Looking Ahead: Balancing Growth & "Remaining Small"
- By Paul Bergantino
- Oct 01, 2011
Q: How have recent consolidations
and acquisitions changed
the landscape of complex rehab
providers over the last few years?
What has caused it, and how has it
changed the way consumers work with
providers, or how providers work with
payors, referral sources and others?
A: I expect and plan for the consolidation
trends to continue as a
result of two primary influences: growth
initiatives fueled by the new investor
capital being infused into our industry
and by the need to significantly lower
costs and improve efficiency in the face
of payor and reimbursement challenges.
Providers are reacting to the downward pricing pressure on reimbursement
and the additional onslaught of documentation hurdles,
processing hurdles, and pre- and post-payment audit burdens. The
insanity adage — “to keep doing the same thing over and over,
expecting a different end result” — appropriately describes provider
sentiment. Many independent providers do not want to experience
the insanity any longer and are prepared to make bold changes to
ensure their ability to service consumers for many years to come.
An option for providers to relieve these challenges is to join a larger
organization. The breadth and depth of a national complex rehab
company can deploy resources to help navigate through some of
these payor and regulatory challenges, which are simply not available
to small local providers.
Growth alone does not address the key issues; smart expansion
is a key strategic goal of our organization. As Starbucks preaches,
“Stay small while you grow.” It very important to strike the right
balance between growth and the ability to provide individual service
by remaining small — the large-scale organization needs to appropriately
use the resources and economies of scale available to it to
continue to deliver what matters most to our consumer, payor and
referring customers: “To deliver accurately fit product, timely.”
Q: Looking back 10 years, what have been key influences on
ATG Rehab? How have you and your team been affected
by policy, funding changes, new technology, new consumer
A: The desire to be the best at what we do, and shaping our
organization to most efficiently react to the requirements
from the growing complexities of dealing with third-party payors is
the overriding infl uence on our organization. ATG Rehab has invested
significant dollars in our operating system and infrastructure to be
sure that we can address the changing payor requirements and to
continue to improve our timeliness. Economies of scale are one of the
best weapons to offset external policy changes. To prepare for the
next 10 years, we will continue to leverage our deep understanding
of the complex rehab technology (CRT) process and our detailed
understanding of our costs. We will work every day to build on the
foundation of our customer-centric organization.
Q: How do you work to stay ahead of the curve on all of the
above? How do you plan today so that you’re not playing
catch-up, but rather determining your own plans and destiny?
A: Our team is focused on being proactive vs. reactive. Many
times, this is not easy…so how do we do this? We focus on
the Three P’s: plan, people and process.
Plan: Each year, our senior team engages in a detailed, collaborative
process to create our annual tactical, strategic and financial plan.
Quarterly, each of our management team members assesses, sets and
resets our individual top five priorities…and we use technology to
communicate our plans and progress with each other in real time.
People: We have worked for years recruiting and training the best
management, ATP and support team in the industry. Our regional
model fosters entrepreneurial spirit, accountability, close-to-thecustomer
local touch and results. We have instilled a strong culture
of internal communication to keep our 700+ associate team members
informed and prepared.
Process: While we are an organization that was built by acquisition,
in 2006 our management team made a conscious decision to stop
acquisitions for a lengthy period of time to focus on our infrastructure.
We want to ensure a consistent, increased use of technology
and the creation/implementation of best practices. We have a
detailed document totaling 150 to 200 pages for every position in our
company — available to all team members via ATGWEB. The creation
of dashboards and reports to be sure all of our team members had
data available —almost at the speed of thought! — all revolved
around building a platform that would be able to expand to become
the leading CRT provider in the nation.
In addition to the three Ps, a key ingredient to a growing, stable
and dynamic organization is to have a strong financial partner. We
chose Audax Private Equity, a Boston-based investor of middle-market
companies with a reputation for spurring growth and creating value.
The combination of committing ourselves to the industry, the 3P
initiatives and our acquisition strategy will not only enable us to stay
ahead of “catch-up,” but will allow us to advance to the next level.
This article originally appeared in the October 2011 issue of Mobility Management.
Paul Bergantino is the CEO and president of ATG Rehab, headquartered in Rocky Hill, Conn.