Executive Summary of November 7 Starling 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 November meeting, these topics included budget discussion, Starling policy for new hires, and board certification/ recertification. 

Budget discussion

Together with the finance committee, the management team put forth a 2018 budget proposal to the board.   As part of the evaluation process, overhead was compared to benchmarks from the MGMA (Medical Group Management Association). Our broad categories of central overhead are: Admin, IT,  EHR, and Billing/ RCD.  For comparison these are proposed budgeted amounts, as a percent of revenue:

Unfortunately, the MGMA data does not include EHR costs. Overall, our central overhead falls approximately at the median for large medical groups. The Billing/RCD department is in the process of restructuring, with the goal of improved effectiveness and automation, but also with an eye toward reducing costs. 

Starling policy for new hires

The CMG and Grove Hill branches have historically hired new physicians under significantly different terms.  Moving forward, it is important for Starling to hire new physicians/APP’s under one model. The terms were discussed at length and are in the process of being finalized. Some pertinent discussion points:

1. All new hires will be Starling hires (not branch), with financial risk and overhead allocation explicitly decided prior to hiring.
2. The financial risk of a new hire can be borne entirely by the department, or with a hybrid department/central model.
3. If Starling is taking financial risk, management should have a say in the department overhead allocation, in order to ensure Starling risk is mitigated.

Board certification and recertification

Starling policy states that new hires should be board-certified or board-eligible. There has not been a policy on maintaining certification for partners. Most payors have a requirement of board certification in order to be on a panel as a participating physician. Many hospitals require board certification for privileges. For better or worse, board certification is seen as a sign of quality by the public. If a physician chooses not to recertify with a board, they are at risk of being dropped by payor panels or losing hospital privileges. As such, the Starling board recommends that all partners obtain board certification and maintain it. 

If there are any questions or comments, please reach out to your board members.