based in Phoenix and expanding to other markets such as Michigan. Core’s model is a “focused factory” that improves quality and dramatically reduces costs in high volume orthopedics such as hip and knee replacement with a special focus on bundled payment opportunities. They also have a rapidly growing management and advisory services practice helping hospitals manage and optimize their orthopedic service lines.

Optum is the rapidly growing $91 billion revenue health services company buried inside the behemoth $200 billion United Health Group. Optum has built its own monster PBM and has stealthily acquired other physician practice and other healthcare delivery assets such as 200 Ambulatory surgery centers through their purchase of Surgical Care Affiliates, and 280 Urgent Care Centers through their purchase of Med Express. Optum has reportedly 20,000 affiliated physicians and has added to their portfolio recently with the acquisition of the former Healthcare Partners Practices that were previously owned by Da Vita with 2,000 employed or affiliated physicians. All of these delivery assets can be brought to bear on the 91 million lives served one way or another by Optum. In particular, 75 geographic markets have been targeted for OptumCare primary care driven practices (35 already penetrated) according to United Health Group’s most recent financial filings.

Investor Backed Ambulatory Services are growing in many states especially where there is no Certificate of Need legislation. A previous column (https://www.hhnmag.com/articles/7795-the-future-of-emergency-care) focused on the future of emergency medicine highlighted there are 10,000 urgent care centers, 5,000 ambulatory surgery centers, 2,800 retail clinics and more than 500 freestanding emergency rooms in the United States. In addition, there are numerous micro hospitals and diagnostic imaging centers that either employ or partner with community based physicians. These new settings provide increased opportunities for physicians to practice without hospitals.

Physician Led ACOs are proliferating rapidly with one study found: “As of January 1, 2017, half of the 480 organizations participating in the government’s Medicare Shared Savings Program (MSSP) — which offers upside potential and downside protection for the 438 Accountable Care Organizations (ACOs) in what the Centers for Medicare & Medicaid Services (CMS) refers to as Track 1 — reported to CMS that they are composed solely of networks of individual physician or small group practices”. This study and others seem to show that “small is beautiful” with independent physician led ACOs apparently out performing ACOs on average. (https://catalyst.nejm.org/do-independent-physician-led-acos-have-a-future/ )

Physician Outsourcers such as Team Health, MedNax, AMN are for profit health service companies. They are not traditional healthcare providers and yet they organize tens of thousands of physicians. Team Health has 20,000 affiliated physicians and provides physicians for hospitals and health systems in several specialties especially emergency medicine, anesthesiology and hospital medicine. MedNax is a physician aggregator/outsourcer with revenues of $3.5 billion and over 4,000 employed or affiliated physicians focused primarily on pediatrics, obstetrics and anesthesiology (including through their well know Pediatrix and Obstetrix brands). For example, MedNax physicians represent over 20% of the nation’s neonatologists (1,125 of the estimated 5,300 neonatologists nationally according to company presentations to investor conferences). AMN is the largest healthcare staffing company with $2 billion in revenue that provides a wide range of healthcare workforce solutions including physicians recruitment, nurse staffing, locum tenens and healthcare workforce optimization services. All of these companies position themselves as providing diverse opportunities for physicians to practice the way they want.

Implications

So what does this all mean for hospitals and healthcare systems across the country?

Looking for Doctors. At every health system board or management retreat I have been involved with in the last five years (and there are a lot of them all over the country) one common recurring strategic issue is attracting and retaining physicians. For the old hands out there, this is not exactly breaking news. This is how the game has been played for a century. But it is different now. All the consolidation, disruption, shift to the ambulatory environment, coverage expansion, physician demoralization, changing character of the labor force in terms of gender and lifestyle all combine to increase the challenge of recruitment and retention of physicians. Whether it is because of over priced housing markets in the Bay Area or Boston, or disinterest in taking call, or an overall shortage of physicians, or all the intervening opportunities described here, most health systems are having trouble attracting physicians. Except Kaiser of course.

Doctors are Unsettled. While hospital based employment provides economic security and (in many cases subsidy) it is not for everyone. Whether it is burnout or demoralization there is no doubt that doctors are unsettled. And many of them are entrepreneurial and value autonomy over anything else (for many physicians, that’s why they went into medicine in the first place so they don’t have to work for a boss). The new plethora of practice arrangements especially with investor backing may represent an attractive option. (Actually making money in these investor backed ventures is a whole other matter as evidenced by the horrible financial history of Physician Practice Management companies in the 1990s).

Not Either/Or. The healthcare outsources like AMN and Team Health work with health systems, the disruptors like CVS-Aetna will partner with health systems, the focused factories like Core Institute may build significant ambulatory operations and still partner with health systems. Like Silicon Valley learned decades ago you need to simultaneously collaborate and compete. Get used to it.

