FCHS New 1 month high today, hiccup over 1 day delay is overThey delayed the Q by one day, it dropped I bot more, now 30 day new high, looks great.
Here is a snip from a report on them:
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There is no shortage of doctors that wish to eliminate the complex regulatory and
administrative burdens that exist within a private practice. Many U.S. physicians are
choosing alternatives to owning independent medical practices due to complex regulatory
compliance, high overhead costs and daily administrative burdens that prevent them from
providing the best patient experience and are limiting their earnings potential. A study
published by Accenture in mid-2015 [https://www.accenture.com/us-en/insight-clinicalcare-
independent-doctor-will-not-see-you-now] suggests that the number of US
physicians in independent practice will decline to just 33% by the end of 2016, down from
57% in 2000.
The "2014 Survey of America's Physicians: Practice Patterns and Perspectives"
commissioned by The Physicians Foundation found that 81% of physicians felt they were
over-extended or at full capacity. Many, 44%, physicians intended to reduce their
workload, work part-time, retire or seek non-clinical jobs. Others will join with other
practitioners or align with large health systems. For example, in San Diego County CA,
over the last two years nearly all doctors are now aligned with only four groups; Kaiser,
Sharp, UCSD and Scripps. In this study 89% of physicians believe the traditional model of
independent healthcare is extinct.
Several groups have approached First Choice Healthcare Solutions to explore
setting up a system in their geographic region.
First Choice has reached critical mass and should be consistently profitable with
increasing margins. The addition and integration of profitable ancillary and diagnostic
services will have a positive impact on gross margins.
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First Choice Healthcare Solutions provides real patient-centric care. Every patient is
assigned an advocate who is responsible for making sure the patient's questions and
concerns about scheduling, their care plans, insurance issues and any other problems
are effectively addressed. Team based care allied to pain management has been proven
to improve patient outcomes, and achieve a better Quality of Life for all patients. A
relative "one-stop-shop, First Choice's system of care strives to ensure that all the
patients needs are available in close proximity. Added profit comes from X-Ray, MRI, Cat
scans and Physical Therapy provided in First Choice's physical therapy centers. Of the
over 100,000 patient visits only about a third will actually need some form of surgery.
Rather, every effort is made to effectively treat patients through pain management,
physical therapy or other non-surgical solution. About one third of the patients are
covered by Medicare and TRICARE ( the military equivalent of health insurance for
military personnel and their families).
Profitable entry into major markets. The company's business model enables it to
recruit physicians with existing, established patient bases, then negotiate to purchase the
physician s former practices furniture, fixtures, accounts receivable, et al, as desired.
First Choice then assumes all financial, administrative and daily management control and
adds ancillary and diagnostic services to the service mix. Through athenahealth's cloudbased
services [athenahealth.com], First Choice controls billing and many other backoffice
functions in a timely and low cost system used by all of its Centers of Excellence.
First Choice maintains the right to refuse high risk high cost patients and can choose
what insurance, HMO or PPO plans they will accept. Consequently, acquisition and
integration expenses can be quickly absorbed with a positive impact on profitability.
Significant savings for patients and third party payers without compromising
profitability. Hospitals are expensive to run and have to treat all patients whether they
can pay or not. They need to be staffed 24/7/365 even if there are not enough patients to
cover expenses. First Choice Centers of Excellence can give patients close to the same
comprehensive high quality level of care and still achieve stronger, more profitable
financial performance. performance -- all while focusing on Orthopaedic and related care.
High profit potential. When rates for Medicare are based, in part, on the costs of
hospital care, a well run medical center can make money.
Dedicated facilities provide optimum patient experience. First Choice provides all of
its services in close geographic proximity so that patients are afforded the greatest
possible convenience and care experience.
The aging population is a built in growth factor. Osteoarthritis is a common problem
as people age and it is a major cause of knee problems. About 20% of knee
replacements will need to be replaced for those that have the first operation between the
ages of 45 and 65. Often replacing one knee, and the resumption of a more active
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lifestyle, will impact the other knee and increase the probability of that knee causing
problems.
With an overall market in excess of $150 billion for treatment outside of the
hospital we think that the opportunity for FCHS to be unlimited.
[The Burden of Musculoskeletal Diseases in the United States. www.boneandjointburdon.org The dollar amount is
derived from adding up the costs of all the hip, knee and shoulder procedures performed in the USA in 2011.]
