Our client was a two-hospital system in the Mid-Atlantic region that was experiencing inefficiencies in their cath lab. The inefficiencies resulted in high costs-per-case, substandard outcomes and lost market share. The lab was used by interventionalists from two independent cardiology groups. HSG explored several alignment methods, including employment, call coverage pay and Professional Services Agreements.  Ultimately, co-management was selected as a viable and cost effective solution.

How HSG Helped

Prior to meeting with the physicians, HSG performed a baseline assessment by comparing cost, satisfaction, and quality data to national benchmarks. Based on these results, we compiled a list of draft metrics and worked with the physicians to select the final five metrics to be included in the agreement.

We also put together a list of duties physicians for which would be paid under the contract. Included were education and training sessions with Emergency Department and cath lab staffs, as well as EMS.


  • Physicians and hospital were pleased with the agreement
  • Physicians exceeded three out of four quality goals
  • Referring physicians recognized improved quality and efficiency, resulting in market share increase
  • Renewed for year two with updated metrics and targets
  • Hospital is exploring similar agreements with other service lines


Neal D. Barker

Partner and Managing Director, Compensation and Compliance