Servant’s heart, owner’s mind and a passion to make a difference. This has been the recipe for success for Dominic Bagnoli, MD, FACEP, FAAEM, and the company he co-founded more than 20 years ago — Emergency Medicine Physicians (EMP). It’s also the foundation for U.S. Acute Care Solutions (USACS), a new company he launched last year.
EMP is the second largest physician-owned emergency medicine group, and one of the top five overall, in the nation. Established in 1992 by Dr. Bagnoli and two other board-certified emergency medicine physicians practicing at a Massillon, Ohio, hospital, EMP now boasts more than 900 physicians and 400 advanced practice providers at 72 hospitals in 16 states across the country.
The company’s growth is due in part to its innovative systems, such as its PhysicianFirst emergency department management system which reportedly shortens “door to doctor” times, reduces left-without-being-seen rates and improves patient satisfaction. Meaningful continuing education and training programs, like its Patient Satisfaction Academy for current clinicians and its Scholars Program for the next generation of physician leaders, have also contributed to the company’s ongoing success.
Dominic Bagnoli, MD, FACEP, FAAEM, Chief Executive Officer, (far left) is shown here in U.S. Acute Care Solutions’ board room with three other members of USACS’ executive leadership team: Sharon Brunecz, Chief Human Resources Officer; Dan Savitt, MBA, Chief Financial Officer; and Dave Johnson, MBA, Chief Operating Officer.
Always looking to improve care, Dr. Bagnoli took a giant step forward last year when EMP and its practice management operations became the foundation for USACS. True to its roots, USACS will remain majority-owned by physicians and focused on building a national leader of integrated acute care solutions — one that’s “valued by patients, preferred by clinicians and chosen by health systems,” according to its mission statement. Welsh, Carson, Anderson & Stowe, a leading healthcare investment firm, will help with this endeavor.
“The creation of U.S. Acute Care Solutions puts physician ownership front and center in a unique partnership with strong operational capabilities and with an experienced capital partner in Welsh Carson,” says Dr. Bagnoli, Chief Executive Officer of USACS. “Welsh Carson has a proven track record of partnering with physicians and major integrated delivery systems to build market leaders, like they’ve done with U.S. Anesthesia Partners, United Surgical Partners, U.S. Oncology and many others. They provide us with a great opportunity to grow our practice and strengthen our values of high quality patient care and physician ownership.”
Leading the Way
Dr. Bagnoli has been credited with EMP’s growth, leading the expansion of the initial scope of the business from emergency department staffing to a multi-faceted business structure encompassing a management organization that provides medical practice back office operations, a third party collections company, and a medical malpractice insurance organization. Over the past 10 to 15 years, he has also added several associated companies and investments that complement the core business.
For his accomplishments, Dr. Bagnoli has received numerous industry awards, including the Ernst & Young Entrepreneur of the Year award and the Harvard Business Club of Northeast Ohio Outstanding Entrepreneurship award. Under his leadership, EMP has also earned accolades — as the Best Employer in Ohio, as one of Weatherhead’s 100 Fastest Growing Companies, and as one of Modern Healthcare’s Best Places to Work in Healthcare in the U.S. for the last five years.
Obviously passionate about emergency medicine, Dr. Bagnoli is a board-certified Diplomate of the American Board of Emergency Medicine, a Fellow in the American College of Emergency Physicians and a Fellow in the American Academy of Emergency Medicine. Most of all, however, Dr. Bagnoli is passionate about patient care.
“I really enjoy building this company because it has real purpose and is mission driven,” he says. “It gives me a small part in helping hundreds of clinicians take care of millions of patients and improve care. That’s why I’m excited about this.”
He’s also excited by the opportunity USACS offers to preserve and grow what he started almost 25 years ago — a physician-owned and -managed group practice.
Preserving Physician Ownership
In today’s healthcare environment, many physician-owned practices are struggling to remain viable. Even hospital-employed and -contracted physicians are questioning their job security as hospitals consolidate to meet the needs of patients and the demands of payors.
“There’s a ton of consolidation now in healthcare. Hospitals are consolidating. The payors, like Aetna and Humana, are consolidating. And physicians really have to do the same, not only to meet the demands and the expectations of the hospitals and the patients, but also to be able to negotiate and work with payors in a collaborative way to provide the care,” Dr. Bagnoli explains.
He points out that, in the past 18 months, he’s seen three well-established emergency medicine physician-owned groups join publicly traded corporations. Watching this happen, he couldn’t help but wonder if EMP could avoid the same fate while still following its original business plan with physician ownership at its core.
“We are passionate about physician ownership,” Dr. Bagnoli says. “We know that physician ownership makes a difference, that having physicians own the practice allows them to be better aligned with the health systems they serve, and that patients are better served by physicians who have a stake in the game.”
If the physicians aren’t owners and they’re just contractors, Dr. Bagnoli believes, they’re not going to treat their business the same way that owners do. “Our VP of Recruiting puts it this way: How often do you wash your rental car?”
In December 2014, Dr. Bagnoli and his leadership team decided to create a new business plan — one that would require considerable capital to succeed. In May 2015, they launched USACS.
Building a Better Business Model
In the past, physician-owned groups had only two options when faced with the challenges of the healthcare environment: stay the course and remain independent, or sell to a larger organization and become its employees. USACS offers an alternative — the opportunity to partner with a company majority-owned by physicians but with the resources, business support and capital of a substantial enterprise.
“When we presented this model to our EMP docs as a way to compete long term, everyone thought it was awesome,” says Dr. Bagnoli. “In fact, they voted to create USACS without one single dissenting vote.”
USACS offers a more comprehensive solution across the continuum of care, including emergency, observation, hospitalist and post- acute-care services.
“We’ve started pilot programs with some of our big health systems to provide an integrated, coordinated continuum of care that’s consistent and really helps the hospital improve service, the quality of care and the experience for the patients, while reducing costs,” Dr. Bagnoli explains.
USACS provides the support services, such as data collection. The company also invests in technology and produces new programs to help hospitals deal with the challenges of keeping their patient population healthy at a lower cost and with better outcomes.
Currently, physicians affiliated with EMP and the three groups which joined USACS in the past three months own 60 percent of the company. Those three groups include the following.
- Tampa Bay Emergency Physicians (TBEP), known for delivering efficient and quality care to patients within the Florida Hospital System for more than 40 years
- Maryland-based MEP Health, a provider of outpatient and emergency care since 1997, serving over a half million patients in nine facilities across three states in the Mid-Atlantic region
- Emergency Physicians at Porter Hospital (EPPH), the exclusive provider of outsourced emergency medicine services for five facilities in the Centura Health system in Denver
“We have a majority of physician board members, and we control the company. So we’ve been able to continue the physician ownership model with USACS but also obtain the capital to grow the business and do more consolidating acquisitions,” Dr. Bagnoli explains. “Eventually, we expect to create the same size and scale as the publicly traded companies, thereby giving physician ownership a chance to survive for the next quarter century.”
He emphasizes that while the company name has changed, the underlying values and company goals have not.
“We’ve been focused on building a national leader, with physician ownership at its core, since 1992,” says Dr. Bagnoli. “I’m even more excited about what we’re doing today than I’ve ever been.”
For more information about U.S. Acute Care Solutions, visit usacs.com or call 800-828-0898.