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OVERVIEW
FCHS operates in the areas of Orthopaedic, Spine surgery, Interventional Pain Management and
Neurology.
On a worldwide basis, 632 million people suffer from back pain, 332 million from neck pain, there
are 251 million people with osteoarthritis and 561 million with other musculoskeletal problems
(Lancet, 15 December 2012).
On the Top 10 list of diseases in America, "back pain" stands at number eight, which according
to Forbes.com costs over $40 billion annually for treatment costs alone. Other estimates that
include disability, work loss and total indirect costs range between $100 and $200 billion per
year. Back pain sent over 3 million people to emergency rooms in 2008 at a cost of $9.5 billion,
making it the ninth most expensive condition treated in U.S. hospitals.
The incidence of joint pain for knees, hips and shoulders for those over the age of 18 accounted
for over 30% of those reporting in 2012. Pain management (algiatry) is one of the services offered by
FCHS.
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Older people tend to have osteoarthritis leading to knee, hip and shoulder problems. 67 out of 100
persons 45 and older have Musculoskeletal problems. This adds up to over 64 million potential
patients which spent $135 billion on osteoarthritis related problems in 2011, which may be
diagnosed in care facilities and account for 29% of all diagnoses in hospitals.
As patients age they become more susceptible to such problems as osteoarthritis and osteoporosis,
peaking within the ages of 65 and older and from age 18 and on the incidence of musculoskeletal
disease becomes significant. It is estimated that in 2011 there were over 94 million people with
problems. Other sources (American Academy of Orthopaedic Surgeons) estimate that 50 percent of
Americans are affected by arthritis of the knee.
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Over 72% of musculoskeletal diagnoses based on where care was received occurred in physician
offices. This is a major competitive factor for companies such as First Choice Healthcare
Solutions.
Osteoarthritis and joint pain are significant sectors of treatment in hospitals and charges
accounted for nearly $175 billion in 2011 out of the $1.3 trillion spent for all arthritis and rheumatic
conditions. This does not include treatment outside of hospitals. Within this amount the growth
potential of First Choice Healthcare Solutions is unlimited. Musculoskeletal diseases cost close to
$800 billion in 2011, and this total is growing.
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The three major operations for joint replacement are knees, hips and shoulders. Recent data for
rotator cuff repair is not available. However, there were 151,866 rotator cuff repair procedures
from 2004 through 2009, which represented an incidence of 13.6 for every 1,000 patients
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assigned an orthopaedic International Classification of Diseases, Ninth Revision (ICD-9) or
Current Procedural Terminology (CPT) code.
In 2011 the number of knee operations (706,292), hips (461,761) and shoulders (66,895) totaled
1.235 million procedures. The estimated hospital charges alone exceeded $50 billion
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Charges and payment by third party payers for the same operation varies across the country. The
charges paid vary by the plan covering the patient. The charge per code number (each part of a
procedure is coded and these codes are used to determine the payment) is determined by what is
paid under that code by Medicare. As described below the range of payment for a procedure varies.
Blue Cross/Blue Shield published a study in January 2016 [bcbs.com/blog/knee-hip-costvariations.
html] that shows that there are significant variations in hip and knee replacement costs
across the country and even in the same state.
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Average High Low
Knee replacement $31,124 $69,654 $11,317
High was in New York City, low was in Montgomery, Alabama
Hip replacement $30,124 $73,897 $11,327
High was Boston, low was Birmingham, Alabama
The cost varies even in the same city and between various plans. In Dallas TX the cost varies
from $16,772 to $61,585 depending on which hospital was used.
Health-care prices are all over the map, even within your plan s network
(Consumer Reports magazine: July 2012)
Traditionally, insurers have based prices on what providers charge. Some rely on proprietary
internal numbers, and some use national data collected and analyzed by Fair Health, a
nonprofit organization based in New York City. [https://www.fairhealth.org/About-FH]
But that s changing as more insurers have begun setting their price as a percentage of what
Medicare pays for the service. A March 2012 investigation by the New York State
Department of Financial Services found that most plans that use this method pay between
110 percent and 150 percent of what Medicare pays. It sounds like a lot but it s
extraordinarily low, says Robin Gelburd, (Fair Health s president at that time). The range