Frequently Asked Questions
Here are a few of our most frequently asked questions:
What type of firm is Rea and Associates?
Rea and Associates, Inc. is a medical management and financial services firm located in Memphis, Tennessee. The company was founded by David K. Rea in 1989 to provide professional consulting services to physicians, group practices and hospitals. During the past 25 years of operations, the professionals at Rea & Associates have assisted more than 1,000 clients in solving a wide array of complex billing, managerial, strategic planning, and reimbursement problems.
What type of medical experience does Rea & Associates have?
Rea & Associates has provided services to medical practices in the Memphis area for over 20 years. Our clients represent physician practices of all sizes, including some of the largest specialty practices in the community. The majority of the our clients have been specialty physician groups and Rea & Associates professionals have particular expertise in cardiology, neurosurgery, urology, infectious disease, general surgery, oncology, and orthopedic surgery
What are the greatest challenges facing independent physician practices today?
The greatest challenge that a small to mid-sized medical practice faces today is maintaining its financial independence. With the advent of ACOs and the implementation of the Affordable Care Act, hospitals are feverishly working with major insurance carriers to create exclusive physician networks. Many independent physician practices will either be excluded from these networks or forced to enter into payment arrangements that historically have been considered financially unacceptable. There are a number of proactive steps that the independent practice can take to preserve their independence and remain financially viable. As a first step, they need to have an indepth assessment of their strengths and weaknesses in order to determine feasible and practical market strategies to improve their financial position.
What options are available to medical practices to level the playing field?
Of course, legal representation is required when one is negotiating with entities interested in purchasing a medical practice. Frequently, attorneys do not have the detailed working knowledge of a medical practice to present the practice in the best manner. A team of healthcare professionals that has in-depth knowledge of medical practice operations and practice valuations is required to establish FMV for the practice and its market potential. In the event that the negotiations do not work out to the satisfaction of both parties. The health care team in conjunction with the practice can explore other arrangements opportunities for the practice. We have such a team in place at Rea and Associates to assist in that transition.
Under what circumstances should I consider bringing on an outside consultant to assist with market research or practice development?
An outside consultant should be brought in to the practice under two circumstances. First, the practice does not have the expertise in the specialized areas of market research or practice development to develop an action plan on a timely basis. Or secondly, the practice needs an independent and quantifiable assessment of where exactly it is positioned in the market and the practice’s strengths and weaknesses. For example, an effective market research plan would focus on the changing demographics of the patient base, changes in the payer mix, fee structuring to enhance insurance contracting, and referral pattern trends and changes.
What are accountable care organizations and how are they likely to affect my practice patterns?
Accountable Care Organizations (ACOs) involve cooperative relationships between hospitals, physicians and insurance plans. ACOs are very much like health maintenance organizations, in that their objective is to accrue as much of the healthcare dollar as possible and manage the distribution of health services to a defined patient population. In other words, the ACO will define the components of its healthcare delivery system and develop complex contractual arrangements with each entity to support their contribution to the delivery of a defined benefit to the insured population. Specifically, the ACO will receive a bundled payment and unbundle that payment in the most cost efficient manner possible for the ACO. The challenge to the practice is to have a team of health professionals representing its interest in properly valuing the practice and the physicians individual contributions to the delivery system. This involves knowledge of RVUs, fee schedules, payer profiles, market characteristics, referral patterns and contract negotiations.
Disclaimer: This information is not meant to serve as legal or financial advice but merely to offer insights based on the experience of Rea & Associates.