More Regular Care = Urgent Care Growth

The urgent care industry is poised for more expansion driven by the Affordable Care Act, hospital closings, primary care doctor shortage, high Emergency Room costs.  Industry sources expect a steady flow of patients seeking regular care (vs. acute care) to flow into urgent care centers within the next 5 to 10 years.

Dr. Kenneth Palestrant, founder of Physicians Immediate Care in Florida, recognizes this trend.  Approximately, 20% of patients use his five centers to receive primary care.  With ACA implementation, Dr. Palestrant expects more hiring of nurse-practitioner and physician assistants in urgent care to address the gap in primary care.  >>Read more

Source:  MedCity News

6 Reasons You’ll Lose Your Best Employees

It's not always money that drives key employees to exit. 

Columnist Jeff Haden outlines and explains a few non-salary reasons.  Know of any others?  >>Read more

1. The business has grown - and so has your ego.
2. A boutique turned into a corporation.
3. The sky no longer seems the limit.
4. Exceptional skill resulted in handcuffs.
5. Flat became multi-layered.
6. Major League Baseball turned into Little League.

Source:  CEO.com

USCB - a New Platform for Bregal

Bregal Partners acquired US Community Behavioral (USCB), a multi-state provider of community-based residential and behavioral services to adults and children.  The PE firm will leverage the size and organization's reputation to foray deeper into behavioral health care sector.  The acquisition, made in partnership with management,  presents a well-capitalized platform poised for expansion.  

US Community Behavioral is a best-in-class provider offering a full continuum of services including supported living, licensed homes, employment services, autism and other therapy-based behavioral services.  >>Read more

New Home for Physicians Endoscopy

Physicians Endoscopy (PE), a healthcare services company that develops and manages endoscopic ambulatory surgery centers (ASC), is now a Pamlico Capital investment.  Pamlico recently acquired the stake in Physicians Endoscopy from Silver Oaks Services Partners.  (PE was a Silver Oaks portfolio company since 2008).  Under Silver Oaks, PE doubled its numbers to 29 centers nationwide.  The company partners with practicing physicians and hospitals.  Its services include development, management, and billing services..an effort to minimize the administrative burden on physicians.  
>>Read more
 

Home Infusion Therapy Leader Acquires CarePoint

BioScrip, recently announced the completion of its acquisition of CarePoint Partners.  With 30 years of infusion therapy expertise, BioScrip's coverage area encompasses 46 states, including 40 specialty infusion pharmacies, and 33 nursing locations.  The BioScrip and CarePoint consolidation will provide home infusion services to over 100,000 patients annually.
The home infusion industry has experienced healthy growth over the past few years and is estimated at $9-11B, according to Russell Bodoff, president and CEO of the National Home Infusion Association.  Since 2011, the industry has seen M&A activity resulting in the acquisition of Crescent Healthcare by Walgreens; Pediatric Health Choices's home infusion, enteral divisions acquired by CarePoint.  >>Read more

Improve Your Company's Exit Readiness

Came across a timeless blog post that should resonate with many small or medium business owners considering a sale:

• Where to start?…Prepare an exit strategy.
• What's next?…Organize key company information.  
• What kind?…Generally, the info falls into these categories:  Financial History, Intellectual Property, Regulatory Compliance.

>>Read more
Source:  Appfolio / Secure Docs

Envision, a Medical Services Co. - Goes Public

Envision Healthcare Corporation successfully debuted on Wall Street with its initial public offering.   The Colorado-based company is a provider of ambulance services for local governments, facility-based physician services (ER, anesthesiology, hospitalist/inpatient care, etc.) as well as patient care across various settings for the chronically ill.  The company, formerly EMSC Corporation, had been expanding via new contracts and physician practice acquisition. 

Envision, which operates American Medical Response (AMR), EmCare Holdings and Evolution Evolution Health, LLC, is expected to thrive in the era of the Accountable Care Act.    >>Read more

How to Minimize Growing Pains

Michael Shafe, MD leads a growing urgent care business, The Urgency Room -  starting and expanding the business to 3 locations within six years.  While growing can be anxiety-ridden, Dr. Shafe reduced some stress by following a roadmap that would apply to other healthcare service businesses.  Check out his Expansion TOP TEN List:

1. Determine what went right and Repeat
2. Ensure business can be replicated
3. Keep locations legally separate
4. Do your research
5. Contract with payers early
6. Prepare financially
7. Hire early
8. Allow adequate time for hiring and training
9. Create a comprehensive Operations Manual
10. Market cost effectively

>>Read more

Cause for Celebration at ATI

Management and staff at ATI, the nationally-recognized provider of outpatient orthopedic rehabilitations, deserve HIGH- FIVES.  In 2013,  ATI has steadily acquired clinics in key mid-atlantic and midwest states: Delaware, Maryland, Pennsylvania, Illinois, Indiana, Wisconsin.  In fact, over 20 clinics have been added under the ATI banner.  We're pleased... as our former client, MX Physical Therapy, was acquired in January and is part of ATI's growth to date.

