Update February 14, 2019

Dear Partners,

We have a new CFO! I am very happy to report that a candidate has accepted our offer letter. I will follow-up with more information soon.

Remember we are on the new overhead formula as of 1/1/19.  In case anyone doesn’t remember, the basic structure is that it is a 65% fixed/35% variable formula. 65% of the total central/indirect overhead for the organization is allocated equally to partners and the remaining 35% allocated in direct proportion to net revenue (revenue after practice expense). Midlevels are allocated as a percentage of gross revenue at a rate 0.6x what the average partner pays. Outside income is assessed 5%.

Bristol Hospital Update:

Our Hospitalist partners are up and running at Bristol Hospital.


The Board has tried to standardize the process to avoid surprises and duplicated efforts. Please let someone in physician leadership know of any anticipated recruitment. Every part of it takes longer than one would think, so starting early is good. We want to have time for adequate attention to all steps including: pro forma/business modeling, payer applications, etc. Also keep in mind that unless a given division intends to take 100% of the financial risk for salary, the Starling Board will request a pro forma and an agreed-upon method of allocation of departmental expenses in exchange for the partnership assuming that risk.

Revenue Cycle Department:

Hayes consultants (www.hayesmanagement.com) are here doing a full audit of processes in RCD to validate current processes or identify areas for improvement. That said, current status continues to trend favorably over time, including: days in AR 31.62 days, up slightly but due to a high charge month (rather than lower/longer collections); days over 120 is down to 14.86% overall, with 10.92% in insurance (as opposed to self-pay, Workman’s Comp, etc), a decrease of 2% from Dec. These values are below/better than industry standards. Please be aware that implementation of a new software “scrubbing” tool in RCD resulted in a short delay for some charges in January. Overall, the new tool will reduce denials and result in better RCD performance by having the claims go out “cleaner,”  but like pretty much anything to do with computers there were unanticipated glitches despite doing testing prior to go-live.  No money is/was lost, but some very late January entries may wind up in early February due to the delay.

Propaganda Corner:

I had envisioned my cautionary statement about “fake news” to be a one-off last time, but it seems we may need a regular segment on that. Please send me stuff you hear that sounds fishy…if you are hearing rumors, odds are so are other partners. We need to stay ahead of such…as an aside, one should take the need some have to spread false information about us as a sign that they take us quite seriously as a competitor and therefore feel the need to try to undermine us – it is a backhanded compliment. 

I am informed there is word at the hospital that we “are getting our financial house in order” to get ready to sell the company. In fact: there is no current contemplation of sale of the company; such a sale would require both a supermajority of the Board and 2/3 of each Branch of the partners to affirm, so it simply could not happen without sunlight on it, as designed in our bylaws. The part about improving our financial function is quite true: the purpose of the RCD consultant is to maximize the amount and timeliness of our providers getting paid for the work they do.  The other rumor about my steady cognitive decline is likewise untrue – I was never that smart and nothing has changed. 

CareMore @ Home: 

This is a program that aims to provide needed care to medically complex patients who have barriers to getting to their providers’ offices. The CT program began in 2017. It is a subsidiary of Anthem, and the clients are patients attributed to our PCPs.  Please click here for a message to the PCPs from CareMore>

February 2019 Board of Directors Meeting:

Partnership at Starling is a privilege that comes with the responsibility of citizenship. It is important for partners to be aware of some Board discussion topics. For the February 2019 meeting, these topics included an update to HIPAA policy violations, Board certification for partners, and $15 minimum salary. Click here to read recent minutes >>