In a Joint Venture It's All About the Patient

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By Joe Carlucci

American Renal Associates (ARA) was founded on one single premise: nephrologists care for their patients, and the dialysis clinic is an extension of their practice.

Nephrologists want the very best available for their patients as they provide care in their office, and they demand the same high quality of care in the dialysis setting. In a wholly-owned dialysis facility they may not be able to do what they believe should be done. Ownership changes all that.

We believed then, and continue to believe, that nephrologist ownership in partnership with an experienced team of dialysis service managers is a very powerful business model based on quality care before economic success.

Joint ownership allows individualization, operational flexibility, clinical autonomy, and the nephrologist’s stamp of approval of the care provided in this setting.

Today, 11 years later, with 115 dialysis centers, more than 140 nephrologist partners, operations in 20 states and the District of Columbia, this physician-owned model in the dialysis service “space” has proven itself as the most attractive and successful structure in the dialysis industry within the United States. The philosophy is very simple: Take good care of the patients and the economic success will follow. Oh, by the way, do what is right for the patients all the time regardless of economics, yes, all the time!

The joint venture model or JV is a pure partnership of nephrologist and manager and has been in existence for many years; however, ARA is the only provider that employs the nephrologist model exclusively.

I believe we were the first in the country to develop and employ consistent processes and organizational methods that are nationally scalable resulting in reduced risk of execution, and ongoing operations and in fact proving that this JV model is quite superior than the 100 percent company-owned model. This might be the reason that over the last 10 or so years the rate of JV start- ups of dialysis centers has accelerated as compared to the 100 percent company-owned models, as more and more nephrologists seek out a way to gain more control over the quality, clinical decision-making, staffing and care delivery at the dialysis facility.

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