How Capital Digestive Care weathered COVID-19 & its approach to deal-making going forward

Capital Digestive Care and its 20 practice locations are heavily entrenched in the mid-Atlantic region, where COVID-19 cases were particularly volatile. Now, as life returns to normal in the region, the group isn't taking any chances and is ensuring a uniform response is consistent across the practice.

President and CEO of Capital Digestive Care Michael Weinstein, MD, spoke to Becker's about the practice's response to COVID-19 and discussed how it plans to grow its presence in the region moving forward.

It all started with a meeting — more specifically, multiple meetings. Dr. Weinstein increased the incidence of monthly board meetings to three times a week to ensure the practice was responding to the pandemic in a uniform fashion.

"We were meeting three times a week talking about finances, personal protective equipment, patient populations and employees," he said. "It was about a month until we went to weekly board meetings."

That brought the Capital Digestive Care through the end of May into June. Dr. Weinstein said the board's decisions were routinely and frequently communicated to the individual branches to ensure employees were kept up to speed, and responses were similar.

"We had these task forces, we would huddle up, talk it out, call the play, and everyone went out and ran the same play," Dr. Weinstein said. "We didn't want one office deciding we don't need to use PPE, for example. As a big group, we have to be consistent to make sure there isn’t a breakout at a location."

Capital Digestive Care benefited from the state's delayed process around reopening — Maryland only reached stage two in early June — and had the benefit of the help from other large practices, as well as the Digestive Health Physicians' Association, a coalition of independent practices and members.

"There's a bit of an advantage to being late to reopen because we can see what the other groups are doing," Dr. Weinstein said. "We can see what Texas is doing, what Minneapolis is doing — we can learn what works and what doesn’t work in other parts of the country and make our decisions based on what we see happening in other states.

When Capital Digestive Care reopened its endoscopy centers, it did so at 25 percent capacity, including long breaks between cases and limited staff whenever appropriate. It also had the benefit of having ample COVID-19 screening tests to ensure staff members and patients were both safe before their procedures.

Going forward, Dr. Weinstein said Capital Digestive Care plans to conduct around 30 to 40 percent of all visits through telehealth. As for elective procedure volume, the platform plans to hit 50 percent for the entire month of July, and hopes to resume to 75 to 85 percent by August, with a goal of hitting 90 percent of normal volume at the end of the year.

Growing the platform

While COVID-19 left its mark on the practice, platform growth and mergers and acquisitions aren't stopping, and might even be boosted by the virus. PE Practice Solutions was formed when Capital Digestive Care partnered with Jamison, Pa.-based Physicians Endoscopy. The platform isn't fueled by traditional private equity goals of making large returns for investors but is instead aimed on "the long game."

"We're very much about the future benefits, not the immediate benefits" Dr. Weinstein said. "It's about the long game – our main goal is to help private practices remain independent. It is easier for us to have these conversations because we aren’t about the transaction. We're about the strategy."

Dr. Weinstein said the platform isn't looking for gastroenterologists who want to sell their practices, but instead looks for practices they think would be good partners. He believes practices that set-up one-stop shops in their practice may be more willing to consider mergers with the efficiencies of consolidated back-office services management going forward because of the effects of the virus.

"Consolidation is going to pick up because of the virus," Dr. Weinstein said. "It's interesting. When we talked to groups before, they had their schedulers, their billing and collections people and everyone was contained in their office. Now all these people are working remotely, and you can't have them at the office. You start to wonder, can I centralize those services?"

He feels the opportunities the platform affords other practices in terms of administrative support may make the idea of joining a platform now more attractive than before COVID-19.

"We formed a gastroenterology practice management group with expertise from both Capital Digestive Care and Physicians Endoscopy looking toward long-term success, not a sell-off or flip," Dr. Weinstein said. "It may result in much smaller numbers, but we think it's an advantage."

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