Pediatrix Medical Group, Inc. (Pediatrix) operates as a provider of physician services, including newborn, maternal-fetal, pediatric cardiology and other pediatric subspecialty care.
The company’s national network is consisted of affiliated physicians who provide clinical care in 36 states. During 2024, the company formalized its practice portfolio management plans, resulting in a decision to exit almost all of its affiliated office-based practices, other than maternal-fetal medicine. As of Dec...
Pediatrix Medical Group, Inc. (Pediatrix) operates as a provider of physician services, including newborn, maternal-fetal, pediatric cardiology and other pediatric subspecialty care.
The company’s national network is consisted of affiliated physicians who provide clinical care in 36 states. During 2024, the company formalized its practice portfolio management plans, resulting in a decision to exit almost all of its affiliated office-based practices, other than maternal-fetal medicine. As of December 31, 2024, these plans were completed. Additionally, the company exited its primary and urgent care service line during 2024 based on a review of the cost and time that would be required to build the platform to scale. On December 31, 2024, the company’s national network comprised approximately 2,335 affiliated physicians, including 1,335 physicians who provide neonatal clinical care, primarily within hospital-based neonatal intensive care units (‘NICUs’), to babies born prematurely or with medical complications. The company has over 490 affiliated physicians who provide maternal-fetal and obstetrical medical care to expectant mothers experiencing complicated pregnancies primarily in areas where its affiliated neonatal physicians practice. The company’s network also includes other pediatric subspecialists, including 240 physicians providing hospital-based pediatric care, over 230 physicians providing pediatric intensive care, and 20 physicians providing pediatric surgical care.
Physician Specialties and Services
The following discussion describes the company’s physician specialties and the care that it provides, either directly or through its affiliated professional contractors:
Neonatal Care
The company provides clinical care to babies born prematurely or with complications within specific units at hospitals, primarily NICUs, through its network of affiliated neonatal physician subspecialists (‘neonatologists’), neonatal nurse practitioners and other pediatric clinicians, who staff and manage clinical activities at over 350 NICUs in 30 states. Neonatologists are board-certified, or eligible-to-apply-for-certification, physicians who have extensive education and training for the care of babies born prematurely or with complications that require complex medical treatment. Neonatal nurse practitioners are registered nurses who have advanced training and education in assessing and treating the healthcare needs of newborns and infants as well as managing the needs of their families.
The company partners with its hospital clients in an effort to enhance the quality of care delivered to premature and sick babies. Some of the nation's largest and most prestigious hospitals, including both not-for-profit and for-profit institutions, retain the company to staff and manage their NICUs. The company’s affiliated neonatologists generally provide 24-hours-a-day, seven-days-a-week coverage in NICUs, support the local referring physician community and are available for consultation in other hospital departments. The company’s hospital partners benefit from its experience in managing complex intensive care units. The company’s neonatal physicians interact with colleagues across the country through an internal communications system to draw upon their collective expertise in managing challenging patient-care issues. The company’s neonatal physicians also work collaboratively with maternal-fetal medicine subspecialists to coordinate the care of mothers experiencing complicated pregnancies and their fetuses.
Maternal-Fetal Care
The company provide inpatient and office-based clinical care to expectant mothers and their unborn babies through its affiliated maternal-fetal medicine subspecialists, obstetricians and other clinicians, such as maternal-fetal medicine nurse practitioners, certified nurse mid-wives, sonographers and genetic counselors. Maternal-fetal medicine subspecialists are board-certified, or eligible-to-apply-for-certification, obstetricians who have extensive education and training for the treatment of high-risk expectant mothers and their fetuses. The company’s affiliated maternal-fetal medicine subspecialists practice primarily in metropolitan areas where it has affiliated neonatologists to provide coordinated care for women with complicated pregnancies whose babies are often admitted to a NICU upon delivery. The company believes continuity of treatment from mother and developing fetus during the pregnancy to the newborn upon delivery has improved the clinical outcomes of its patients.
Other Pediatric Subspecialty Care
The company’s network includes other pediatric subspecialists such as pediatric intensivists, pediatric hospitalists and pediatric surgeons, among others. In addition, its affiliated physicians seek to provide support services in other areas of hospitals, particularly in the pediatric emergency room, labor and delivery area, and nursery and pediatric departments, where immediate accessibility to specialized care may be critical.
