Executive Summary of December Board Meeting
Partnership at Starling is a privilege that comes with the responsibility of citizenship. It is important for all partners to be aware of some board discussion topics. For the December meeting, these topics included a review of NPS, proposed change of financial accounting method, formal risk sharing program for recruitment and employed physicians, and clarification of compliance policy.
NPS review
Bryan Graven (CEO of NPS) presented an overview. Starling and Orthopedic Associates of Hartford, who are co-owners of NPS, each pay “cost” for services they utilize, while other NPS clients pay more. The board discussed areas where service could be improved, including stability and consistency of access. NPS plans to implement a new help desk system and offer Saturday hours. Continued upgrades to hardware on the GH side are planned and should help service. More follow-up is planned.
Accounting method
Currently (and historically) GH and CMG have used cash and accrual accounting methods, respectively. This arrangement was kept in place initially with the merger but is inefficient and costly. The proposal is for both branches to adopt an accrual accounting methodology for purchased goods and services. This will however, result in some increased or decreased expenses for various partners on a temporary basis. The reasons for this choice were reviewed and accepted. Finance will anticipate any “extra” charges that may arise, discuss with the affected partners, and spread out the cost over 12 months, as needed.
Recruiting and Employed physician risk policy
Currently, new physicians are hired under different terms in the GH and CMG branches. One of the major differences is where the financial risk resides. In GH, the group pays salary and takes risk; at CMG, often the department takes the risk. Moving forward, a consistent policy is required. For the process of new physician recruitment, there are two proposed pathways:
- The department takes 100% of the financial risk, and retains 100% of any applicable financial bonus
- The department and Starling share the financial risk 50%-50%, and split any applicable financial bonus 50-50 as well
The financial risk includes recruiting costs, salary, etc. If Starling is accepting some of the risk of hiring a physician, it reserves the right to review the department overhead allocation and ensure that the financial model will provide the new physician every change to succeed. The Starling board reserves the right to use different models as needed.
Compliance Policy
Currently, Starling compliance policy states that any time an employee looks at his/her own medical record, whether intentional or not, it is considered a terminable offense. The board asked the compliance committee to review the policy and propose any adjustments.
Sarit Patel, MD, MBA
Chair, Starling Board