What's in store for new Envision CEO James Rechtin — 7 company insights

After Christopher Holden's resignation, Envision Healthcare tapped James Rechtin — the president of OptumCare — to take over as president and CEO.

Here's what the company looks like as Mr. Rechtin takes the reins:

1. Nashville, Tenn.-based Envision acquired what is now its ambulatory segment, AmSurg, in 2016. As of December 2019, AmSurg owned 258 ASCs in 35 states, making it one of the country's largest owners and developers of ASCs. AmSurg has partnerships with around 3,500 specialty physicians. 

2. AmSurg accounted for about 15 percent of Envision's revenue as of late 2018, according to Moody's. By the end of 2019, Envision was expected to achieve $50 million in revenue synergies due to the merger with AmSurg.

3. In late 2018, investment firm KKR acquired Envision for $9.9 billion. It was the largest healthcare buyout of the year, Bain & Co. reported. Before the acquisition, AmSurg reported $328 million in second-quarter net revenue for 2018, with same-center revenue growth hitting 2.9 percent.

4. A month after KKR's buyout, Moody's analyst Jonathan Kanarek predicted Envision could sell AmSurg for around $3 billion. Mr. Rechtin may have to evaluate this possibility, but for now, the segment remains part of Envision. 

5. By late 2019, the debt backing KKR's buyout dropped in value. Investors seemed to fear that the government's increased scrutiny over surprise billing could lower Envision's revenue, and ratings agency Fitch placed KKR's $5.4 billion loan on its list of "struggling" deals.

6. The surprise billing concerns continue to follow Envision. Mr. Holden, who was a leader at Envision for 13 years, stepped down as the company and KKR battled criticism over alleged surprise billing tactics.

7. Like many healthcare organizations, Envision has faced data security challenges. In early 2019, Envision's physician staffing branch, EmCare, was hit by a massive data breach that may have compromised the personal information of up to 60,000 patients, employees and contractors. After the incident, the company was compelled to adopt advanced IT solutions and train employees on email and IT security.

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