Avanza accommodates each client’s evolving needs with highly customized engagements, multi-disciplinary teams, flexible project scopes and variable lengths of engagement. We provide precisely the expertise you need and nothing you don’t. Our case studies illustrate ways in which we have helped clients meet their fiscal, regulatory and community obligations.
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To develop an lower cost option for its constituents, a large healthcare payer was considering whether to invest in an ambulatory surgery center (ASC) development and management company with bundled payment expertise. The organization focused on developing collaborations for bundled surgical services in the ASC market. The payer and ASC developer had an existing working relationship, but both parties were interested in formalizing ties through an investment in the company and/or a partnership arrangement.
A rural hospital in the Southwest faces many of the same challenges posed to other rural providers. These include how to effectively provide high-quality healthcare to a small community in a medical center that must offer a basic level of services. The hospital's leadership recognized it needed to begin to address inefficiencies that could magnify the negative effects of the challenging healthcare environment facing rural hospitals. Rather than focus on the organization's entire operations, leadership sought assistance with identifying operational and strategic improvements to current imaging and lab practices.
An acute-care hospital wanted to purchase an ASC. It intended to convert the facility to a department of the hospital as a CMS-designated provider-based entity, often referred to as an HOPD. Following months of negotiations, the ASC's owners agreed to sell the facility to the hospital. About one week prior to when the transaction was to commence, the hospital's leadership learned from legal counsel that converting the ASC to a provider-based surgery department was a much more complex regulatory process, and failure to follow the appropriate rules would result in non-compliance with CMS and the jeopardizing of managed care contracts.
A women's health clinic was underperforming. The organization was marginally profitable and saw high demand for its services, and yet it faced a number of strategic, financial and operational challenges. Practice pattern preferences of clinicians were creating operational inefficiencies and hampering access to care. The facility was not maximizing its existing revenue opportunities or exploring new revenue enhancement strategies. Competition was increasing while the clinic was struggling with perception and reputation issues.
A federally qualified health center (FQHC) was struggling with its revenue cycle management. The organization was unsure about whether its commercial contract rates were appropriate and if terms were fair. Data on collections was lacking. The center was unaware of the credentialing status for many of its providers. The FQHC had also made the decision to change its billing and collections company.
A once-thriving outpatient breast imaging and diagnostic center was struggling to maintain market share. Volume was down largely due to increased competition and the loss of a number of leading physicians over several years. The facility was outdated, as was some of the technology in use. Inefficiencies and problems had developed in many areas, including scheduling, patient education and engagement, and leadership.
A major academic medical center set out to develop a comprehensive spine center. This center would bring together surgical and non-surgical providers for collaboration in a clinic setting to facilitate referrals from the area’s primary care physicians and ensure undiagnosed patients receive appropriate care. The academic medical center wanted all patients in need of possible spine-related care to enter the system through the spine center so their condition could be correctly assessed for either a surgical or non-surgical treatment plan.
Several orthopedic surgeons from different practices performed all of their outpatient and inpatient cases at one local hospital. The surgeons wanted more control over their surgical environment and proposed forming a joint venture partnership with the hospital to develop a freestanding ambulatory surgery center. But such an approach may not have been in the best interest of both parties.
An independent, freestanding ambulatory surgery center operating profitably for many years started to feel the effects of tightening reimbursement and increasing costs. The owners decided to reduce their risk by selling some of the equity in the ASC to a hospital or management and development company.
A federally qualified health center (FQHC) was struggling to effectively serve the needs of its pediatric patient population. Many children were not receiving the routine care they required, and parents often utilized emergency departments to address the minor health concerns of their children. The FQHC was eager to develop a program that would have a direct and positive impact on children’s health, addressing not only physical health, but also social determinants of health where possible.
A large academic medical center in the Northeast requested assistance with a two-phase project that included (1) building a freestanding, provider-based orthopedic surgery center for new and existing services, and (2) developing a musculoskeletal ambulatory care center. The hospital wanted both centers located in the same building, and it intended to move its outpatient orthopedic procedures, musculoskeletal physician practices and ancillary services into the new facility. The outcome would be a comprehensive program that could compete with other freestanding orthopedic programs in the area.
A large community hospital acquired an ambulatory surgery center with intention to convert it to a department of the hospital as a CMS designated provider-based entity. The hospital wanted to ensure the new surgery department continued to operate profitably and with the high-level of efficiency physician users expected; while at the same time adhering to the CMS provider-based regulations.
The operating rooms at a large community hospital were at capacity, and the hospital wanted to acquire an ambulatory surgery center off campus and convert it to a department of the hospital as a CMS designated provider-based entity to eliminate construction costs, provide the hospital with the operating rooms it needed immediately and forge a partnership between the hospital and physicians.
A 20-physician, multi-specialty surgical center operating for five years in a large urban area boasted high patient satisfaction, low turnaround times, busy operating rooms, a capable administrator/clinical manager and a hard-working business office manager, and yet was cash-flow breakeven each month and investors had not received any distributions.
A large orthopedic group wanted to develop and manage its own ambulatory surgery center, but do so without alienating the local not-for-profit hospital, with whom the orthopedists had a long relationship.
A premier academic medical center planned to open a satellite outpatient surgical department, move less complex, lower-reimbursing orthopedic procedures to the department and create space in the hospital operating room for higher-reimbursing, inpatient cases.
After a successful multi-specialty surgery center learned it would lose its long-time administrator to relocation, the board offered its clinical manager the vacated position despite her admitted lack of administrative experience and business skills.