Less. More. for. Pinnacle Anesthesia Consultants SPOTLIGHT

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1 SPOTLIGHT Andrea Bohannon describes how this anesthesia provider grew without increasing overhead. Michael Sharkey reports. Pinnacle Anesthesia Consultants More Less for

2 Over the past year, Pinnacle Anesthesia Consultants welcomed 21 new physicians to the organization, effectively expanding its service area to Fort Worth, Texas. Impressively, the Dallas-based company added the providers without increasing corporate overhead. Through a major technology initiative, PAC upgraded its infrastructure and vastly improved efficiency, decreasing costs by 17 full-time equivalent employees. The company invested $400,000 in its infrastructure, $160,000 on an electronic medical record system, and $100,000 on a new physician scheduling system. Internally, we ve decreased FTEs, increased the reliability of our data, and improved efficiency and accuracy, CEO Andrea Bohannon said. It s resulted in increased revenue, decreased expenses, and improved cash flow. As an organization, we ve upgraded our infrastructure to become more reliable day in and day out. PAC s efficient do-more-for-less growth strategy yielded tangible results in According to Hoovers, the company experienced a 485% eruption in sales, making it the largest anesthesia provider in North Texas and one of the biggest in the country. People investment In May of 1999, North Texas Anesthesia Consultants and DFW Anesthesia Associates combined forces to form PAC. Today, the company comprises more than 200 boardcertified or board-eligible anesthesiologists, over 100 allied health professionals, and more than 180 supporting positions. In addition to the anesthesia services it provides in hospitals, surgery centers, and clinics, PAC provides chronic pain medicine programs at 16 different facilities throughout North Texas. The pain medicine services are a combination of office visits for reviewing the patient s history during a physical exam and setting up a treatment plan, Bohannon said. Our treatment plans may consist of medication management, procedures such as spinal block injections, or other types of intervention aimed at eliminating or reducing a patient s pain. The biggest challenge the organization faces on both sides of its business, according to the chief executive, is physician recruitment. We re in competition with the rest of the country to find and attract quality physicians and certified registered nurse anethesists, Bohannon said. Likewise, staff employee turnover is extremely expensive. So we ve implemented a number of programs to attract top talent, motivate, and retain them.

3 help keep employees motivated and at the top of their game. The effort by Pinnacle s management team to control costs and recruit top people has allowed the company to develop processes that result in improved service to surgeons, facility customers, and patients. According to Pinnacle s president, Michael Hicks, Pinnacle is owned by physicians and, like other businesses, exists to promote the welfare of its owners and employees. By keeping our costs low, we are able to provide and develop services that are important to our patients, surgeons, and facilities in north Texas. PAC s commitment to attracting and retaining quality employees is reflected in its cost structure. Seventy percent of the company s cost on the management support side and 90% on the clinical side goes toward salaries and benefits. Bohannon said the organization also provides extensive training and recognition programs to One such service is our quality improvement initiative, Hicks continued. Pinnacle s QI program tracks the performance of each physician in terms of clinical outcomes, compliance with federal and state law, and patient care documentation. The vast majority of non- Pinnacle physicians do little or no work in these areas outside of the requirements of the hospitals in which they may practice. In nearly every situation of which I am aware, Pinnacle s QI program exceeds that of the traditional facility-based HEALTHCARE SPOTLIGHT

4 LOCKE LIDDELL & SAPP Locke Liddell & Sapp, LLP has a broad-based premier healthcare practice and understands the nuances of the highly regulated and constantly changing heathcare industry. We represent physicians, non-profit and for-profit hospitals, and other healthcare organizations and businesses in regulatory, litigation, transactional, securities, tax, and employment matters. QI or credentialing process, so much so that several north Texas hospitals have chosen to adopt Pinnacle s QI process in lieu of developing their own. Penciled in Even with a full staff of physicians, PAC faces a unique challenge in the Dallas area: the surgical volume has been diluted by a number of new facilities over the past five years. In the past, Bohannon said, PAC provided services in 30 facilities. Today, the company works in 50 different hospitals and surgical centers, but the overall volume of patients hasn t increased proportionally with the facilities. The challenge is keeping physicians busy for a full day, Bohannon said. Surgeons have various times of day they like to get their surgery done. We find ourselves needing a lot of anesthesia providers in the morning, but the cases drop off dramatically in the afternoon. PAC implemented a $100,000 scheduling system to help deal with the dilemma. With 206 anesthesiologists spread across the six-county Dallas-Fort Worth area, maximizing manpower is essential, Bohannon said. The new system, when fully implemented, will capture all anesthesia appointments, and allow the company to manage the distribution of its physicians. If one division isn t busy on a certain day, we need to know where else we can put them to work, she said. Instead of hiring another doctor, we can determine how to best use our manpower to maximize our resources. It s comparable to air traffic control, we need to know

5 savings in new staff positions and increased its service area. Bohannon said the company would continue to pursue the do-more-for-less strategy by investing in a $30,000 personnel and payroll system this year and a new practice management system next year. Organic growth Because PAC doesn t market directly to patients, but rather to the facilities and surgeons that provide operations that require anesthesia, Bohannon said developing strong relationships with clients is critical. Growing the business is about the direct, one-on-one relationships that we have, she said. We continue to work day in and day out on those relationships. where our doctors are at all times to help keep them busy all day. The new scheduling system was just a small part of PAC s investment in technology. The organization s infrastructure underwent a $400,000 overhaul, effectively automating a number of previously manual processes. The company saw near instantaneous results with a decrease in FTEs by 17. PAC invested the The objective moving forward is to continue to grow those relationships to facilitate organic growth, while adding a new segment to the business. PAC is currently in the planning stages to develop a clinical research program; the project is expected to get off the ground in Said Bohannon, We don t plan on this being a huge revenue gain for us, but we feel like it s a way for us to give back to the communities we serve. W W W. H E A L T H E X E C U T I V E. C O M D E C E M B E R RSM MCGLADREY RSM McGladrey s Pension Consulting Services group offers a host of value-added services that can enhance the lives of your employees while complementing your business objectives and long-term strategies. From plan design, documentation, and government compliance to recordkeeping, plan administration, and employee education and enrollment, our experience enables us to provide products and services that work hand in hand with your program goals. HEALTHCARE SPOTLIGHT

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