It’s easy to believe that everything in the healthcare industry is negative. This isn’t the case at all. Some of these clinics, hospitals, and surgical centers are thriving, due to good money management techniques. Those that take advantage of the Federal ERISA appeals process are able to collect on all of their commercial health insurance claims, putting their financials in the black, not the red. This money management allows them to expand into other geographical areas where they can serve more patients. In addition, some of them also expand their services as well, making them even more useful in these new areas.
New Joint Ventures in the United States
According to a compilation of sources, there are over 25 outpatient surgical centers that have been developed through joint ventures so far this year. These centers are based in a number of different states, including the Midwest, the Northeast, and the West, among others. Let’s break them down by region.
In the Midwest, there’s one in Kansas. Sources say that “Surgical Care Affiliates will manage Indian Creek Ambulatory Surgery Center in Overland Park, which is expected to open in June. Kansas City-based University of Kansas Health System and physician investors will jointly own and operate the multispecialty facility.” In Ohio, “Sandusky-based Firelands Regional Medical Center is closing its ASC in June and reopening it in collaboration with NOMS Healthcare and Fisher-Titus Medical Center in Norwalk.” Next is Oklahoma, where “Tulsa Bone & Joint Associates broke ground on the Union Pines Surgery Center, a joint venture with Tulsa-based St. John Medical Center.” Illinois has seen some growth as well, “Champaign Surgery Center opened Feb. 4, replacing the older Champaign SurgiCenter. The surgery center is a joint venture between Urbana-based Carle and Champaign-based Christie Clinic.” Finally, there’s the new one in Wisconsin, “Towson, Md.-based SurgCenter Development is developing a spine ASC in Neenah, Wis., through a joint venture with physicians. The joint venture, Advanced Spine Center of Wisconsin, is expected to occupy the building in June.”
Out West, there are a number of new surgical centers as well, including one in Washington state, “Anchor Health Properties entered into a joint venture with a Carlyle Group affiliate to acquire three medical office buildings in Seattle: the Woodlands Medical Office Building and two buildings featuring The Doctors Clinic.” In Idaho, “Physician owners of Skyline Surgery Center partnered with Pocatello-based Portneuf Medical Center, Blackfoot-based Bingham Memorial Hospital and Idaho Falls-based Mountain View Hospital to form a joint venture.” Colorado and California aren’t far behind with, “Steamboat Springs-based providers UCHealth Yampa Valley Medical Center and Steamboat Orthopaedic & Spine Institute are collaborating on an orthopedic ASC project” and “Greenbrae-based Marin Health Ventures leased 17,280 square feet in a medical office building to build a joint-venture ASC.”
Changes are Happening on the East Coast and the South
On the East Coast, Virginia has some plans in the works, “Three organizations are teaming up to develop a $14 million medical office building and ASC in Suffolk. Construction on the joint venture involving Suffolk-based Lakeview Medical Center, Chesapeake-based Bayview Physicians Group, and Suffolk-based Sports Medicine and Orthopaedic Center began May 14.”
In the South, Tennessee will see the following changes, “The Bone and Joint Institute of Tennessee — a partnership between Franklin-based Williamson Medical Center and more than a dozen orthopedic surgeons — opened its new facility April 29.” And in North Carolina, “A $7.1 million ASC with backing from Lenoir-based Caldwell UNC Health Care and a group of eight surgeons is slated for completion in August.” Missouri is right behind them, “Medical Facilities Corp. and NueHealth partnered with St. Luke’s Hospital in Chesterfield to develop a new ASC.” Meanwhile, in Florida, “Raleigh, N.C.-based Compass Surgical Partners formed Tampa-based Legacy Surgery Center in partnership with a group of physicians.”
Quite a Few Are Planned for the Northeast
The Northeast, particularly New Jersey, is ready for expansion, “Vantage Surgery Center is offering same-day total joint replacement procedures after moving from Medford to a new building in Moorestown. Vantage is a joint venture between Virtua — a Marlton-based health system — and physician investors from Sewell-based Reconstructive Orthopedics, Voorhees-based Advanced Pain Consultants and Mount Holly-based Pain Care Associates.” Massachusetts has quite a few projects in motion, “Melrose-based Melrose-Wakefield Healthcare received state approval to build a $16 million ASC at Medford-based Lawrence Memorial Hospital. The ASC is a joint venture between Melrose-Wakefield and Worcester-based Shields Health Care.” As well as, “Worcester-based management services organization Reliant Medical Group plans to develop a joint venture ASC in Natick with local physicians and Quincy-based Shields Health Care Group” and “Boston-based Brigham Health and South Weymouth-based South Shore Health System are collaborating on a medical building development as part of a $1.6 billion redevelopment in Quincy.”
How Good Billing Practices Lead to Expansion
In many of these cases, the expansions are fueled by private investors and partnerships with other medical care facilities, but in others, they are due to good billing practices. You see, every hospital, surgical center, or other location has a billing department that sends the claims out to the commercial health insurance companies. From there, those companies either pay the claims, partially pay the claims, or sent them back unpaid. When this happens, the hospital or clinic is able to send the claim back to them (after making any adjustments or changes as needed), up to three times at the state level. Usually, after the claims are rejected three times, they are placed on the wrong side of the balance sheet and forgotten about.
However, surgical center managers can contact a company that handles Federal ERISA appeals in order to get those claims paid. According to the law, those commercial health insurance companies must pay those claims. It takes a special company in order to file these appeals, as they are quite complicated.
If you want to fund the expansion of your outpatient surgical center or simply want to move your hospital from the red to the black, then contact us. We specialize in Federal ERISA appeals. Just call us or fill out the form on our website today.