GenesisCare filing for bankruptcy

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What do you call an agreement when a hospital lets you do your own professional billing?
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A_DeMichele said:
What do you call an agreement when a hospital lets you do your own professional billing?
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We have this arrangement at some of our hospitals. We just call it a professional services agreement.

Patient gets a technical bill from hospital and a professional fees bill from us. We use a different billing company than the hospital.
 
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A_DeMichele said:
What do you call an agreement when a hospital lets you do your own professional billing?
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I thought this was a PSA? The concept of a PSA where they bill the technical and professional.... and then pay you based on RVUs... sounds like employed model to me, mang. But just dumb academic over here who has never been part of a PSA.
 
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evilbooyaa said:
I thought this was a PSA? The concept of a PSA where they bill the technical and professional.... and then pay you based on RVUs... sounds like employed model to me, mang. But just dumb academic over here who has never been part of a PSA.
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I thought same
 
A physician services agreement is simply an agreement to provide physician services. Obviously, the difference between that and being employed is simply that you're not employed by the hospital. Just as an employed contract can pay a flat rate, collections, percentage of global, or rvu rate, so can a PSA. There's no requirement it be based on a certain thing. Just a contract with an independent contractor.
 
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I am not certain what the retirement situation is everywhere… but I am aware of more than one academic center that utilizes exotic plans where they “match” more than you contribute, and you can contribute much more than the 401(k) max… certainly offsets some of the W2 pain.
 
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Lamount said:
I am not certain what the retirement situation is everywhere… but I am aware of more than one academic center that utilizes exotic plans where they “match” more than you contribute, and you can contribute much more than the 401(k) max… certainly offsets some of the W2 pain.
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This is when over time a situation like this can surpass “doing your own professional billing” especially if you keep ~15 or less under beam.
 
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TheWallnerus said:
This is when over time a situation like this can surpass “doing your own professional billing” especially if you keep ~15 or less under beam.
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...and assuming they stay solvent (looking at you, Illinois) often there are pension plans in some of these state institutions. Some of the academic jobs I looked at a decade ago did have some retirement perks...


But as a PSA you can get creative too including 401K's maxxed at ~54K/year and a defined benefit cash balance plan as well . Of course there's no "match" it's all just coming from your own revenue.

But at less than 15 under treat like you're saying, no way there's enough revenue to fund that much in tax deferred on PSA revenue alone. You'd need a supplement from the hospital.
 
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What you want is a "fixed price" for your services, payable monthly (as most hospitals do their contractor pay this way). And get them to foot the bill for X weeks of locums coverage.

When I tell you that the terms of the contract were deeply negotiated, you must believe me, they will push back on just about everything. So its important to know where you can give some leeway (maybe venue, random drug testing, 90 day notice instead of 120 or 180) and where you can't (never arbitration, vacation only counts when someone else is hired/paid while you are not there, there are no set times for the office just that the usual and customary, etc.) and... we haven't even touched on the good old terms of termination minefield.

Most physicians aren't ready for the complexity that 1099 can bring, but once you unlock it.. you won't go back to W2 ever again.
 
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Lamount said:
I am not certain what the retirement situation is everywhere… but I am aware of more than one academic center that utilizes exotic plans where they “match” more than you contribute, and you can contribute much more than the 401(k) max… certainly offsets some of the W2 pain.
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I had this at one university-type of a place; they unfortunately start and stop extra retirement contributions at will
 
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SneakyBooger said:
BTW, how did Danny get out of his noncompete?

I might want his attorney on retainer!
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RickyScott said:
A special law was passed!
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Yep! Best govt money can buy. No longer needed such power to screw new grads anymore and it was hurting then the same way now

floridapolitics.com

After lobbying, lawmakers allow disgruntled cancer docs to void no-compete language

"We had some folks approach us and say there were issues with specialty providers."
floridapolitics.com floridapolitics.com
 
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200.gif
 
medgator said:
Yep! Best govt money can buy. No longer needed such power to screw new grads anymore and it was hurting then the same way now

floridapolitics.com

After lobbying, lawmakers allow disgruntled cancer docs to void no-compete language

"We had some folks approach us and say there were issues with specialty providers."
floridapolitics.com floridapolitics.com
Click to expand...


Committee/Subcommittee hearing bill: Appropriations Committee
Representative Rodrigues, R. offered the following:

Amendment (with title amendment)

Between lines 110 and 111, insert:

Section 2. Section 542.336, Florida Statutes, is created
to read:

542.336 Invalid restrictive covenants.—
A restrictive covenant entered into with a physician licensed
under chapter 458 or 459 who practices a medical specialty in a
county where one entity employs or contracts with, either
directly or through related or affiliated entities, all
physicians who practice such specialty in that county is not
supported by a legitimate business interest and is void and
unenforceable. Such restrictive covenant shall remain void and
unenforceable for three years from the date a second entity that
employs or contracts with, either directly or through related or
affiliated entities, one or more physicians who practice such
specialty begins serving patients in that county.