Top 10 Healthcare Workplace
Kudos to the Bolingbrook, IL-based organization… for recognition as a Top 10 healthcare company based on results of the yearly WorkplaceDynamics survey.  The survey measures employee satisfaction, engagement, organizational health.  Overall, ATI was ranked #54 of the 872 companies (with 1000+ employees)  participating in the top workplaces programs.  >>Learn more

In the Spring, ATI was also recognized regionally as a top workplace in the Philadelphia and Indianapolis regions, respectively.

As a proud President and CEO, ATI's Dylan Bates noted:

“As we look to the future, and as our company continues to grow, we are even more determined to provide an environment in which our employees can enhance their skills, succeed in the field of their choice, and grow from the positive experience of having excellent outcomes for our patients,” 

Good Job ATI...

Do Well by Doing Good

Community Marketing - it's smart marketing for local businesses… 
It raises your profile and elevates your reputation in the community.  And, that's a good thing if referrals and foot traffic are important.  So, how to?

According to Dr. Roger Levin from the Levin Group...

• Create an annual High-Visibility Event that benefits the community.
• Choose a Good Cause and "Own" it. 
• Involve your entire team to identify a local need and fill it.
• Keep the staff engaged so all have a stake in event success. 

Possibilities:  food drive for local food bank, fundraiser for nonprofit

Make the event memorable and worth repeating year after year:

• Think creatively
• Pay attention to details
• Create a timetable
• Assign responsibilities 
• Meet deadlines  

Enjoy Your event, the community connections and a job well done!

PatientFocus Signs Agreement with Choice Medical

PatientFocus, a healthcare billing company providing enhanced patient billing services, has signed an agreement with Choice Medical, Inc., a specialty distributor of orthopedic, neurosurgical, orthotic and prosthetic product lines. 

The agreement will give Choice Medical patients access to Patient Focus’ suite of patient-pay account management services.  Payment options will include check, credit card, bank draft, Health Savings Account and PayPal.  >>Read more

Hats off to U.S. Physical Therapy…

Forbes recognized the operator of outpatient physical therapy as a Top 100 U.S. small business.  Its #60 ranking is impressive as is its operational footprint - approximately 450 clinics in over 40 states.  Founded in 1990 and currently headquartered in Houston, U.S. Physical Therapy has close to 2000 employees.  

Kudos to other healthcare services companies appearing on the latest Forbes America's Best Small Companies list:  

• Metropolitan Health Networks
• Air Methods
• Bio-Reference Laboratories
• HealthStream
• HMS Holdings
• Ensign Group

Inclusion was based on earnings growth, sales growth, ROE in the past 12 months and over 5 years.
Source:  The Motley Fool

Pay Raise for Physical Therapists?...

Medicare recently released its proposed fees for healthcare professionals scheduled to take effect January 1, 2014.   As expected, there were winners and losers…a few are noted below but Click here to learn how others will be affected.  

Winners
Physical / Occupational therapists… +1%
Family practitioners…+1%
Chiropractors…+2%
ER physicians…+2%
Losers     
Dermatologists…-1 to -2%
Radiologists… -1 to -2%
Pathology specialists…-5%
Radiation therapy centers…-13%

3 Questions to Get Your Business Unstuck

Unsure of your business' next steps?  Glenda Eoyang, author of Adaptive Action:  Leveraging Uncertainty in Your Organization suggests that you start with 3 questions:

1. What is going on around you?  (Helps assess the current state of business affairs.)
2. So, what does this mean? (Helps clarify why it's important.) 
3. Now what do you do? (Set the path but be willing to change course, if necessary.)

Read more>>>

Source:  CEO.com

Retail Clinics Continue to Roll Out

Up 7% percent (as of July 1) - that's the growth of retail clinics year over year, according to Merchant Medicine, a consulting firm in the field of walk-in medicine. 

Impressive…

Today, the total number of retail clinics is over 1400 in 38 states and Washington, D.C.* and the upward trend will continue.  Evidence is the recent announcement by CVS, Minute Clinic's owner, of their plans to double locations by 2016 from 570 to 1000.  

