Tenet Healthcare looks at the potential sale of its Conifer division
Healthcare provider Tenet Healthcare is looking at the potential sale of its financial services division Conifer. The unit remains responsible for Tenet’s hospital and physician revenue cycle management and value-based care solutions.
The move will enable Tenet to reduce some of its long-term debt. The company has ramped up its cost reduction initiatives by $100mn, where it aims to achieve $250mn of annualised run-rate savings by the end of 2018.
The business has been in choppy waters since the summer, and has also recently announced plans to lay off over 1000 members of staff in order to reap further savings in the upcoming year. The departure of Chief Executive Trevor Fetter also had been a cause for uncertainty.
Goldman, Sachs & Co. LLC has been appointed as financial advisor and Kirkland & Ellis LLP as legal advisor in a potential sale. The company has also implemented a number of performance thresholds which management are to meet in order to obtain incentive compensation under Tenet’s Annual Incentive Plan.
“We are continuing to take aggressive actions to improve financial performance and returns for our shareholders by executing on our previously announced divestiture plans, accelerating growth, enhancing quality, eliminating unnecessary costs, improving margins and free cash flow, and lowering our leverage ratio,” explained Ronald A. Rittenmeyer, Executive Chairman and CEO.
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“I want to acknowledge the insights received from many shareholders, including Glenview Capital, which have been very helpful in our efforts to reposition Tenet.”
“We remain open to all options that can enhance shareholder value, and given that we have adequate liquidity to operate our business and no near-term debt obligations, we have the flexibility we need to achieve the best alternative for shareholders,” he continues.
“Conifer has great business lines with strong growth potential and robust free cash flow. As we initiate a process to explore a potential sale of Conifer, our objective is to maximise the value of Conifer for our shareholders and put Conifer in the best position to continue to provide quality service to its clients, including our own hospitals.”
Additionally, Tenet’s 2018 outlook has highlighted the prediction of organic revenue growth within its acute healthcare facilities and the potential to undergo a number of acquisitions to expand its service offerings.
NHS staff face severe impact on mental health due to COVID
The decision to drop COVID-19 restrictions in England this month alarmed doctors in the National Health Service (NHS) while hospitalisations are on the rise. At the same time, hospitals have started cancelling operations again adding to the existing backlog of operations, which estimates say could take a year to clear.
Dr James Gilleen of the University of Roehampton and his Covida Project team are warning of the ongoing risks to the mental health of NHS staff, many of whom are traumatised from the first wave of infections. “As the UK continues to see COVID-19 infection numbers rise at a similarly alarming rate as those seen during the country’s second wave, it’s combined with a renewed strain on the NHS and its staff" he said.
The Covida Project is a digital tool created to assess the psychological impact of the COVID-19 pandemic on frontline workers including NHS staff, the police and carers.
“Healthcare workers are already exhausted and burnt-out; they are traumatised from their experiences of working during the pandemic. During the first wave in May 2020, a study from the Covida Project found an unprecedented quadrupling of the number of NHS staff with high levels of anxiety, depression and post-traumatic stress disorder (PTSD) compared to before Covid-19" Gilleen said.
"Having the most severe levels of these symptoms was statistically linked to four key factors - insufficient access or pressure to reuse Personal Protective Equipment (PPE), insufficient workplace preparation, insufficient training and communications, and a higher workload. Staff aren’t just anxious, depressed and traumatised from being over-worked – it is from feeling unsafe and at risk."
The Covida Project found that almost a third of healthcare workers reported moderate to severe levels of anxiety and depression. The number reporting very high symptoms was four times higher than before the pandemic.
Gilleen adds, “With COVID-19 restrictions now fully removed in England, NHS staff face the daunting triple-threat of rising Covid-19 hospitalisations, huge backlogs of medical operations to clear, and the added expectation of large increases in winter flu, which is already being seen even now in summer.
"These difficulties are present at a time when the NHS is already under-resourced, impacted by sickness and/or staff being ‘pinged’ to self-isolate through the government’s track and trace app, and staff continuing to fear the daily risk of infecting family and friends.
"Together these are considerable psychological burdens and create a perfect storm for the mental health and well-being of NHS staff."
Gilleen says there may be worse to come, especially if new, more transmissible variants develop. "Previous research after other pandemics such as SARS has shown that residual mental health symptoms like PTSD can continue for years, so the impact of repeated waves over the long-term will be potentially catastrophic for the mental health of NHS staff.
He has some clear recommendations to protect the wellbeing of frontline healthcare workers. “To protect the mental health of NHS staff they must feel they are less at risk or in danger, have access to the required level of PPE, not be continuously over-worked, with better staffing, more opportunities for rest and space to share their stress.
"Despite this and similar findings from other studies, still not enough is being done to protect NHS staff mental health and wellbeing and we fear it will continue to suffer in the months to come. With this comes the real risk that large numbers of staff will burn out or even quit the NHS.”