Case Studies
1. Radiology Exclusive Contract with Stipend Support
A radiology group had held an exclusive contract at its hospital for years. Workload was increasing rapidly while reimbursement was declining. Despite the fact that low reimbursement made it was impossible recruit to the group, the hospital refused to offer more than token, five-figure stipend support.
Replacing former counsel, we utilized elements of the Strategic Group Process including framing the issue of the necessity of support, controlling the flow of financial data and influencing how it was interpreted by the hospital's valuation consultant and, ultimately, by hospital administration.
We obtained a multi-year exclusive contract for the group, including stipend support in excess of $1.6 million per year, an increase of over 1,100%.
2. Managed Care Negotiation
A single specialty, multi-physician and allied health professional group sought to improve the reimbursement received from a major national payor. The payor controlled a major portion of the managed care market but paid at a hugely discounted rate that, in reality, required the client to subsidize through better paying work.
We embarked on the process of gathering deep background data on the payor and its negotiators and on investigating the level of reimbursement at other facilities by means compliant with price-fixing restrictions.
Utilizing a negotiating strategy that took advantage of changes in timing, quickening or slowing the pace as tactically appropriate, we succeeded in obtaining a 44% increase over the existing level of reimbursement.
3. Anesthesia Exclusive Contract
An anesthesia group held the exclusive contract to provide all anesthesia services at a major hospital. Both the scope and intensity of coverage had increased over the current term of its contract, yet collections suffered due to poor patient mix.
We represented the group through two phases of the renewal of its contract.
We took the group from $875,000 a year in fixed coverage support, with no control over the intensity of coverage, to a first renewal at the $2.2 million dollar level and now to a second renewal at an initial $2.4 million a year with absolute control over any expansion of coverage.
The deal includes fixed increases linked to agree-to growth in coverage and, in total, has a conservative stipend support value of $8 million over its three year term.
4. Healthcare Finance
Our client is a purchaser of hospital workers compensation accounts receivable. A hospital with which it had not done business in the past was interested in a deal, but stated that loan covenants prevented it from selling accounts receivable.
Interfacing directly with the hospital's CEO, we devised a revolutionary pre-purchase arrangement whereby accounts would be owned by our client before becoming receivables.
The plan took the arrangement outside of the prohibitions of the loan covenants and provided our client, and the hospital, with an extremely valuable business opportunity.
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