Not surprising…

After all, a Forbes article points to the fact that retail clinics are expected to be a key component of Obamacare when it kicks in next January (2014) -  either through a private health plan operating on an exchange or through Medicaid health insurance programs for the poor.  Read more>> 

Solid ground…

Healthcare's walk-in side must be doing something right.  An editor at Physicians Practice, suggested in a blog post that traditional practices could learn a few things from retail clinics.  During a recent visit, she was impressed with the walk-in's "cleanliness and efficiency in handling patient intake, prescription list, insurance information and payment all by one person."  Another important point, her "care-coordination was equally smooth".    

*Convenient Care Association

Quick Look Back...

A few months ago, the MT Consulting newsletter featured the thoughts of investment banker John Slater from FOCUS.  His article in the March, 2013 FOCUS newsletter pointed to an expected rise in company valuations in 2013.   His words also caught the attention of blogger Billy Frank at Axial, a technology company that offers an online marketplace connecting people, information and capital.  Yesterday’s Axial post recognized Mr. Slater’s words...and those of others in 17 Must-Read M&A Quotes from 1H 2013.  Take a look!

"The next 12-18 months will almost certainly be a highly favorable period for business exits.  If this proves to be a cyclical market top, the next favorable period for businesses owners wishing to sell may not come around before the 2020s.  In 2020 today’s sixty six year old Baby Boomer will be seventy-three and today’s fifty eight year old will be sixty five and studying Medicare options.” ~ John Slater

Infusion Therapy Provider Capitalizes on Growing Market

© Kulty Stock Free Images

Medical Specialties Distributors (MSD), supplier of infusion therapy products and supplies sees a bright future.  With the infusion therapy industry predicted to grow 50% by 2019*, MSD strengthened its position with the recent acquisition of Medical Technology Resources (MTR).  MTR specializes in drug-delivery technology and the billing of infusion products to healthcare providers.   

 "MTR's unique offerings and strong presence in the Midwest enhances our leadership position in the growing home infusion and oncology markets," said James Beck, president and CEO, MSD.  "Over the past three years, we have grown our national footprint through partnerships with multi-site health care providers and strategic relationships with leading manufacturers.  This acquisition is one more step toward our goal of creating a stronger growth platform for MSD.

In 2010, MSD partnered with Water Street Healthcare Partners, a private equity firm that focuses exclusively on the healthcare market.

The U.S. market for infusion therapy devices was valued at just under $1.5 billion in 2012, a 3.2% increase over 2011*. The market includes infusion pumps, intravenous (IV) sets, and needleless connectors (NLCs).  Spurring growth is NLCs and disposable ambulatory infusion pumps (as the number of alternate infusion therapy sites increase).  >>Read more 

* RnR Market Research

Retail Clinics Popular with High Earners

Trending up – that’s what a late 2012 survey report revealed about the use of retail clinics (generally located in drug stores and staffed by nurse practitioners or physican's assistants).   Not a surprise... that the survey publisher attributes the rise in use to convenience of appointment-free services, expanded hours compared to the average physician office and lower costs.  The survey from healthcare market research publisher, Kalorama Information, reported that 21.3% of US adults have visited a retail clinic - up from 10% in 2006.  

Now, Kalorama reports that retail clinics are favored more by higher earning households.   A survey of 2000 adults revealed that “59% of survey participants who said they used retail clinics had a household income of more than $50,000, while only 16 percent had a household income of under $25,000.”  Again, not a big stretch...as higher earners are visiting stores more frequently.  

As chain operators (Walgreen’s, CVS, Wal-mart, etc.) continue to promote their in-store clinics and offer services attractive to this income group (e.g.: camp physicals, weight loss programs), increased retail clinic visits is expected.  >>Read more

Direct Access in All 50

Done deal!  Indiana, with signed legislation, becomes the last state to allow residents to seek physical therapists’ services without a physician referral.  The state chapter of APTA has been working on Direct Access for over 13 years... now a reality beginning July 1st.

Benefits of Direct Access include a patient’s quicker access to care and medical cost reduction.  >>Read more

Plus 2 for The Ensign Group

The Ensign Group, Inc. ended the month of May with two more assisted living facilities under its corporate umbrella.  With operations primarily in the western US, the company now enters California's Central Coast region and complements existing facilities in the greater Salt Lake City-area.

118 Facilities in 11 States 

Last week’s acquisitions continue the company’s expansion of its assisted living base, increasing Ensign’s healthcare facility portfolio to 118 in 11 states.  Ensign group service companies include skilled nursing, rehabilitative care, home health care, hospice care, urgent care in addition to assisted living.

The Ensign subsidiary, Bridgestone Living, Inc. will oversee the transition of the 110-unit Santa Maria Terrace (Santa Maria, CA) and 69-unit Lake Ridge Senior Living (Orem, UT).   

>>Read More about Ensign's California and Utah acquisitions.