Pediatric Intensive Care: Pediatric intensivists are hospital-based pediatricians with additional education and training in caring for critically ill or injured children and adolescents. The company’s affiliated physicians who provide this clinical care staff and manage pediatric intensive care units (‘PICUs’) at over 60 hospitals.
Pediatric Hospitalists: Pediatric hospitalists are hospital-based pediatricians specializing in inpatient care and management of acutely ill children. The company’s affiliated hospital-based physicians provide this inpatient pediatric and newborn care in PICUs, well-born nurseries and pediatric emergency rooms at over 50 hospitals.
Pediatric Surgery: Pediatric surgeons provide specialized care for patients ranging from newborns to adolescents, for all problems or conditions that require surgical intervention, and often have particular expertise in the areas of neonatal, prenatal, trauma and pediatric oncology. The company’s affiliated physicians in this subspecialty include pediatric plastic and craniofacial surgeons and general and thoracic pediatric surgeons. Areas of particular expertise include management of neonatal and congenital anomalies, prenatal counseling, trauma management, pediatric oncology, gastrointestinal surgery, as well as common pediatric surgical conditions.
Other Newborn and Pediatric Care: Because the company’s affiliated physicians and advanced nurse practitioners generally provide hospital-based coverage, they are situated to provide highly specialized care to address medical needs that may arise during a baby’s hospitalization. For example, as part of the company’s ongoing efforts to support and partner with hospitals and the local referring physician community, its affiliated neonatologists, pediatric hospitalists and advanced nurse practitioners provide in-hospital nursery care to newborns through the company’s newborn nursery program. This program is made available for babies during their hospital stay, which in the case of healthy babies typically consists of evaluation and observation, following which they are referred, and their hospital records are provided, to their pediatricians or family practitioners for follow-up care.
Newborn Hearing Screening Program: The company’s affiliated physicians also oversee its newborn hearing screening program. Since the company launched this program in 1994, The company believes that it has become the largest provider of newborn hearing screening services in the United States. In 2024, The company screened over 805,000 babies for potential hearing loss at 340 hospitals across the nation. Over 40 states either require newborns to be screened for potential hearing loss before being discharged from the hospital or require that parents be offered the opportunity to submit their newborns to hearing screens. The company contracts or coordinates with hospitals to provide newborn hearing screening services.
Clinical Research, Education, Quality and Safety
As part of the company’s ongoing commitment to improving patient care through evidence-based medicine, it also conducts clinical research, monitor clinical outcomes and implement clinical quality initiatives with a view to improving patient outcomes, shortening the length of hospital stays and reducing long-term health system costs. The company’s physician-centric approach to clinical research and continuous quality improvement has demonstrated improvements in clinical outcomes, while reducing the costs of care associated with complications, as well as variability in protocols. The company provides extensive continuing medical and nursing education to its affiliated clinicians in an effort to ensure that they have access to current treatment methodologies, national best practices and evidence-based guidelines. The company believes that referring and collaborating physicians, hospitals, third-party payors and patients all benefit from its clinical research, education, quality and safety initiatives.
Business Strategy
The key elements of the company’s strategy is to build upon core competencies; utilize enhanced technology solutions; promote same-unit and organic growth; adaptation of telehealth; acquire physician practice groups; and strengthen and broaden relationships with the company’s partners.
Clinical Research, Education, Quality and Safety
As part of the company’s patient focus and ongoing commitment to improving patient care through evidence-based medicine, it engages in clinical research, continuous quality improvement, safety and education initiatives.
Clinical Research: The company conducts clinical research to discover ways to improve clinical care for its patients. The company shares its discoveries throughout the medical community by publishing its observations in peer-reviewed medical journals. To help facilitate and support research efforts, Pediatrix has a Research Advisory Committee (‘RAC’). The goal of the RAC is to design, implement and maintain a program for clinical research oversight and support that enables the company’s practices to conduct research that is safe, effective, financially viable and legally compliant. The RAC’s multi-disciplinary approach involves the collaboration of both clinical and business professionals, including finance, legal and compliance. With participating clinicians located throughout the country, the RAC supports a comprehensive scope of research efforts. This nationwide perspective allows the company to better anticipate future needs and opportunities.
