The Great Oaks Template
for Medical Consolidation:
Partnership with Core Clinics™

Great Oaks’ Partnership with Core Clinics™ (PCC) provides a model for clinic management compatible with patient-centered health care.  It is designed for doctors who plan to practice for at least five years. A PCC platform is foundd by a small group of doctors at the start. Subsequent financing needed for operations and expansion is provided primarily by a commercial bank. This means the enterprise is effectively doctor-controlled from the outset. Doctors retain ownership and autonomy.

“This approach to consolidation flips all the right switches.”
Ken Thrasher CPA, Co-Founding Partner of Bennett Thrasher LLP

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As an independent sponsor, Great Oaks works first with doctors and their advisors to meet the organizational, financial and operational objectives of the medical services team – forming a sustainable business platform.   Next, Great Oaks structures financing to meet the requirements of the participating commercial bank.   The result is a doctor-controlled enterprise with funding for future growth of clinics and redemption of doctors’ shares as needed.

HOW THE PARTNERSHIP WITH CORE CLINICS WORKS

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Central to Great Oaks’ approach to medical consolidatoin is investment in clinics, empowering physicians to build a stronger practice platform:

  • Participating doctors MAY sell a portion of their practice value initially, retaining a majority interest.
  • Doctors control the policies that govern clinic operations and participate more fully in the value created.
  • Member physicians exercise more local autonomy than would normally be possible in a consolidation controlled by private equity capital and downstream obtain substantially higher financial benefits
Data-driven / Dynamic / Secure / Connected

HOW THE PARTNERSHIP WORKS: AN ILLUSTRATION

Project Photo

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A participating doctor with a practice value of $5,000,000 could expect:

  • A competitive salary together with an attractive bonus and benefits package.
  • $1.5 million distributed at the outset from sale to the PCC platform of 30% interest
  • A second capital distribution of $1,750,000 after five years from selling more shares to the PCC platform
  • Substantial dividends paid annually from shares retained by the doctor.
  • Retained equity shares with a projected value of $10 million or more within  seven to ten years.

HOW THE PARTNERSHIP WORKS: FINANCING

04

The PCC is:

  • Primarily bank-financed with no personal guarantees .
  • Designed for doctors who plan to actively practice medicine for at least five years.
  • A sustainable platform designed for equity growth and generating substantial annual dividends for doctors.
  • After five years, doctors can cash out retained shares.

Having a small group of doctors as Core Clinics opens two important channels for the professional medical association:

  • Available funds to cash out some of the doctors’ practice equity up front .
  • Funding available for equipment, clinic expansion, and staffing growth that supports business development
After five years, doctors in Core Clinics can redeem most or all of their shares and the platform will remain entirely doctor-controlled.

05

Merging a clinic into a larger operating partnership allows a doctor to cash out a significant portion of the equity value and leave the remaining equity ‘at work’ earning dividends from the platform.

HOW THE PARTNERSHIP WORKS: PRIMARY BENEFITS

06

More Cash

Doctors can monetize 100% of the initial practice value within 7 to 10 years and still retain valuable “legacy shares” in the partnership. Substantial dividends also augment attractive salary and bonus compensation.

More Autonomy

Operating policies and procedures are controlled by the platform’s participating doctors by means of an affiliated management services operation rather than private equity investors—a doctor-friendly environment.

06

Long-Term Assets

A doctor’s shares in the platform earn substantial dividends annually that increase over time, along with the shares’ value, as the PCC platform grows. These shares are “legacy assets” and not controlled by outside investors.

Salary, Incentive Income, and Benefits

The employment agreement will include provisions for medical and professional insurance, vacation, base salary with incentive income features based on performance, and provisions for reimbursable professional expenses such as conferences.

06

Sustainability

The substantial profits sought by private equity typically can be achieved only by a sale or merger of the platform within 4 to 6 years. The PCC business platform is sustainable. The lower cost of bank financing allows the platform to redeem doctors’ equity in “rollover shares” without having to sell the platform.

07

An affiliated management services organization (MSO) comprised of professional health care executives will be responsible for all day-to-day clinic operations supporting patient care and medical procedures.

THE MANAGEMENT SERVICES ORGANIZATION

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The doctors’ partnership will have a role on the MSO board of directors, where the partnership regulates the operating policies of the MSO.


Benefits to physicians include:
  • More autonomy in local clinic policies
  • Maintaining local clinic identity/brand
  • Ready access to capital for practice expansion and adding new staff as necessary  

The MSO model gives doctors and medical staff more time to focus on patient care and professional development.

Partnership with Core Clinics:™ Why It Works

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While profitability is essential for any viable enterprise, in the sustainable PCC model improving financial results will always be tempered by a doctor’s core values and professional standards.  

The Great Oaks PCC template offers a balance between prudent business practices and an optimal clinical experience for patients and staff.

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Great Oaks PCC: Prudent business practices, optimal clinical care



Contact: Edward Briesemeister
404.789.4447
neb@GreatoaksPCC.com