Four Months After Becoming a Founding Partner in USACS: Where Are We?

On January 1^st of this year, MEP Health became a founding partner in US Acute Care Solutions. Four months later, one thing is abundantly clear, if it wasn’t already: if you’re not comfortable with change, you’re probably working in the wrong industry. Some might say you’re living in the wrong century.

Our decision to help form a new, national acute care company took some by surprise. And, it raised the question of whether we had acted out of short term interests, rather than getting ahead of long-term industry trends.

More than 120 days into this journey, it’s time to pause and reflect on that question. We made our decision after a lot of thought, but more importantly after a deep look at the industry trends which directly impacted our business:

• Consolidation of health systems. More and ever-larger health systems continue to acquire single, community hospitals.
• Consolidation of payers. There are now just three major commercial payers in the market: the Blues, United Healthcare, and Aetna.
• The trend toward integrated services. Providers must increasingly provide resources across the care continuum, including observation medicine, hospitalist, and post-acute care services.

Finally, there was a recognition that this period of consolidation was an opportunity to realize some value for all of us who have helped build the company to this point. The value for us collectively would be greater than if we had stayed the course.

The future of emergency medicine

If we could guarantee that the path forward would look like the path behind, it’s safe to assume no one would ever make a change. But that is not the world we live in.

The reality is that myself and many of the company’s leaders must lead the organization into uncharted territory. We’d succeeded in the past in becoming a large, regional leader. But even that success was borne in part of our ability to change and adapt. Now it’s time to adapt again.

That said, change is hard. Some in our company will decide to look for something new, and that’s a natural result of change on this scale. Others will see this as an opportunity to be on the ground floor of building a national healthcare company, one which will redefine how we deliver acute care. As they say, it’s all in your perspective.

For me, the decision to become a founding partner of USACS came down to two questions:

1. Would individuals have as good or better opportunities moving forward than they would have had in the past?
2. Is this decision consistent with the values upon which we founded the company?

What we’ve accomplished so far

Both questions will only be answered with time. But that said, after four months we do have some indications of the path we’re on. Here’s what’s happened so far in the last four months:

• Over 200 Leaders from across the country, including over 25 members of the Mid-Atlantic Region, met in Denver to share best practices and begin to define national standards for quality though the National Clinical Governance Board.
• Our Observation Medicine program is being scaled to a national audience to serve the needs of many USACS Hospital partners throughout the country.
• Our APP training and leadership development programs have been recognized as trendsetting and are being incorporated into the developing national standards of training for APPs company-wide.
• We conducted a salary survey. Seventy percent of our full time physicians responded, and based on those results we are redesigning an incentive compensation plan long described as difficult to understand.
• We have a focus, at the national level, to become an employer of choice for women, and many of our leaders from the Mid-Atlantic Region are playing an important role.
• EVERY full time physician is now a stockholder in USACS.
• We are already taking advantage of our national reach and scale to negotiate better payer contracts and continue to be able to increase compensation for our providers.

This is huge progress in four months.

That said, there are certainly things we could have done better. Clear and prompt communication during transitions like these is always a challenge, and that challenge remains. We still need to communicate what the opportunities are for our providers and support staff moving forward. And, we need to find the happy medium between being clear and direct while at the same time dealing with continued unknowns.

I’ve said in the past, whenever we’ve launched into new service lines or created new processes, that we are building the car as we drive it. Well, this time we are building the jump jet airplane as we fly it. Not everything is set in stone, and that’s both a challenge and an opportunity for those of us with the opportunity to define the company as it is forming.

In the near future at least, uncertainty will continue to be a constant, as it has been the past four months.

A consistent message

For those of us who have had the opportunity to meet individuals from other parts of USACS, whether in Canton, Denver, Tampa, or anywhere else, I hear a consistent message: this company is full of great people trying to do the right things for the right reasons. Certainly in my position on the Board of Directors for our company, I see and hear the same thing.

In the near future, we’ll be welcoming many more people to our company. We’ve recently announced a partnership in Colorado and are in serious discussions with many other groups in key markets throughout the country.

These groups face the same choices we did, and they will move into the future with the same challenges. Whether the decision to join USACS will prove to be the best one for MEP Health, only time will reveal, and I am confident time will show that it indisputably was. But there is much work ahead.

In January of 2010 I spoke about a future in health care as a shining city on the hill:

That future involves our patients being seen immediately by an exceptional provider who has immediate access to past medical information. The patient is treated compassionately and efficiently using the latest advances in technology while results are explained in ways they can understand. Once our patients are treated, rapid follow-up is scheduled when necessary to avoid a revisit to the ER and allow other non-urgent conditions to be fully evaluated.

By joining USACS, I believe we have moved a few steps closer to that reality. It was the right decision at the right time with the right partner for the right reasons.