We counsel dialysis programs and vascular access centers on strategic options for their businesses, including divestiture, joint venture and outsourcing of inpatient dialysis services. Our team has significant experience negotiating transactions with the leading national dialysis organizations to provide the best deals that meet the goals of our provider clients, which include increasing profitability, reducing costs, and improving quality, outcomes and patient care.
We consider ourselves an extension of each client’s C-suite. Our approach typically starts with an assessment of the market and the options available to the client. We then plan the strategy based on the desired option. The strategy often includes seeking proposals from potential dialysis and vascular access partners, using our knowledge of the market and our understanding of the client’s needs to design an RFI or RFP to solicit offers or proposals from potential partners.
We assist the client in managing the flow of information, protecting competitively sensitive information, evaluating proposals, organizing site visits and Q&A sessions with potential partners, drafting and negotiating a term sheet offer from the leading partner candidates, and ultimately guiding the partner selection process and decision. After selection, we assist in negotiating the definitive agreements required to close the transaction and the ancillary exhibits and schedules, using the term sheet as our guide. Our comprehensive approach is intended to minimize the time demands on the client’s senior executive team by managing the process, timeline and communications with prospective partners.
Dialysis Program Asset Sales
IHS and Faegre Drinker together have completed more than 300 dialysis transactions involving the sale of program assets on behalf of academic medical center, community hospital and independent dialysis provider clients across the United States. Our experience has provided insight into the relevant metrics for operating dialysis centers, which enables us to better assist our clients in negotiating and securing fair terms and conditions. As mentioned above, we have extensive experience with the primary players in the dialysis market, adding value for our provider clients in the strategic planning and negotiation of their transactions.
Dialysis Joint Venture
Dialysis joint ventures are complex transactions. Our team has a long track record of success assisting clients with structuring these deals to maximize return on investment. We draw on our deep business, project management and legal experience to help clients get the best value. Our experience developing more than 100 de novo dialysis facilities through Faegre Drinker gives us the ability to help complete your project in a cost-effective and timely manner, all while taking into account the need to improve the quality of care and manage the health of this important group of patients. Our approach to assisting clients in the context of a joint venture arrangement is similar to our approach to an asset sale and is designed to minimize the time demands on senior leadership by directing the process and managing the communication from prospective business partners.
Outsourcing of Acute Dialysis Services
We also assist clients in outsourcing the operation and management of their inpatient acute dialysis services to a national or regional dialysis provider when they have determined that it would be more efficient and/or effective for an outside manager, whose core expertise is dialysis, to run that business. We are able to assist our clients in undertaking a competitive RFP process to help them select the best partner for their particular needs. As a result of our deep understanding of the dialysis market, we understand the typical issues and charges that can increase monthly service fees and, accordingly, can build key protections into the documents for the client. We also have worked on arrangements where the dialysis service provider bears some financial risk for certain outcomes.
Vascular Access Center Consulting
If a high-functioning vascular access center has reached economic maturity and/or an owner feels it is no longer able to manage its vascular access business effectively or efficiently, we can help clients assess whether it would make sense to divest those centers to one of the national or regional independent vascular access center companies. Even if a client is not looking to get out of the business entirely, often a partial divestiture to a national provider can be an attractive alternative, given the complexity of navigating recent changes in reimbursement with respect to vascular access procedures and the capital required to convert such centers to operate as ambulatory surgery centers as a result of such shifts in reimbursement.
Our team works with clients to pursue the best strategy for their businesses. We help clients obtain the best business and legal terms possible to maximize enterprise value and improve clinical outcomes for their businesses. More specifically, in vascular access joint ventures, we also seek to build maximum flexibility for our clients into the definitive agreement, and to define a meaningful role for them in governance and clinical decision-making.