ANSWERS · PRACTICE FINANCE

Should I stay independent or join a hospital or PE group?

The choice comes down to autonomy and upside versus stability and relief from administrative burden — and the administrative burden is often the real driver, not the economics. Before deciding, quantify how much of the pressure is fixable (billing, denials, staffing, contracts) versus structural, because a lot of "we can't survive independent" is recoverable revenue and fixable overhead.

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What actually matters

  • Independence keeps autonomy, culture, and the upside of your own equity
  • Joining trades that for stability, capital, and someone else running the back office
  • The pressure is frequently administrative — billing, denials, staffing — which is fixable without giving up independence
  • Quantify your true financial health first (net collection rate, denial leakage, overhead) before concluding you can't stay independent
  • If you do sell, those same numbers drive your valuation

Common questions

Why are so many practices joining PE or hospitals?

Mostly administrative and reimbursement pressure. But much of that pressure is fixable revenue-cycle leakage, which is worth addressing before making a permanent, hard-to-reverse decision.

Where Volari fits: A large share of "we can't make it independent" is uncollected revenue — denied and underpaid claims. Recovering it can change the math on the decision.

Related answers
How do I read an EOB or 835 remittance?How do I know if I'm being underpaid by insurers?In-house billing vs. outsourcing: which is right for my practice?How do I renegotiate payer contracts for better rates?How do I hire and keep a good medical biller?How do I survive a payer or Medicare audit?

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