Florida Cancer Specialists & Research Institute

In October 2010, Gainesville Hem atology Oncology Associates (GHOA) joined Florida Cancer Specialists & Research Institute (FCSRI), a larger, privately owned hematology/on cology regional practice. The merger established FCSRI’s presence in the Gainesville area, and offered expanded benefits to the GHOA physicians already at that location. This article describes the processes involved in creating this mutually beneficial opportunity for both practices and the patients they serve.

The Options
Wanting to position the practice for future growth, GHOA researched a number of potential practice models, including affiliating with the local hospital, joining other oncology groups, and remaining a small, 5- physician practice. “We came to believe that joining a strong group with a lot of know-how, specifically in oncology, would be more beneficial for us and our patients than joining a hospital,” explained Lucio Gordan, MD, a medical oncologist in the Gainesville office. Associates at both practices had conversed informally over the years at medical conferences and oncology society meetings, which ultimately led to FCSRI being identified as the ideal group with which to affiliate.

Meanwhile, FCSRI was in search of strategic ways to expand their services. “We had been looking to grow the group where there were good opportunities,” said William N. Harwin, MD, a medical oncologist in Ft. Myers and president of FCSRI. “Gainesville had a very strong group and strategy, as well as a strong presence in the market, which fit well with our business model.”

The Steps
During initial meetings, FCSRI explained the components of its corporate business model: operational strategies, management structure, and the financial aspects of physician remuneration, including partnership and voting rights. Dr Harwin and Brad Prechtl, CEO of FCSRI, also visited the practice in Gainesville. According to Dr Harwin, this not only provided the opportunity “to see the doctors in operation in their office,” but also furthered development of the “trustworthy personal relationship” needed for long-term success.

Physicians in both practices agreed that trust, along with a transparent process, was essential. Together, they developed a template for their agreement before involving legal representatives to finalize the deal, noted Dr Gordan.

The Challenges
During the merger process, the groups were faced with several hurdles. “Working through the emotions of transforming from a small practice to a large organization and instilling a level of trust and confidence was paramount to the success of the merger,” explained Prechtl. Another challenge was how to reduce the number of staff at the Gainesville office. “A selection process was instituted to determine who would be the best fit in the FCSRI model,” said Dr Gordan.

Merging the 2 electronic health record (EHR) systems was also no small feat, because the 2 systems could not be seamlessly integrated. This necessitated manual data transfer, which took over 3 months to complete. After that task was accomplished, the staff in Gainesville had to be trained on the new EHR system and become comfortable using it.

The Payoff
“In our overall business model, there are a lot of benefits from eco n - omies of scale,” said Prechtl. “These include advantages in pharmaceutical purchasing, new business opportunities, a supplementary in-house pharmacy practice, and favorable contracts with payers, to name a few.”

However, the benefits derived from the merger extend well beyond business matters. As a combined practice group, the physicians in Gainesville have improved many aspects of their patients’ care. For example, they now are able to serve more patients because the chemo - therapy unit is in the same location as the clinic. In addition, the new EHR system has enhanced communication with referring physicians; and access to clinical trials will soon expand because of FCSRI’s thriving research program and association with the Sarah Cannon Research Institute, one of the largest community-based clinical trial organizations in the nation.

“As a part of the Florida Cancer Specialists network, we have become quite a lot stronger here in Gainesville,” said Dr Gordan in summing up the advantages of the merger, “and I think FCSRI has benefited, as well.”

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