Quality and Safety: Through the leadership of the company’s affiliated clinicians, it has cultivated a culture of continuous quality improvement and safety, which is the cornerstone of the company’s success and helps it to fulfill its mission. The company’s team of clinical experts leads and provides oversight of national quality and safety programs across various specialties and subspecialties.
Continuous Quality Improvement (‘CQI’): CQI initiatives are important for the company’s clinicians. The company provides its clinicians with the opportunity to collaborate and share best practices and facilitate access to valuable information, resources, and professional development tools. The company’s affiliated clinicians can identify areas for improvement, and then systematically monitor, study, learn, and implement change. Complex initiatives are derived and based on the company’s long-standing CQI efforts, its value-based care initiatives, and various clinical quality collaboratives. The company’s quality metrics include standard clinical outcome reporting, trend analysis and threshold performance, which are provided to its affiliated clinicians.
Patient Safety Organization (‘PSO’): The company has a federally listed PSO, the mission of which is to improve the quality and safety of care rendered by its clinical providers through the collection and analysis of quality data. As a federally listed PSO, the company’s mission to improve the safety of care rendered is supported by the dissemination of best practices information and implementation of patient safety programs. The company endorses High Reliability Organization (‘HRO’) concepts to provide ‘Just Culture’ training to its clinicians. The approach has been customized to meet its affiliated physician practices’ needs and is based on principles outlined by the Agency for Healthcare Research and Quality (‘AHRQ’), Institute for Healthcare Improvement, National Patient Safety Foundation and Team STEPPS, the teamwork system developed by the AHRQ and the Department of Defense.
Education. The company provides continuing medical and nursing education to its affiliated clinicians to ensure that they have access to current treatment methodologies, national best practices, and evidence-based guidelines. The Pediatrix Center for Research, Education, Quality and Safety is accredited by the Accreditation Council for Continuing Medical Education and accredited by the American Nurses Credentialing Center’s Commission on Accreditation. As an accredited provider of continuing medical and nursing education, the company offers a variety of live and online educational credit opportunities that can be accessed on demand by its providers and are in synergy with latest research publications and healthcare industry standards. The company is continually expanding its learning materials to new subspecialties. In addition, each year, thousands of healthcare providers worldwide take advantage of educational programs hosted by Pediatrix.
Innovation. The company’s collaborative innovation is a pathway towards excellence in research, education, quality and safety. Because of the critical role innovation plays, its team strives to integrate the latest technological advances, artificial or augmented intelligence, genomics and mobile applications into everyday care. Telehealth and mobile health, virtual reality, point-of-care diagnostics and advanced data analytics are shaping the future of medicine. The company’s team is actively engaged in integrating the latest innovations that can optimize clinical care delivery and augment its clinical research initiatives with the goal of further optimizing patient outcomes.
Information Systems
The company maintains several information systems that support its day-to-day operations, ongoing clinical initiatives and business analysis.
BabySteps: BabySteps is a clinical electronic documentation system used by the company’s affiliated neonatal physicians and other clinicians to record clinical progress notes and certain laboratory reports and to provide them with a decision tree to assist them in certain situations with the selection of appropriate billing codes. During 2024, the company focused on advancing the efficiency of clinical documentation, integration and interoperability, introducing new billing capabilities, and advancing the security posture of the BabySteps platform. The company added new personalization features and practice specific templates to enhance and streamline the clinician experience and decrease clinician documentation burden, as well as hundreds of new integrations with hospital partners designed to increase workflow efficiency, decrease data entry errors, and advance its interoperability capabilities. The company created two new modules, Newborn Express and Neo Express, to support charge capture and streamlined documentation of newborn and neonatology services, reducing the number of applications in use by clinicians, allowing for a simplified clinician experience and practice/organizational cost savings. In 2024, The company received its initial HITRUST recognition for the BabySteps platform, validating the companys security posture both internally and with its external hospital partners.