But People will get Sick. No matter how successful disruptors and innovators are there will still be sick, vulnerable patients needing hospitalization. Your I-Phone won’t change your diapers, or turn you in bed at four in the morning, or bring together hundreds of highly-trained professionals, just for you, to deliver complex care like transplantation. And let’s not forget that complex care for the sick is where the money is in healthcare. Just 5% of patients account for 50% of costs and a lot of it quite frankly is not easily disruptible, no matter how many PowerPoints argue the contrary. We will need hospitals, doctors and nurses in our future more than ever as we age and get sicker as a society. But hospitals must understand that Médecins sans Hôpitaux will have an effect on their strategy and operations as physicians have more opportunities to practice in a wider range of settings.

Ian Morrison PhD is an author, consultant and futurist in Menlo Park, California

Article source:The Health Care Blog

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Nobilis Health Adds In Network Surgery Center in Dallas, TX – San Antonio Business Journal

HOUSTON, Feb. 7, 2018 /PRNewswire/ — Nobilis Health Corp. (NYSE American: HLTH) ("Nobilis" or the "Company") today announced the opening of an ambulatory surgery center located near the Uptown District in Dallas, Texas ("ASC"). The ASC has two operating rooms and will provide multispecialty services, including those offered under Nobilis’ nine direct to consumer marketing brands.

Kenneth Efird, Nobilis’ President, stated, "While we have been operating in the Dallas-Fort Worth market for years, the addition of this ASC enhances our ability to provide high quality healthcare services to a new demographic of patients and adds an additional location in this market to better serve our aligned physicians. The ASC will operate under in network contracts with major commercial payors, advancing our goal to grow our portfolio of in network volume and revenue."

About Nobilis Health Corp.

Nobilis Health (www.NobilisHealth.com) is a full-service healthcare development and management company, with more than 30 locations across Texas and Arizona, including hospitals, ambulatory surgery centers, and multi-specialty clinics. In addition, Nobilis Health partners with more than 30 facilities across the country. Marketing nine independent brands, Nobilis Health deploys a unique patient acquisition strategy driven by proprietary, direct-to-consumer marketing technology, focusing on a specified set of procedures that are performed at its facilities by local physicians. Nobilis Health’s business model connects patients with physicians and delivers the highest quality healthcare.

Forward-Looking Statements

This press release contains certain forward-looking statements within the meaning of Canadian and United States securities laws, including the safe harbor for forward-looking statements contained in the Private Securities Litigation Reform Act of 1995. Forward-looking statements include all statements that do not relate solely to historical or current facts and may be identified by the use of words such as "may," "believe," "will," "expect," "project," "estimate," "anticipate," "plan" or "continue." These forward-looking statements are based on current plans and expectations and are subject to a number of risks, uncertainties and other factors which could significantly affect current plans and expectations and our future financial condition and results. These factors, which could cause actual results, performance and achievements to differ materially from those anticipated, include, but are not limited to our ability to successfully maintain effective internal controls over financial reporting; our ability to implement our business strategy, manage the growth in our business, and integrate acquired businesses; the risk of litigation and investigations, and liability claims for damages and other expenses not covered by insurance; the risk that payments from third-party payers, including government healthcare programs, may decrease or not increase as costs increase; adverse developments affecting the medical practices of our physician limited partners; our ability to maintain favorable relations with our physician limited partners; our ability to grow revenue by increasing case and procedure volume while maintaining profitability at the Nobilis facilities; failure to timely or accurately bill for services; our ability to compete for physician partners, patients and strategic relationships; the risk of changes in patient volume and patient mix; the risk that laws and regulations that regulate payments for medical services made by government healthcare programs could cause our revenues to decrease; the risk that contracts are cancelled or not renewed or that we are not able to enter into additional contracts under terms that are acceptable to us; and the risk of potential decreases in our reimbursement rates. The foregoing are significant factors we think could cause our actual results to differ materially from expected results. However, there could be additional factors besides those listed herein that also could affect us in an adverse manner.

We have not undertaken any obligation to publicly update or revise any forward-looking statements. All of our forward-looking statements speak only as of the date of the document in which they are made or, if a date is specified, as of such date. Subject to mandatory requirements of applicable law, we disclaim any obligation or undertaking to provide any updates or revisions to any forward-looking statement to reflect any change in our expectations or any changes in events, conditions, circumstances or information on which the forward-looking statement is based. All subsequent written and oral forward-looking statements attributable to us or persons acting on our behalf are expressly qualified in their entirety by the foregoing factors and in our Annual Report on Form 10-K for the fiscal year ended December 31, 2016, filed on March 14, 2017, as updated by other filings with the Securities and Exchange Commission.

Contact Information:

Tuan Tran Vice President, Investor Relations (346) 207-6342 IR@Nobilishealth.com

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SOURCE Nobilis Health Corp.

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