Navigating complex financial issues Knoxville News Sentinel

19 мая 2014 | Author: | No comments yet »
Pershing 60

Health Care Heroes: Ed Pershing

Edward V. Pershing

Occupation: Co-founder, president, Pershing Yoakley Associates. Founding shareholder of Realty Trust Group, a top U.S. real estate advisory firm; Healthcare Horizons Consulting Group, a health claims analysis firm whose clients include Walmart, Google, Hewlett-Packard, Home Depot and Pilot; PYA Waltman Capital, a registered investment advisory firm ranked among the nation’s top 100 RIAs for 2012; and Bluegill Creative, a multimedia firm. Associated businesses also include Research Planning Consultants, PYA/Stamp, MRG Medical Solutions, and PYA GatesMoore, formed through a recent merger

Previous experience: Certified public accountant with Ernst Ernst

Community service: Member, Gov. Bill Haslam’s Task Force on Health Wellness; founding board member, finance committee, Ronald McDonald House; vice chair, Great Smoky Mountains Institute at Tremont; University of Tennessee Chancellor’s Associates; past board member and chairman, finance committee, Knoxville Chamber; former advisory board member, Tennessee Wesleyan College School of Nursing; co-founder, Mr. P’s Foundation, which awards scholarships to graduating seniors

Education: Bachelor’s degree, accounting, University of Tennessee

An unexpected thing happened to Ed Pershing on his way to a career as a corporate lawyer — the health-care industry exploded.

And for the Alcoa native with visions of vetting big business deals on a national scale, the timing was, as it turns out, impeccable.

Pershing, president and co-founder of Knoxville-based Pershing Yoakley Associates, surveys the national, regional and local health-care landscape and reflects on the dramatic change he’s been a part of for nearly 40 years. His unplanned role in that change helps define the company he and partner Doug Yoakley have built advising hospitals and physicians on business matters ranging from tax, financing and valuation to real estate and insurance reimbursement.

I look back on it and think we were probably crazy to start it when we did (1983). The recession; I still remember how difficult it was, Pershing says.

The company has come far from the early uncertainty.

Pershing Yoakley Associates ranks as the 12th largest privately owned health-care consulting firm in the United States, according to Modern Healthcare magazine, with 2012 revenue of more than $40 million. It has grown from three employees to more than 240 employees, with more than a half-dozen affiliated companies and offices in Knoxville, Atlanta, Tampa, Fla. and Austin, Texas.

The 1974 University of Tennessee College of Business graduate planned to work as an accountant for two years, pass the CPA exam and attend law school. But a stopover at then-Big Eight accounting firm Ernst Ernst after graduation changed all that by introducing him to a career-long partner and stoking an entrepreneurial passion.

Pershing, 60, has built a reputation in Knoxville and across the country for steering health-care clients through complicated issues like expansion, consolidation, government regulation and financing. He’s respected for an ability to recognize emerging trends, giving clients time to react.

His work in improving access to medical care in the Knoxville community — through such projects as the Ronald McDonald House, Interfaith Health Clinic and Lisa Ross Birth Women’s Center — as well as being a key facilitator on a number of confidential engagements between community organizations have also earned him plaudits.

Bob Koppel, retired president of East Tennessee Children’s Hospital, credits Pershing and his firm with advising the nonprofit hospital on successful expansion projects.

He’s a very bright guy. He’s energetic and he’s creative. He has a knack for identifying health-care trends and he’s a problem-solver, Koppel says.

Another longtime PYA client is Covenant Health, which manages the largest network of hospitals in East Tennessee. Covenant Health CEO Tony Spezia says the business Pershing has built has put Knoxville on the map with its national reputation for health-care consulting.

He’s a very successful business person who has built a firm that serves companies across the country that is headquartered in Knoxville, Spezia said. I consider Ed to be an important adviser to me in my career.

Pershing values the relationships he’s developed with health-care leaders and the business he and Yoakley have built, but brushes off the self-made man label.

He simply calls it being in the right place at the right time.

‘Respected for his professionalism’

Shortly after joining Ernst Ernst, Pershing decided a career in corporate law wasn’t for him. He began working with Yoakley, a co-worker at Ernst Ernst, and the two shared clients, some of whom were health-care organizations.

I consider it divine intervention, Pershing says, recalling how the multinational accounting giant selected him and 17 other accounting professionals in 1977 for a yearlong training program in health-care consulting. In essence I was educated to do consulting. I was fortunate enough to become known as a health-care consulting resource in this part of the country.

