Your Hospital Issues an RFP for Anesthesia Services: Now What?

As a national anesthesia consulting firm, we are seeing hospitals and healthcare systems change or attempt to change their incumbent anesthesia groups with increasing frequency. A recent survey of hospital leadership has confirmed our experience and demonstrates that the mechanism by which hospitals seek to effect a change is frequently through a request for proposal (RFP).  Read the entire co-written article by Robert Johnson, MBA and Robert Stiefel, MD here.

Enhance Healthcare Releases Recent Anesthesia Survey Results

SurveyResults-downloadThumb“Going Under,” Enhance Healthcare’s recent C-suite survey, provides an inside look into how and why hospitals seek new anesthesia providers.

We discovered that Facilities are increasingly frustrated with local groups’ increasing cost, as well as the inability to provide value added data, drive efficiency or to provide effective physician leadership.

The RFP process has become much more standardized, and the options for change more robust.  C-suite executives have more confidence in large, sophisticated, well-capitalized vendors, while at the same time the financial and operational imperative for change has escalated.

Enhance Healthcare Consulting(EHC) is a specialized consulting firm that independently evaluates anesthesia groups to measure performance, improve service and reduce costs.

3 ways physicians can better serve hospitals

As the healthcare industry transitions to a value-based model of care, hospital leaders are under increasing pressure to develop strategies to gain market share and meet rising patient expectations. It is thereby critical for hospital-based physician practices to align themselves with the goals of the health system and demonstrate proactive support of these goals’ pursuit.

The following are three ways hospital based physician practices can assist in achieving the hospital’s goals:

Quality of Care

High quality care is always the top priority for healthcare providers. With reimbursements now tied to outcomes, hospital leaders are seeking ways to ensure quality standards are consistently met and exceeded.

For example, in the OR, anesthesia plays a crucial role in the quality of procedural outcomes. When analyzing anesthesia processes, consider how the group handles issues such as infection control and safety practices, and whether their policies and procedures are based on industry best practices.  It is also wise to discuss with the physicians how they measure and report quality performance so they can in turn compare that performance to benchmarking data and identify areas for improvement. Every physician practice should be driven to achieve the highest quality of care to better support the patients and hospitals they serve.

Patient Satisfaction

Low patient satisfaction scores can negatively impact both reimbursement and the hospital’s greater value to its community. That is why it is important that your physicians understand their role in the patient experience. This experience includes everything from the way the patient is greeted by reception and support staff, to the face-time patients receive with physicians, to the way the billing and collection process is handled.

In the internet age, sites such as and are solely dedicated to rating the performance of both physicians and hospitals. Patients often choose providers and health systems based exclusively upon online reviews and social media threads; according to the Pew Internet and American Life Project, 83% of Americans look online to research health and medical information as well as physicians. Ensuring your hospital based physicians groups are providing the best patient experience possible and are maintaining a positive online presence has now become a significant driver of growth and profitability for hospitals and health systems.

Proactive Leadership

Strong physician leadership is key to a successful hospital/group partnership. Practice leaders should coordinate with hospital administrators to understand the hospital’s quality, satisfaction and growth goals, then work closely with his or her group to ensure it is helping to meet those goals. Here are some steps physician leaders can take to demonstrate proactive leadership:

• Participate in hospital committees to show an active interest in the decision-making process and the future success of the hospital
• Distribute satisfaction surveys to both patients and medical staff to ensure a positive work environment and patient experience
• Identify subspecialties or procedures your department is lacking, and explore opportunities to begin offering these services
• Encourage practice physicians to maintain certifications and participate in on-going training to provide the highest quality of care

It has become critical for physicians to address these areas and support the growth of the hospital they serve. However, it is perhaps even more important to put procedures in place to measure progress, identify areas for improvement and remedy problems before they threaten the security of the hospital’s future.

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The Changing Landscape of RFP’s

When hospitals outsource their hospital based physician services, a close, long-term relationship is often created between facility and vendor.  Nonetheless, for reasons of cost, service or quality, the services may be put out for a bid in a Request for Proposal (RFP).  As advisors to both provider groups and hospitals, we have been involved in over 50 RFP’s in the last 20 years.  As we recently assessed the outcomes of these RFP’s over time, we have noticed a meaningful shift in the expectations of the facility issuing the RFP and in the likelihood of an actual change in hospital based provider group as a result of the process.

Approximately 10 to 15 years ago, the process of a formal RFP was often a “stalking horse” – using the threat of outside vendors to reduce the cost of an existing vendor – with no real intent to change provider groups.  At that time, there were fewer large regional and national vendors as options for facilities, and quality/performance reporting was not a core expectation of hospital based providers.  If a facility truly desired to change a provider group, it was often accomplished through a direct discussion with a known vendor who had the trust of facility leadership.  In our experience, formal RFP’s had a less than 5% chance of resulting in a change of vendors.  From the vendor and the hospital perspective, the RFP landscape often looked like a sharp cliff leading into a deep, wide canyon.  Very little chance of getting to the other side!

