Cornerstone Finds Foundation in HMA

The management structure at Cornerstone Clinic allows Wendell “R.W.” Ross to focus on what he does best: care for patients.

Ross founded the Cornerstone Clinic in 1988, and in 1996 sold it to publicly traded Health Management Associates Inc. of Naples, Fla.

When he sold his private practice to HMA, he lost about 15 percent of his patient base, but it was for the greater good.

“I thought they were seeing me because they loved me, but they were seeing me because I didn’t make them pay their bill,” Ross said.

HMA has put the practice in a much better financial situation.

The three-physician firm has grown to 15 physicians since the sale and has four locations, three of which are in Van Buren and one in Alma. The clinic has 10 primary-care physicians and five specialist physicians.

“There are a lot of private practice physicians out there,” said Tony Barber, HMA’s senior vice president. “A lot of them have their hands full dealing with patients. They need a business partner. We fill that void, and from a strategic standpoint we have the infrastructure to operate practices from a remote basis.”

Barber said the company’s own centralized and professionally maintained computer system gives physicians the ability to maintain a database in the office, without the expense of in-house information systems personnel.

“It all boils down to infrastructure,” Barber said. “We want our offices to look like a private practice.”

Ross said HMA’s ability to negotiate contracts with insurance providers has given him a much better financial advantage than he had as an independent operation.

“It is very difficult to just hang out your shingle and be an independent practitioner because you are pretty well closed out of the managed-care systems,” Ross said.

Before becoming HMA-owned, Ross said he spent a lot of time dealing with accounting issues.

“I realized I was not that adept at business,” Ross said. “HMA has never interfered with the way I practice medicine. They are excellent business people. It was the understanding from the start that they manage the business.

“They collect the bills and get the best price for supplies, but they don’t interfere clinically with how I treat my patients.”

HMA had net-patient service revenues of $3.2 billion in fiscal 2004 and total assets of $3.5 billion. It owns 56 hospitals and has an estimated 350 to 400 physicians in its network. The acute-care operator’s calling card is non-urban areas in the Southeast and Southwest with populations from 30,000 to 400,000.

Ross said the 1996 sale of Cornerstone included his equipment inventory and accounts receivable. He received a guaranteed income for a year, and now makes a percentage of what he collects. He said Cornerstone’s success boils down to personal service.

“We don’t just treat the individual, we treat the family and the interaction between family members,” Ross said. “A great part of family medicine is preventative medicine.”

What Ross did is not unlike other physicians in a growing number of markets. Barber said “strategic integration” is becoming “the thing.”

“The complexities of medicine are such anymore that group practices are coming here to stay,” Barber said. “I think as long as they have an identity that makes sense. As long as the physicians in the group have something in common that doesn’t subtract from the financial model of the group, then I think they are here to stay.”