His selection to that elite international program altered Pershing’s future.

Ernst Ernst returned him to Knoxville near the end of his training to assist Baptist Hospital of East Tennessee with its 1977 bond issue to finance the hospital’s central wing. At the same time, he began working with Children’s Hospital and Sevier County Medical Center. Then in 1978, Pershing led a team to assess the feasibility of refinancing St. Mary’s Medical Center’s 1977 bond issue.

It was around this time that the health-care industry began seeing a spike in tax-exempt debt financing, which became a service line for finance consulting businesses. Yoakley and Pershing developed a close working relationship at Ernst and, after much deliberation, broke away to form Pershing Yoakley Associates in 1983.

Pershing has worked for every Knoxville hospital, though usually not at the same time.

Ed has done work for every hospital in town. He walks a very fine line and there’s never a breach of confidentiality when Ed is involved. He’s respected for his professionalism, Koppel says. He’s done much for the health-care community in the Knoxville area.

Health care’s impact on PYA is dramatic. Health-care consulting is about 65 percent of its business, with tax and audit services making up the remaining 35 percent. Pershing said 90 percent of the business is related to health care, banking and financial institutions.

In addition, Pershing is a founding shareholder of a number of affiliated businesses including real estate development, investment advisory and multimedia design firms.

As Pershing has helped grow PYA over three decades, he is quick to credit others including Ray Groves, the Ernst Ernst chairman, whom Pershing calls a health-care visionary; E.B. Copeland, an early board member at Fort Sanders Alliance, which transformed into Covenant Health; former Baptist Hospital CFO Fred Spencer; and the Sisters of Mercy, who operated St. Mary’s Hospital. Pershing says all were instrumental in teaching him the business of health care, from finance (Spencer) and patient care (Sisters of Mercy), to making informed decisions and standing by them (Copeland).

Pershing’s early introduction to issues facing hospitals have resulted in important community assets, including the Lisa Ross Birth Women’s Center, created to give prenatal care and midwife services to women of varying income levels. The idea for the center arose from Pershing’s work to establish a medical center in Jellico, Tenn. where he saw pregnant women with limited access to care.

The idea was for all area hospitals to support it (Birth Women’s Center). But we weren’t successful in that so it was operated independently. There was a high incidence of women on Medicaid not able to be seen by a health-care professional, Pershing says.

He’s volunteered his expertise to other health-care issues too, particularly the TennCare program.

Pershing formed a task force to develop a provider network as a way to head off a TennCare crisis in the 1990s.

Pershing, Dr. Jack Lacey and Marvin Eichorn, CFO of Mountain States Health Alliance in the Tri-Cities, identified ways to redefine payment methods, change payment rates, incorporate incentive payments and redesign care delivery models across East Tennessee hospitals. As a result, emergency department visits and hospital admissions declined significantly, access to primary care improved and coverage by specialists was more readily available and accessible.

The task force’s program was a financial win and TennCare satisfaction increased in East Tennessee. The success prompted Pershing to develop a TennCare Position Paper and led he and Lacey to develop Knoxville Area Project Access to improve uninsured individuals’ access to medical care.

Pershing’s community work led to his appointment to Gov. Bill Haslam’s Task Force on Health Wellness in Tennessee, an ambitious program to lead the state in achieving the greatest percentage improvement in health and wellness of any state over the next five years.

Pershing speaks with pride about his accomplishments but says there have been some regrets along the way.

Chief among them? The sales of two of Knoxville’s leading hospitals — Baptist and St. Mary’s, which had influential roles in his early career.

In less than the span of my career, I’ve seen two Knoxville hospitals fail, and that speaks to the need for sound management and leadership, he says. Leadership matters and can be the difference between success and failure. Regardless of your beliefs, not-for-profit versus for-profit, there is a need for faith-based hospitals.

He recalls an early lesson he learned from Copeland of Fort Sanders Alliance: Tell the client what they need to hear, not what they want to hear.

He hopes the community has learned a valuable lesson from the loss of two of Knoxville’s founding hospitals in less than four years. Neither Baptist nor St. Mary’s was client of Pershing Yoakley at the time of their sales, but Pershing feels somewhat of a proprietary interest given his role as a leading consultant and his early dealings with them.

And that’s why I feel like I failed as a community leader. We need to be mindful that competition is important. But public health policy issues sometime deem it necessary to set aside competition and address health care from a community standpoint.

2012, Knoxville News Sentinel Co.

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