Negotiating Hospital-Physician Contracts
Advocacy
With Millions on the line for each group, we’re able to speak intelligently on behalf of the hospital with the authority to customize the result to meet the group’s particular needs or reward the strengths of the group (i.e., more mature physician groups may need higher retirement contributions vs. groups right out of residency may need more sign-on consideration).
Experience
One of our unique advantages is that our CEO, who was a Hospital Administrator (CEO, COO, I-CFO, VP) and Hospital Attorney (General Counsel), has negotiated hundreds of physician management contracts from the hospital perspective as well (across many physician specialties).
Data Integrity
Given that there are often many specialties being paid (in various ways) by the Hospital it’s important to tie the final collaboration to data such that it’s not used against the hospital to be leveraged to pay the other groups at the same (higher) percentile. The data has to support the legal and operational goals and objectives to be justified to the Board, the organization’s stakeholders, and regulators.
Fair Market Value
We are experts in the legal rules and guidance around Fair Market Value defined in 42 USC 1395nn(h)(3), Commercial Reasonableness, which are government terms and requirements, and pay that doesn’t consider the volume and value of referrals. Our CEO has extensive experience with negotiations that are compliant with the following, including, but not limited to Stark, the Antikickback Statute, Civil Monetary Penalties, Conditions of Participation, False Claims Act, etc., to protect both the physician group and hospital from any costly legal violations.
Best Practices
We can also avoid the pitfalls that have led to many ED physician groups leaving the market (e.g., The No Surprises Act) by carefully planning and education to develop best practices. Our CEO negotiated with 3 ED groups within 6 months at a particular hospital and understands the challenges of practicing Emergency or Hospitalist medicine.
The Right Fit
We offer Hospitals many ways for them to incorporate contracts with physicians and physician groups. It’s not a cookie-cutter template, it’s customized to the hospital’s concerns and objectives in a long-term partnership integration.