----------------------------------------------------- TITLE AMENDMENT
Remove line 11 and insert:
penalty; creating s. 542.336, F.S.; making certain restrictive
covenants void and unenforceable for a certain period of time;
providing an effective date.
 
GenesisCare Likely to Sell Bankrupt Healthcare Assets in Pieces


GenesisCare Likely to Sell Bankrupt Healthcare Assets in Pieces

  • Company may not get bids for entire US business, lawyers say
  • Australian company operates cancer treatment centers
GenesisCare, an Australia-based operator of cancer treatment centers, is likely to sell its bankrupt US operations in pieces instead of attracting a buyer willing to rescue the entire business, lawyers said in court Wednesday.

Interest so far indicates bidders are likely to focus on individual assets based on where they are located, company lawyer Lindsey Blum told the judge overseeing the Chapter 11 case during a hearing in Houston. Bids for the various operations are due in September and if enough offers come in, the company will hold an auction in early October.
 
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A buddy of mine in a rural GenesisCare location is having their center shut down with 10 days notice and losing his job.

My understanding is that they tried to sell it, but no buyers.

I wonder how many of their rad oncs will be looking for a new job soon.
 
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It's a good thing the Senior Vice President of this company,

along with the Chief Policy Officer of this company,

have essentially been in charge of Radiation Oncology for many years,

by occupying zenith or near-zenith leadership positions in the ABR and ASTRO.



Certainly the struggles mirroring this company and the specialty as a whole are coincidental, right?
 
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RickyScott said:
More consolidation
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They were already allied

MHP is a large group of physicians - mostly medonc, surgery and pcps. The ROs were partners but not “partners”. Now, they are owned.

They run **** in metro Detroit.

OneOncology making an incursion in the area, too
 
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RealSimulD said:
They were already allied

MHP is a large group of physicians - mostly medonc, surgery and pcps. The ROs were partners but not “partners”. Now, they are owned.

They run **** in metro Detroit.

OneOncology making an incursion in the area, too
Click to expand...
OneOncology active in a lot of markets it seems. I think they'll make a few bids
 
RealSimulD said:
They were already allied

MHP is a large group of physicians - mostly medonc, surgery and pcps. The ROs were partners but not “partners”. Now, they are owned.

They run **** in metro Detroit.

OneOncology making an incursion in the area, too
Click to expand...
This is where the Beaumont old guard went?
 
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RealSimulD said:
MHP is a large group of physicians - mostly medonc, surgery and pcps. The ROs were partners but not “partners”. Now, they are owned.
Click to expand...

Hah. The fake "partner" That sounds familiar.
How many in our specialty don't work for someone else at this point? Med oncs, urologists (I even had an offer from an orthopedic surgeon owner), hospitals, academic chairs, the government, etc.
 
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Rest assured KKR (private equity owner) secured their bag ($) before GenesisCare went down. Don't think for a second they are on the hook for that debt when the music stopped (well after they sucked the marrow out of the business). The "losers" in this situation are the employed physicians... and of course patients. The other winners were the GenesisCare equity holders when they sold out to KKR (2012). This is the (PE) way. (see also the story of KKR-owned Envision Health care: Envision Healthcare - Wikipedia)
KKR likely employed the usual tactics of things like leasebacks (liquidating the real estate), dividend recaps (company borrows money, then. gives it to the PE), operating optimizations (eg layoffs, quality cuts), then strategic bankruptcy (to avoid paying the debt)
Hard to say how much the State of Rad Onc contributed to this, but would definitely be an oversimplification. The actual mechanics involving healthcare (reimbursement, patterns of care, etc) are likely secondary contributors here
communitydoc13 gets it
 
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PE is like the alien parasite. It eats the company from the inside out, kills the host, and looks for a new host.

GenesisCare was a loser from the get go, and when I inquired about a job, it was obvious they had hired bad, really bad, admins to supervise and couldn't care less about the vast majority of their docs (a few privileged ones in plum locations that were busy being the exception).

Can't say I have any tears for 21C/GC.. they were bad for radiation oncology as a specialty. Maybe care can now diffuse back at least somewhat into the 'local' community. We shall see.
 
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mehrlicht said:
Hah. The fake "partner" That sounds familiar.
How many in our specialty don't work for someone else at this point? Med oncs, urologists (I even had an offer from an orthopedic surgeon owner), hospitals, academic chairs, the government, etc.
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that really seems lost on ASTRO, and SK. Almost all of us are employed and salaries determined by supply and demand, not professional billing codes.
 
