Novant Health's WNC plan: Ex-GenesisCare surgeons were just the start

ASHEVILLE – Novant Health will open its surgical practice in Asheville Nov. 8, bringing the former GenesisCare physicians back into the operating room after a seven-week hiatus.

The practice's opening marks the latest corporate health care expansion in Asheville. Novant has significant ambitions to expand in Western North Carolina. The ex-GenesisCare physicians are hardly the beginning.

Novant allowed the physicians to continue practicing in Asheville. The surgeons are now the seedlings of the Winston-Salem-based nonprofit conglomerate's expansion plan into Western North Carolina.

Asheville is no stranger to the corporate practice of medicine. HCA Healthcare, a for-profit Nashville-based company, acquired the Mission Health system in 2019 for $1.5 billion. Since the purchase, concerns from patients, doctors and staff have mounted, ranging from antitrust lawsuits to frustrations with quality care. The new Novant surgeons had just been burned by a corporate entity, but facing an accelerated timeline, they said they had few other options. Now they are part of Novant’s plan to grow in the region.

The six surgeons began exploring their options for a new practice around when GenesisCare declared bankruptcy in June, Paul Ahearne, a surgical oncologist with the practice, recently told the Citizen Times. These options included opening a private practice without involving themselves with a corporation.

Opening a private practice also meant a major pay cut for the surgeons, who would have had to bargain with insurance companies on their own, rather than relying on their corporate backers to conduct the negotiations. Ahearne and Colin Bird, a colorectal surgeon with the practice, estimated that the physicians would earn between 20% and 40% less than what they would make under a corporate umbrella.

Some of the physicians in the practice are still paying off medical school debts, which are typically $200,000, according to a recent American Association of Medical College Study. According to various online salary-reporting websites, surgical oncologists’ salaries can range from $150,000 to well over $300,000.

Bird told the Citizen Times that the surgeons would have had to hire their own staff, become re-credentialed with every insurance company and take out a multimillion-dollar loan to open a private practice.

Despite the risk, the surgeons were considering taking the pay cut, Bird said, but GenesisCare informed the surgeons in August that their practice would close in two months. Opening up a private practice would have kept the surgeons out of commission for an extended period.

“That would require a minimum six-to-eight-month lead time that we didn’t have,” Ahearne said.

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Novant typically takes six months to open a new practice, Senior Vice President of Consumer Operations Patrick Easterling recently told the Citizen Times. The nonprofit opened this practice in two months.

Ahearne said that the group ultimately felt most comfortable with Novant because of its established presence in the state and because it would bring a new choice to the region.

Novant officials assured that the nonprofit would not leave the physicians scrambling like GenesisCare did.

“Novant Health and the organizations that make up Novant Health are over 100 years old, so we’re not going to go bankrupt,” Easterling said.

Easterling said that the physicians’ contracts allow them to stay in the community if they choose to move on from Novant.

The surgical practice is not Novant’s first foray in the region. It acquired three urgent care clinics in Asheville and Black Mountain in May and an imaging center before those. Novant applied for certification for an acute care hospital in Buncombe County, which was ultimately awarded to AdventHealth. It also tried to purchase Mission in 2019.

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Easterling said it is leaning on physicians in the region to identify where specialties are lacking, naming rheumatology and dermatology as examples. Novant will look to grow its physician network in those areas and then once Certificate of Need laws loosen in 2025, will look to open new facilities.

“We really want to focus on what we can bring to the community in terms of access to good health care, access to good physicians and infrastructure and support,” Easterling said. “We see Asheville is an attractive market. We believe the people of Western North Carolina need access to quality health care. They need access to choice. And we think we play a role in that.”

Mitchell Black covers Buncombe County and health care for the Citizen Times. Email him at mblack@citizentimes.com or follow him on Twitter @MitchABlack. Please help support local journalism with a subscription to the Citizen Times.

This article originally appeared on Asheville Citizen Times: Why did the ex-GenesisCare surgeons sign with Novant?