Clinical Data Warehouse: BabySteps Cloud enables the company’s affiliated physician practices to capture a consistent set of clinical information about the patients to whom the company provides care. The company de-identify and transfer data from the clinical documentation that resides in BabySteps to its ‘clinical data warehouse’ that since inception has accumulated clinical information on more than 2.0 million patients and approximately 35 million patient days. With comprehensive reporting tools, the company’s physicians can use this information to benchmark outcomes, enhance clinical decision-making and advance best practices at the bedside. Using a variety of clinical performance markers, its de-identified data warehouse also helps it track medication and procedure interactions, link treatments to outcomes and identify opportunities to enhance patient outcomes.
pMD Charge Capture: The company’s electronic charge capture system is used to code and bill for pediatric intensive care clinicians, hospitalists, other hospital providers, as well as all hospital services delivered by its ambulatory providers. The company also uses administrative data derived from this system to drive quality assurance and quality improvement programs.
Nextgen: The company has licensed the Nextgen Electronic Health Record (‘EHR’) and Practice Management (‘PM’), an integrated product line for its affiliated office-based physicians and other clinicians to record patient clinical documentation and manage the full revenue cycle. This product line provides additional benefits to the company’s office-based practices, including clinical decision trees to assist physicians with the selection of compliant billing codes, medication management (including electronic prescription of controlled substance and prescription drug monitoring programs), promotion of consistent documentation, patient engagement tools, virtual visits and telemedicine tools, Artificial intelligence tools for streamlined clinician documentation, and data for research and education. The company continues to evolve the NextGen EHR and PM to respond to regulatory updates and its evolving office-based services landscape.
The company’s management information systems are also an integral element of the billing and reimbursement process. The company maintains systems that provide for electronic data interchange with payors that accept electronic submissions, including electronic claims submission, insurance benefits verification and claims processing and remittance advice, which enable it to track numerous and diverse third-party payor relationships and payment methods. The company’s information systems provide scalability and flexibility as payor groups upgrade their payment and reimbursement systems. The company continually seeks improvements to its systems to expedite the overall process, streamline information gathering from the company’s clinical systems and improve efficiencies in the reimbursement process.
The company maintains additional information systems designed to improve operating efficiencies of its affiliated practice groups, reduce physicians’ paperwork requirements and facilitate interaction among the company’s affiliated physicians and their colleagues regarding patient care issues. Following the acquisition of a physician practice group, the company implements systematic procedures to improve the acquired group’s operating and financial performance. One of the company’s first steps is to convert a newly acquired group to its broad-based management information system. The company also maintains a database management system to assist its business development and recruiting departments to identify potential practice group acquisitions and physician candidates.
Physician Practice Group Administration
The company provides multiple administrative services to support the practice of medicine by its affiliated physicians and strive to improve operating efficiencies of the company’s affiliated physician practice groups.
Unit Management: A senior physician practicing medicine in each physician specialty or subspecialty practice that the company manages acts as the medical director for that practice. Each medical director is responsible for the overall management of his or her practice, including staffing and scheduling, quality of care, professional discipline, utilization review, coordinating physician recruitment and monitoring the financial success within the practice. Medical directors also serve as a liaison with hospital administration, other physicians and the community.
Staffing and Scheduling: The company assists with staffing and scheduling physicians and advanced practice nurses within the units and practices that the company manages. For example, each NICU is staffed by at least one specialist on site or available on call. The company is responsible for managing and coordinating the process for the salaries and benefits paid and provided to its affiliated physicians and practitioners. In addition, the company employs, compensate and manage all non-medical personnel for its affiliated physician practices.
Recruiting and Credentialing: The company has significant experience in locating, qualifying, recruiting, and retaining experienced physicians. The company maintains an extensive nationwide database of neonatologists, maternal-fetal medicine physicians, and other pediatric subspecialty physicians. The company’s medical directors and physician leaders play a central role in the recruiting and interviewing process before candidates are introduced to other practice group physicians and hospital administrators. The company verifies the credentials, licenses and references of all prospective affiliated physician candidates. In addition to the company’s database of physicians, it recruits nationally through trade advertising, referrals from the company’s affiliated physicians and attendance at conferences.