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RickyScott said:
that really seems lost on ASTRO, and SK. Almost all of us are employed and salaries determined by supply and demand, not professional billing codes.
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Exactly protecting code or even episode of care reimbursement accomplishes nothing when there are 25 new grads beating on the door to work in a metro not caring how much of the global billing is paid out to them.

I'm sure they understand it but don't just care as protecting the employed isn't in their interests and has a politically unpopular/difficult solution (reducing trainees). It's kind of like owning a house with a cracked foundation leaking water and rabid racoons in the attic and deciding to spend your efforts at the moment mowing the lawn. Riding mower with a beer in hand. Getting the hard work done and feeling a sense of accomplishment.
 
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mehrlicht said:
Exactly protecting code or even episode of care reimbursement accomplishes nothing when there are 25 new grads beating on the door to work in a metro not caring how much of the global billing is paid out to them.

I'm sure they understand it but don't just care as protecting the employed isn't in their interests and has a politically unpopular/difficult solution (reducing trainees). It's kind of like owning a house with a cracked foundation leaking water and rabid racoons in the attic and deciding to spend your efforts at the moment mowing the lawn. Riding mower with a beer in hand. Getting the hard work done and feeling a sense of accomplishment.
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apparently, "maldistribution" is the greatest crisis threatening radonc per SK
 
RickyScott said:
that really seems lost on ASTRO, and SK. Almost all of us are employed and salaries determined by supply and demand, not professional billing codes.
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Ironically, from the "Show Me" state.

"Our opinion is that there is a growing need for radiation oncologists in the United States. More importantly, there is a need for new training programs in the midwest and south. The demand for radiation oncologists has outpaced the supply. This shortfall of radiation oncologists is especially problematic in the midwestern and southern regions of the United States. As an example, the state of Missouri has only one training program. This shortage has, in part, resulted in an increase in salaries for radiation oncologists in academic programs, as demonstrated by the Association of American Medical Colleges faculty salary survey report". Redirecting

It's funny how, in the face of data that supply may have now outpaced demand, in the face of widespread assumptions that this will certainly occur by 2030, there not a peep from a single radiation oncology chair.

I think this... inconvenient truth... about employment seems lost on many radiation oncologists, but not all. The ASTRO ones who get it don't seem eager to teach the ones that dont though. One might even argue that some work to ensure the lost stay lost.

Maybe it's time for another Graypeace editorial?

 
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NotMattSpraker said:
Ironically, from the "Show Me" state.

"Our opinion is that there is a growing need for radiation oncologists in the United States. More importantly, there is a need for new training programs in the midwest and south. The demand for radiation oncologists has outpaced the supply. This shortfall of radiation oncologists is especially problematic in the midwestern and southern regions of the United States. As an example, the state of Missouri has only one training program. This shortage has, in part, resulted in an increase in salaries for radiation oncologists in academic programs, as demonstrated by the Association of American Medical Colleges faculty salary survey report". Redirecting

It's funny how, in the face of data that supply may have now outpaced demand, in the face of widespread assumptions that this will certainly occur by 2030, there not a peep from a single radiation oncology chair.

I think this... inconvenient truth... about employment seems lost on many radiation oncologists, but not all. The ASTRO ones who get it don't seem eager to teach the ones that dont though. One might even argue that some work to ensure the lost stay lost.

Maybe it's time for another Graypeace editorial?

Click to expand...

Knowing how much the original Graypeace editorial has moved any needles...

If I were somehow called on to pen a follow-on Graypeace editorial, I would be glad to write it.

If I could use Zapf Dingbats font.
 
NotMattSpraker said:
Ironically, from the "Show Me" state.

"Our opinion is that there is a growing need for radiation oncologists in the United States. More importantly, there is a need for new training programs in the midwest and south. The demand for radiation oncologists has outpaced the supply. This shortfall of radiation oncologists is especially problematic in the midwestern and southern regions of the United States. As an example, the state of Missouri has only one training program. This shortage has, in part, resulted in an increase in salaries for radiation oncologists in academic programs, as demonstrated by the Association of American Medical Colleges faculty salary survey report". Redirecting

It's funny how, in the face of data that supply may have now outpaced demand, in the face of widespread assumptions that this will certainly occur by 2030, there not a peep from a single radiation oncology chair.

I think this... inconvenient truth... about employment seems lost on many radiation oncologists, but not all. The ASTRO ones who get it don't seem eager to teach the ones that dont though. One might even argue that some work to ensure the lost stay lost.

Maybe it's time for another Graypeace editorial?