Fast forward to today.  As we all know, the healthcare picture has evolved, with significant patient care and technological improvements.  Quality care is assumed and therefore has become somewhat commoditized. At the same time, reimbursement pressure, reporting and quality tracking requirements as well as a great deal of private equity investment in the hospital based physician space has significantly increased the number of viable large vendors available to compete for RFP’s.

Facilities are increasingly frustrated with local groups’ increasing cost, as well as the inability to provide value added data, drive efficiency or to provide effective physician leadership.  The RFP process has become much more standardized, and the options for change more robust.  C-suite executives have more confidence in large, sophisticated, well-capitalized vendors, while at the same time the financial and operational imperative for change has escalated.  Speaking purely from our own experience, over the past year we have seen approximately a fivefold increase in the issuance of RFP’s, with 30% of hospital based RFP processes resulting in a provider change.  That change may involve an entirely new entity or acquisition of the local providers into a larger group.

Either way, as health care reform reshapes the macro environment, numerous factors appear to be aligning to support the increased use and impact of RFP’s for hospital based services.  We might even say that over the last 10 to 15 years the landscape has shifted from a daunting canyon to an inviting, lush landscape with various low hanging fruits for both vendors and facilities.

Three words to the wise: “Get big fast”

Change is coming to radiology in ways the profession could not have anticipated in a pre-Affordable Care Act world. The forces driving the change are many and varied—economic, regulatory, technology-enabled—but one common denominator has emerged as the “cardiopulmonary system” of the transformation: hospitals under intense pressure to perform in order to survive.
Read the full post here


Hospital based physician (HBP) services including Anesthesia, Emergency Department, Hospitalists, Pediatric Services and Radiology, are vitally important to the quality of patient care, efficiency and profitability of hospitals. Distributing a request for proposal (RFP) for a HBP service line can often be a painful process and one which should not be taken lightly.

Nonetheless, with the reality of shrinking margins, hospitals find themselves in a place where they must evaluate all major expenditures. In addition, requirements for provable quality of service supported by trackable metrics now frequently necessitates the search for better options available in the marketplace.

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Enhance Anesthesia & Perioperative Consulting Announces Corporate Name Change…

Enhance Anesthesia & Perioperative Consulting Announces Corporate Name Change to Enhance Healthcare Consulting to Reflect Broader Hospital-Based Physician Service Line Commitment
Former HCA Executive Robert Johnson Joins Enhance Healthcare Consulting as Principal

Aventura, Fla. (Dec. 22, 2014)—Enhance Anesthesia & Perioperative Consulting announced today that it is changing its corporate name to Enhance Healthcare Consulting (EHC) to reflect its broader hospital-based physician service line commitment and its expertise in driving the necessary innovations to shape the future of physician alignment healthcare strategies.

“For our clients, physician alignment is paramount and EHC is changing the way hospital-based physician specialties, ranging from anesthesia and emergency medicine to inpatient pediatric services, are delivered in order to increase access, lower costs and improve quality,” announced Dr. Howard Greenfield, EHC Co-Founder and Principal.

EHC is a specialized consulting firm that independently evaluates both outsourced and employed hospital-based providers by specialty and across service lines to measure performance, improve service and reduce costs. The firm is not a practice management company but rather an unbiased, trusted advisor to hospital and physician leadership on the financial, clinical and operational performance of hospital-based physicians.

The firm’s services cover the entire provider and vendor management process, including managing existing providers to ensure optimal performance, remediating partnerships that have deteriorated or grown outdated, and forging new value-add vendor partnerships supported by a strong and quantifiable business case.

As a further demonstration of its commitment to addressing critical issues across hospital-based physician providers, EHC also announced that Mr. Robert Johnson, a former senior executive with several leading national healthcare corporations, has joined EHC as a principal of the firm. Mr. Johnson, who has been at the forefront of the healthcare industry’s recent focus on hospital-based physician services (anesthesia, emergency, radiology, neonatology etc.), brings management depth, negotiation expertise and an unparalleled network of industry contacts to help meet the growing needs of EHC’s expanding client base.

“Robert Johnson brings more than the knowledge and skill of a person with 25 years of healthcare management,” says Dr. Robert Stiefel, EHC Co-Founder and Principal. “His background ideally positions him to offer clients practical solutions for complex problems resulting from physician and hospital interactions. Bob provides unique insights with deep clinical, operational and financial perspectives developed from working for both hospital systems and provider groups.”

Mr. Johnson has extensive experience providing hospital-based physician service executive management for several academic health systems including Johns Hopkins, Duke and Baylor. He also has held executive positions for hospital-based service providers, including Coastal Emergency Physicians and Sheridan Healthcare. Most recently, Mr. Johnson was the Vice President of Hospital-Based Physician Services for the Hospital Corporation of America, Inc. (“HCA”). He played a critical role for HCA in evaluating, operating and leading provider negotiations with anesthesia, emergency, radiology and pediatric physician programs.

About Enhance Healthcare Consulting

EHC is a specialized consulting firm that independently evaluates both outsourced and employed hospital-based providers by specialty and across service lines to measure performance, improve service and reduce costs.
For additional information, visit

Suman Dada
CCO Healthcare Partners
(312)-207-2369 x231