Friday, January 11, 2013

Big Florida Hospital Weds Large Cardiology Group
It’s still the same old story,
A fight for love and glory,
A case of do or die!
Herman Hupfeld (1894-1851), As Time Goes By, Also in film Casablanca
January 11, 2013 -  Florida Hospital in Orlando has purchased the Florida Heart Group comprising 19 cardiologists and 125 workers.
In reality, this is more of a forced marriage than a purchase. Government arranges, orchestrates, and engineers the marrigage. The matchmakers are Obamacare and CMS.  In 2010, CMS announced it was slashing cardiology fees by 40% over a phase in period of 4 years. 

The handwriting was on the wall. These cuts made it difficult to stay in cardiology practice and to recruit cardiology fellows. Cardiologists needed a business partner.  The cuts set in motion hospital acquisitions of cardiology groups, for purposes of mutual survival, rather than for love and glory.
The grooms are hospitals.   Hospitals, whose admissions are declining,  desperately need cardiologists.  Year and year out,  cardiologists are the leading specialty admitters to hospitals, often  the most profitable “service line.” Stents, bypasses, heart  imaging, and cardiac procedures  are a leading hospital profit line.
The brides are cardiologists.  They have the skills to do the job of caring for patients with heart disease, the leading cause of hospital admissions (and readmissions) and death in America.
Health reform. the Affordable Care Act, with its bevy of regulations and compliance demands, intensifies the need for hospital-physician collabortion. Hospitals and cardiologists can nol longer live without one another.  Complying with reform measures, such as interoperable electronic records between doctors and hospitals, is enormously expensive.
Hospitals need the heart disease traffic. Cardiologists, with sharply reduced revenues and rising educational debts, need access to capital, technology, marketing, and information resources, things which only the hospital has the wherewithal to supply.
More than even, hospitals are in the doctor business.  The Florida Hospital Group has 290 doctors. 110 locations, and plans to add 125 to 150 more doctors in the next 3 years.  The heart group has 19 cardiologists, and  125 employees in 3 locations.   Orlando Health, Florida Heart’s biggest competitor,  just added 95 more primary care doctors to its roster of employed physicians.    The fight is on for market share, and there is no love lost.
The upsides of these hospital-physician marriages are more coordinated, comprehensive, controllable care.  The downsides may be higher costs and health system monopolies with the threat of federal anti-trust suits, and the expense of hiring lawyers and consultants to avoid these suits.

Tweet:   Florida Hospital in Orlando has just bought a group of 19 cardiologists, a process set in motion by CMS slashing cardiology fees by 40%.

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