Click to expand...

This kind of post wouldn't be allowed at ROhub, yet is perfectly suited to sdn. That's why astro and the entrenched academics who run it hate this place so much @Rad Onc SK

#SDN4lyfe
 
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NotMattSpraker said:
Ironically, from the "Show Me" state.

"Our opinion is that there is a growing need for radiation oncologists in the United States. More importantly, there is a need for new training programs in the midwest and south. The demand for radiation oncologists has outpaced the supply. This shortfall of radiation oncologists is especially problematic in the midwestern and southern regions of the United States. As an example, the state of Missouri has only one training program. This shortage has, in part, resulted in an increase in salaries for radiation oncologists in academic programs, as demonstrated by the Association of American Medical Colleges faculty salary survey report". Redirecting

It's funny how, in the face of data that supply may have now outpaced demand, in the face of widespread assumptions that this will certainly occur by 2030, there not a peep from a single radiation oncology chair.

I think this... inconvenient truth... about employment seems lost on many radiation oncologists, but not all. The ASTRO ones who get it don't seem eager to teach the ones that dont though. One might even argue that some work to ensure the lost stay lost.

Maybe it's time for another Graypeace editorial?

Click to expand...


Still, ten years on, it's absolutely stunning to me that an academic radonc would directly admit to increasing residency spots in order to decrease the bargaining power and salaries of younger radoncs.

Even more stunning it was done in the official journal of our society. I've heard of many specialties "eating their young" but I've never, ever heard of one treating the next generation as badly as radonc has treated ours.
 
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OTN said:
Still, ten years on, it's absolutely stunning to me that an academic radonc would directly admit to increasing residency spots in order to decrease the bargaining power and salaries of younger radoncs.

Even more stunning it was done in the official journal of our society. I've heard of many specialties "eating their young" but I've never, ever heard of one treating the next generation as badly as radonc has treated ours.
Click to expand...

It's baffling trying to figure out who exactly Hallahan's intended audience was. Certainly an incredibly small one, but I agree bizarre that it was published in a journal where >99% of those reading it did not possess the eyeballs that was meant for.
 
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He has a plum job for lyfe. Comes and goes as he pleases, sees and does what he wants, and is never ever at risk.

You think he gives even one for your plight?
 
OTN said:
Still, ten years on, it's absolutely stunning to me that an academic radonc would directly admit to increasing residency spots in order to decrease the bargaining power and salaries of younger radoncs.

Even more stunning it was done in the official journal of our society. I've heard of many specialties "eating their young" but I've never, ever heard of one treating the next generation as badly as radonc has treated ours.
Click to expand...

Citing personal conversation again, but I do not think the ASTRO "properties" are even a little cohesive. The ASTRO board does not seem control SCAROP, nor the ASTRO journals, the conference, or ARRO. I could 100% see that the Red editorial staff wanted to allow all letters so not to appear biased toward one position or the other.

mehrlicht said:
It's baffling trying to figure out who exactly Hallahan's intended audience was. Certainly an incredibly small one, but I agree bizarre that it was published in a journal where >99% of those reading it did not possess the eyeballs that was meant for.
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The FTC? LOL. I've always wondered where was this hyper conservative ASTRO lawyer at the time they were loading up the letterpress blocks to send out that letter!

Agreed overall, and that letter reads as if there was much more there, but then it just got deleted to make the word limit. I spoke to one person involved (not an author) and they seem to agree that may be what happened.

Regardless, this exchange is TEN. YEARS. OLD. These individuals are still around kickin' it in Rad Onc and are free to clarify or explain their position. They have not. SCAROP is still actively anti-trusting new grads. The workforce analysis got shockingly little discussion through official channels.

I know I know, don't make assumptions. But like... really. What am I supposed to think here?
 
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sirspamalot said:
He has a plum job for lyfe. Comes and goes as he pleases, sees and does what he wants, and is never ever at risk.

You think he gives even one for your plight?
Click to expand...

It is definitely possible that it was just an ego flex. I'm just going to speak the evil truth about what I think and get away with because I can and will with no repercussions. Probably gets off on you peons still getting so worked up about it a decade later. Paul Wallner did the same crap.
 
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Of course the 21C/GC people at the top got the bag. This is always the case and the people below are totally screwed. “Slip out back door” Curran and the others will just continue getting paid traveling the world to Ireland/Australia while some are unemployed. Former 21C crony Wallner lives in a 20M dollar house.

Former 21C crew now opening up a “concierge” proton center in Florida. Like my boys the O’Jays said and Percy Shelley commented in 19th century poetry, the rich get richer while the poor get poorer…


But don’t worry folks nothing to see here. All is well and never been better!
 
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