Billing, Collection and Reimbursement: The company assumes responsibility for assisting its affiliated physicians with contracting with third-party payors. The company is responsible for billing, collection and reimbursement for services rendered by its affiliated physicians. In all instances, however, the company do not assume responsibility for charges relating to services provided by hospitals or other physicians with whom it collaborates. Such charges are separately billed and collected by the hospitals or other physicians. The company provides its affiliated physicians and other clinicians with a training curriculum that emphasizes detailed documentation of and compliant coding protocols for all procedures performed and services provided, and the company provides comprehensive internal auditing processes, all of which are designed to achieve compliant coding, billing and collection of revenue for physician services. The company recently transformed its revenue cycle management function from an outsourced provider to a hybrid function that utilizes both its corporate personnel as well as one or more third-party service providers.
Risk Management: The company maintains a risk management program focused on reducing risk, including the identification and communication of potential risk areas to its medical affairs staff. The company maintains professional liability coverage for its national group of affiliated healthcare professionals. Through the company’s risk management and medical affairs staff, the company conducts risk management programs for loss prevention and early intervention in order to prevent or minimize professional liability claims.
Compliance: The company provides a multi-faceted compliance program that is designed to assist its affiliated practice groups in understanding and complying with the increasingly complex laws, rules and regulations that govern the provision of healthcare services.
Other Services: The company also provides management information systems, facilities management, legal support, marketing support and other services to its affiliated physicians and affiliated practice groups.
Relationships With Partners
The company’s business model, which has been influenced by the direct contact and daily interaction that its affiliated physicians have with their patients, emphasizes a patient-focused clinical approach that addresses the needs of the company’s various ‘partners,’ including hospitals, third-party payors, referring and collaborating physicians, affiliated physicians and, most importantly, its patients.
Hospitals and Other Customers
The company’s relationships with its hospital partners and other customers are critical to the company’s operations. Hospitals control access to their units through the awarding of contracts and hospital privileges. The company has been retained by approximately 395 hospitals to staff and manage clinical activities within specific hospital-based units and other departments. The company’s affiliated physicians are important components of obstetric, pediatric and surgical services provided at hospitals. The company’s hospital-based focus enhances its relationships with hospitals and creates opportunities for the company’s affiliated physicians to provide patient care in other areas of the hospital. For example, the company’s physicians may provide care in emergency rooms, nurseries, intensive care units and other departments where access to specialized obstetric and pediatric care may be critical.
The company’s hospital partners benefit from its expertise in managing critical care units and other settings staffed with physician specialists, including managing variable admission rates, operating costs, complex reimbursement systems and other administrative burdens. The company works with its hospital partners to enhance their reputation and market the company’s services to referring physicians within the communities served by those hospitals. In addition, its affiliated physicians work with the company’s hospital partners to develop integrated services programs for solutions within the services the company provides. Integrated programs provide the company’s hospital partners and the company with incremental growth and result in a broader spectrum of care across its specialties and permit the company to extend its patient service lines into the company’s existing markets. The company’s relationships with its hospital partners are continually evolving with the goal of being viewed by them as a solutions provider across all of the company’s specialties.
Under the company’s contracts with hospitals, it has the responsibility to manage, in many cases exclusively, the provision of physician services for hospital-based units, such as NICUs, and other hospital settings. The company typically is responsible for billing patients and third-party payors for services rendered by its affiliated physicians separately from other related charges billed by the hospital or other physicians to the same payors. Some of the company’s hospital contracts require hospitals to pay the company administrative fees. Some contracts provide for fees if the hospital does not generate sufficient patient volume in order to guarantee that the company receives a specified minimum revenue level. The company also receives fees from hospitals for administrative services performed by its affiliated physicians providing medical director services at the hospital. Administrative fees accounted for approximately 14% of its net revenue for 2024. Some of the company’s contracts with hospitals require it to indemnify them and their affiliates for losses resulting from the negligence of its affiliated physicians. The company’s hospital contracts typically have terms of one to three years which can be terminated without cause by either party upon prior written notice or renew automatically for additional terms of one to three years unless terminated early by any party.
