Administrator, Consolidated Medical Practices of Memphis, PLLC
Some people are healers; some people enable, empower, strategize, facilitate and create an arena in which healers can function fearlessly.
Ed Avery, administrator for Consolidated Medical Practices of Memphis (CMPM), sets an impressive pattern and pace as problem solver and navigator for his group of 26 physicians and 17 nurse practitioners, who deliver multi-specialty care to between 700 and 800 patients in 14 locations across the Memphis area on a daily basis.
Avery is admittedly a man who doesn’t like to sit still — and who enjoys wearing a variety of hats that keep him active and challenged each day.
Evidence: Although his Bachelor’s degree from the University of Memphis is in public health administration, Avery also owns and operates a commercial grain farm in Crawfordville, Ark. Alongside files and administrative “to do” stacks, his desk supports farm equipment catalogs and even a broken monitor from a tractor cab awaiting shipment for repair.
Avery remembers growing up on a farm north of Raleigh when Raleigh Springs Mall was a sagebrush field. Nostalgia plus boredom and a high energy level compelled him to add farming to his healthcare “day job” 20 years ago.
His day jobs have been colorful and varied, too, including hands-on patient care experience as a clinical assistant and a group therapy leader and counselor, as well as negotiator and agent-for-change in local hospitals, institutes and healthcare systems.
“I started out checking people in and working on the floors,” Avery said, “and short of being a medical provider, there’s not a job that I can’t sit down and do, between the offices or a hospital. I’ve been the person you walked up to and checked in with, and the person that negotiated the contracts.”
Does that give him an edge in his current role as administrator/negotiator for CMPM?
“I think so,” he said. “There are times when I have to go back to the doctors or the clinicians and say, ‘Tell me operationally what’s happening between points A and B, step by step.’ But for the most part I’ve been there and I’ve done that job and I know operationally how we’ve got to get through the procedure.”
In the wake of previous jobs with Semmes-Murphey Neurological and Spine Institute; Methodist Le Bonheur Health Care Systems/Health Choice, LLC; St. Joseph Hospital; and Mid-South Hospital, Avery became involved in the plan to create a multi-specialty practice that would allow beleaguered physicians to benefit from the efficient process of combining redundant costs, while also taking advantage of the beefed up bargaining power of a larger group.
While Avery was developing his own plan, the seeds of a parallel plan were being planted by the MetroCare Physicians of Health Choice.
“Reimbursements were getting cut and carriers were saying, ‘That’s the contract – take it or leave it!’ Primary care physicians asked the MetroCare Board for help,” Avery said. “MetroCare put up a grant to do some consulting and find options to help family practice and internal medicine survive. One of those potentials was this company.”
Avery spent a year using MetroCare and Health Choice’s facilities to meet with doctors who had learned from the successes and failures of previous mergers, and CMPM benefited significantly from their input.
“Their experience drove the contracts and the operational structure of this company,” he said.
The results paid off with the creation in 2008 of what Avery believes is now the largest non-governmental internal medicine practice in Memphis, and the only multi-specialty practice outside of UT, with specialties that include internal medicine, pediatrics, allergy, cardiology, OB/GYN and hematology/oncology.
As CMPM’s administrator, he describes himself as more hands-on than most, since the management team — Avery, a controller and a billing manager — is so small. “We run a very tight ship,” Avery said. “All three of us will do whatever it takes to get the job done that day. It holds down costs, and that’s always a good thing.”
Avery enjoys the variety of challenges that each day brings and pointed to a few projects on his desk: “Finishing up the licensing on a nuclear camera and making sure the software is functioning properly; that stack is Blue Cross credentialing; this is an article one of the doctors brought in, showing dramatically higher costs related to hospital-owned practices versus private practices — my job is to verify the numbers and confirm that hospitals are costing Medicare twice what private practice does, and sometimes four times.”
Negotiating provider contracts, one of his primary duties, has also become one of his greatest challenges, due to confusion surrounding the Affordable Care Act, blending commercial business insurance plans with governmental plans. “We’re fortunate that we had existing contracts in place that bridge the two- and three-year turnover time, but I’ll have to see where we stand then,” he said.
Changed and “scrambled” carrier contracts have created patient confusion, too. “We’re seeing a lot of folks that have enrolled in exchange plans who have been misinformed that their doctor was in that plan,” Avery said. “I think it’s going to continue to be extremely confusing. Rather than being able to negotiate things on a local level and consider what’s in the best interest of a commercial product in the market, we’re now having to deal with federal regulations and goals, and that may or may not have any benefit to us. It’s certainly going to increase operational costs.”
Despite his concerns, Avery anticipates continuing growth and expansion for CMPM.
He continues to pursue new initiatives — exploring participation in accountable care organizations (ACOs) developing in Memphis, and considering the benefits to the practice and its patients of participating in medical home projects.
Avery considers his family his greatest accomplishment —“a beautiful wife and three beautiful children aged 16, 14, and 12.” He loves travel and spends as much time on a sailboat as he can manage. He’s now considering a 50th birthday sailing trip to Greece.
