In 2014, Chris Maiorana helped create Practice Advisors 360 in Medway, Mass. The company offers various types of services to physicians and health care providers looking to open a clinic or practice, or to relocate. Maiorana, a partner in the company, discusses work that Practice Advisors 360 does in Rhode Island.
PBN: What types of doctors and practices do you generally work with, and on average, how many new practices open in Rhode Island a year?
MAIORANA: Practice Advisors 360 does not limit the specialty of the doctors with whom we work. Our team understands what is important to our practitioners and works that into our conversations with landlords and sellers. Obviously, location matters when looking for the right space. However, location also depends upon how their office captures their patient base and earns revenues.
What differentiates us is we are experts in negotiating lease or purchase deals specifically tailored to doctors; securing cost-effective financing; and having a network of best-in-practice contractors, planners, architects, equipment suppliers, specialty market and public relations and project managers. This takes the stress out of the project, allowing the clinician to focus on their clinical programs while ensuring their project – whether it is their first or 10th – is completed timely and resourced efficiently.
For example, with retail locations, doctors such as dentists, optometrists, dermatologists, veterinarians, med spas and physical therapists will want to have solid visibility to grow their businesses. For more traditional, medical office locations, we work with plastic surgeons, primary care physicians, vascular surgeons, pediatricians and specialists, as they typically may be part of a destination model, such as a medical building. Our business works with health care lenders that are based regionally and nationally that specialize in lending to medical practitioners.
Practice Advisors 360 typically handles five to 10 projects in Rhode Island annually and up to 50 throughout New England. As a firm, which also operates nationally, we will open or sell as many as 200 per year.
PBN: What is the landscape like right now for doctors who are selling their practices or opening a new one? Is it significantly different from pre-COVID times earlier in 2020?
MAIORANA: We are finding this to be a seller’s market for existing practices due to cost and time of creating one from scratch. The biggest difference we are seeing between pre-COVID-19 and this current environment is that there are more practices coming to market as doctors make the decision to sell rather than meet regulations and costs of PPE [personal protective equipment].
PBN: Are there any trends that you are currently noticing?
MAIORANA: After seeing many practitioners who were starting their first office put their projects on hold during the early stages of the COVID-19 shut down, many, if not all, have restarted once again with the goals of opening in the spring to summer of 2021.
During the shutdowns of COVID-19, we did notice that many of the multi-location practitioners with whom we work to help them grow their existing business asked us to assist with their refinancing, as well as adding new locations. Most practitioners continued to push their projects forward during the phased reopening. There was a level of confidence in their proven working model to find new communities where they could find additional profitability.
PBN: Did the COVID-19 pandemic force many practices to close in Rhode Island?
MAIORANA: Yes, especially those that were not viewed as essential medical care. However, many have reopened and at this time are operating close to 75-100% of revenues they were seeing pre-COVID. Some are finding that due to distance guidelines, they will have to operate at a capacity that is less than full production. Most have modified their practice operations, or are in the process, to meet guidelines, keep their patient base confident in their process and have sufficient supplies of PPE.
PBN: With telehealth and video visits now offered by almost all health care providers, are you noticing any differences in what health care providers are looking for in terms of brick-and-mortar locations?
MAIORANA: We have noticed this trend picking up in recent years with telehealth, even pre-COVID 19. As a result, doctors may need less exam room space, but there still is the need for space for staff to connect with their patients, such as more traditional office and administration space.
So, there is a change in how production and volume of patients are handled and ultimately reimbursed with the insurance carriers with which they are credentialed. It is also too early to judge what post-COVID-19 will look like as more medicine moves towards video and telephone, concierge-style. However, all businesses in all industries are grappling with what their offices will look like.
At the end of the day, we feel that there will be little change when it comes to location for their offices, as they still will want to serve areas that are densely populated with residents and workers and have higher propensities to spend their disposable incomes on their health care.