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commercial construction by Mark Gordon | Managing Editor
A medical billing firm goes Fort Knox in building its new company headquarters.
Forgive Tom Blankenship if he repeats himself when talking about how deep his medical-billing firm, Partners in Practice, went when building in redundancies to its new Lakewood Ranch corporate headquarters. Indeed, there are so many redundancies, it's easy to forget which ones he's already talked about.
It could be the reinforced hurricane protected roof of the building, which is bound by three extra feet of wall space. Or it could be the Sapphire, a $20,000 fire extinguisher the company bought for its high-tech server room; the Sapphire uses patented technology to delicately extinguish a fire while avoiding non-burning parts of the room.
Then again, it could also be the six-inch thick concrete walls designed to be more energy efficient and structurally strong without giving up the guts of either component. Those walls are built to withstand winds up to 270 mph, more than 100 mph over the wind speed of a grade five hurricane.
"We went a little overboard," says Blankenship, the firm's chief executive. "There's a tremendous amount of redundancy here."
Partners in Practice moved its entire operation from downtown Sarasota to its 22,000-square-foot Lakewood Ranch digs in May, seven months after construction began. Built by Sarasota-based contractor Charles & Chase, the construction cost $4 million, a figure that doesn't include technology and software upgrades.
The firm settled on Lakewood Ranch after spending almost three years looking up and down the Gulf Coast for a suitable space. Blankenship considered going as far north as Tampa and St. Petersburg and as far south as North Port and Port Charlotte.
The company was looking to expand for sheer space reasons, Blankenship says, but the building's protective Fort Knox-like design was always an integral component of the move. At its core, the company is responsible for securing thousands of pieces of personal medical data - a heavy responsibility.
Thinking about that, as well as remembering the 2004 and 2005 hurricane seasons that ruined several unprepared businesses, including medical offices, was plenty enough to scare Partners in Practice executives into action. Says Blankenship: "We wanted to make sure that would never be an issue for our clients."
On guard
Another aspect of the company Blankenship hopes is worth repeating is the business itself, both the model and its success.
The seven-year-old company has grown steadily, going from 20 employees when it was founded in 2000 to 100 today. What's more, accounts receivables have more than doubled during the last five years, from $120 million in 2002 to a projected $258 million in 2007.
Blankenship declined to release specific annual revenues, only saying those have grown, too, at a rate of about 20% to 25% a year.
The firm, which Blankenship runs with his business partner, Karen Vale, has made a policy of reinvesting significantly in the business. That's continued with the new building, both in construction and what's inside.
The company bought new software for its clients, for example, which is costing $1.5 million in implementation and training. It also recently signed a contract with SunGard, a global disaster recovery firm that guarantees it will completely replicate Partners in Practice's data within 48 hours if it's lost due to a storm, fire or some other calamity. Partners in Practice pays suburban Philadelphia-based SunGard about $3,000 a month for the protection.
And the building itself didn't come cheap, as redundancy, by definition, comes with a higher price tag. Blankenship says the company is paying for its $4 million headquarters through a combination of company revenues and bank financing.
One of the more unique features of the building are the concrete walls that hold it together, assembled by Bradenton-based Efficient Wall Systems. The company's intricate system, which it used in residential and commercial construction in areas from Orlando to Naples, starts with manufacturing a series of concrete panels in its factory.
Crews then bring the six-inch thick panels to the worksite and pump them full of concrete in an assembly line fashion. Next, the panels are made into walls piece by piece, which in the case of the Partners in Practice building took about 12 days, says Jason Ranney, a vice president with Charles & Chase, who subcontracted the walls portion of the job to Efficient Wall Systems.
On price, the walls are comparable to the more traditional mason-block method of commercial construction, says Ranney, but not so much when it comes to top hurricane winds. "A conventional mason wall," says Ranney, "is not going to protect against winds of that force."
Medical mantra
The building, both its redundant protectiveness and its accommodating size, became a necessity as Blankenship and Vale led the company's growth. Neither Blankenship, nor Vale, the company president, have an M.D. But the duo might as well have doctorates in medical billing.
Blankenship did earn an MBA from the University of Florida, which is where he began working on the billing and behind the scenes side of medicine. Vale, with a bachelor's degree in health care administration, has worked in medical practice management for 25 years. One of her stops was running the business operations for the 450-doctor medical facility at George Washington University.
The pair met while working at the Heart & Vascular Center, once one of the biggest medical groups in Greater Sarasota. But the practice went from $50 million-plus in revenues in 2000 to not even operating by 2002. Blankenship says the practice was partially undone by fighting among doctors about the best way to run the medical practice. "We saw a lot of what not do in the medical business," Blankenship says.
Vale left the practice in early 2000, and Blankenship followed less than a year later. They formed Partners in Practice quickly thereafter and physicians that once made up the Heart & Vascular Center began streaming in as clients. All told, Partners in Practice picked up about 80% of the Heart & Vascular Center's displaced doctors.
Blankenship developed a mantra based on Heart & Vascular Center experience: The practice of medicine and the caring of patients is only a small part of the medical business.
"We are not just a billing company," Blankenship says today. "We are everything a doctors' office needs to be successful."
An 'Easy Button'
Those services include medical transcriptions, monitoring managed care services, installing and maintaining software, implementing phone systems and working on business plan assistance, down to lease negotiations.
It could be almost too much, says Vale, reasoning the company might becoming too good for its own good.
"Our biggest challenge is that we make it look so easy," Vale says. "Our clients don't realize all the things we do on their behalf."
Vale says there have been several clients that left the firm after a few months, thinking this billing and software thing wasn't too hard. Just as soon, she says, the clients come back, realizing their perceptions of the business side of medicine were wrong.
As Partners in Practice looks to grow, both in Florida and beyond, such as Georgia, that challenge spawns another dilemma: Actively selling - or not selling - the company's services.
The company has yet to go directly to doctors either one-on-one or in a medical conference setting to pitch what it can do. Its clients have all come from referrals and general word-of-mouth.
Blankenship, for one, doesn't relish the idea of pitching the company directly to physicians. Telling a doctor he doesn't know how to do something as well as he once thought, Blankenship says, would be the "hardest sales job in the world."
REVIEW SUMMARY
Industry. Health Care
Business. Partners in Practice, Lakewood Ranch
Key. The firm, which is growing 25% a year, recently moved into a custom-built hurricane protected building.
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