Third-Party Payors
The company’s relationships with government-sponsored or funded healthcare programs (‘GHC Programs’), including Medicaid, and with managed care organizations and commercial health insurance payors are vital to its business. The company seeks to maintain professional working relationships with its third-party payors, streamline the administrative process of billing and collection, and assist its patients and their families in understanding their health insurance coverage and any balances due for co-payments, co-insurance, deductibles, or benefit limitations. In addition, through the company’s quality initiatives and continuing research and education efforts, The company has sought to enhance clinical care provided to patients, which The company believes benefits third-party payors by contributing to improved patient outcomes and reduced long-term health system costs.
Referring and Collaborating Physicians
The company’s relationships with its referring and collaborating physicians are critical to the company’s success. The company’s affiliated physicians seek to establish and maintain professional relationships with referring physicians in the communities where they practice. Because patient volumes in its NICUs are based in part on referrals from other physicians, particularly obstetricians, it is important that The company is responsive to the needs of referring physicians in the communities in which it operates. The company believes that its community presence, through the company’s hospital coverage and outpatient clinics, assists referring obstetricians, office-based pediatricians and family physicians with their practices. The company’s affiliated physicians provide comprehensive maternal-fetal, newborn and pediatric subspecialty care to patients using the latest advances in methodologies, supporting the local referring physician community with 24-hours-a-day, seven-days-a-week on-site or on-call coverage.
Affiliated Physicians and Practice Groups
The company’s relationships with its affiliated physicians are important. The company’s affiliated physicians are organized in traditional practice group structures. In accordance with applicable state laws, its affiliated practice groups are responsible for the provision of medical care to patients. The company’s affiliated practice groups are separate legal entities organized under state law as business corporations or professional associations, professional corporations, limited liability companies and partnerships, which the company sometimes refer to as its ‘affiliated professional contractors’. Each of the company’s affiliated professional contractors is owned by a licensed physician affiliated with it through employment or another contractual relationship. The company’s national infrastructure enables more effective and efficient sharing of new discoveries and clinical outcomes data, including best demonstrated processes, access to its sophisticated information systems, clinical research, and education.
The company’s business corporations and affiliated professional contractors employ or contract with physicians to provide clinical services in certain states. The company is typically responsible for billing patients and third-party payors on behalf of the company’s affiliated professional contractors for services rendered by the company’s affiliated physicians and, with respect to services provided in a hospital, separately from other charges billed by hospitals to the same payors. The company’s hospital contracts also typically require that the company and the physicians performing services maintain minimum levels of professional and general liability insurance.
Government Regulation
Existing federal laws, as well as similar state laws, governing Medicare, Medicaid, other GHC Programs and other non-governmental arrangements and interactions, impose a variety of fraud and abuse prohibitions on healthcare companies like the company. These laws are interpreted broadly and enforced aggressively by multiple government agencies, including the Office of Inspector General of the Department of Health and Human Services (‘OIG’), the Department of Justice (‘DOJ’), Centers for Medicare and Medicaid Service (‘CMS’), and various state agencies.
As part of the company’s business operations, including in connection with medical record keeping, third-party billing, research and other services, the company and its affiliated physician practices collect and maintain protected health information regarding patients, which subjects the company to compliance with HIPAA (the federal Health Insurance Portability and Accountability Act of 1996, as amended, and its implementing regulations) requirements.
The company has implemented security policies, procedures and systems, including training programs, designed to comply with the requirements set forth in the Security Rule (data security regulations).
Geographic Coverage
The company provides physician services across 36 states. During 2024, approximately 67% of its net revenue was generated by operations in the company’s five largest states. The company’s operations in Texas accounted for approximately 32% of its net revenue for the same period.
Service Marks
The company has registered with the United States Patent and Trademark Office the service marks ‘Pediatrix Medical Group and Design,’ ‘Obstetrix Medical Group and Design,’ ‘BabySteps,’ the ‘Baby Design,’ ‘iNewborn,’ and ‘NEO Conference and Design,’ among others.
History
The company was founded in 1979. It was incorporated in Florida in 2007. The company was formerly known as MEDNAX, Inc. and changed its name to Pediatrix Medical Group, Inc. in 2022.
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