We also provide consulting services in areas such as Emergency Department design, electronic medical record systems, urgent care start-up and management, on-call panels and more.
A Brief History
Formed initially with the establishment of an Emergency Medicine program in 2000 at five large Emergency Departments (EDs) in Western New York, Exigence quickly became a national leader providing comprehensive solutions for hospitals and communities. We manage EDs ranging in volume from 12,000 visits per year to a hospital system with over 180,000 visits per year. We have provided emergency medicine services in six states in the Southwest, Southeast and Northeast regions of the country. Currently, we serve over 600,000 patients each year.
In 2005, Exigence opened its first urgent care center and occupational medicine program, seizing the tremendous opportunity to meet patient and community needs. We now partner with physicians and hospital administrators across the country to design, build and manage high-volume urgent care/occupational medicine centers that provide excellent medical care in a professional, courteous, compassionate and timely manner.
Exigence began a Hospitalist staffing, management and consulting program in 2007 to meet the growing need for seamless care from the ED to inpatient, and compliance with Core Measures. Today, we provide continuous, coordinated and compassionate patient care through numerous Hospitalist programs. We provide customized solutions for our hospitals partners including rapid response programs and specialty units such as geriatrics, neurosurgery and skilled nursing.
Exigence has earned a reputation for creating synergy across business lines. Our comprehensive approach results in:
- Improved and consistent delivery of quality care by qualified providers
- Achievement of key organizational performance benchmarks
- Reduced risk potential
- Improved patient satisfaction
- Improved practice integration
- Maximized financial outcomes
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Gregory F. Daniel, MD, MBA
Chief Executive Officer
Dr. Gregory Daniel brings a unique mix of skill, experience, and knowledge to the role of Exigence CEO. In addition to more than 20 years of experience as an emergency medicine physician, Dr. Daniel also has a keen business sense fostered with both real-life experience and an MBA degree. It is the combination of those skills that built the successful model that is Exigence.
Since he founded the organization in 2000, Dr. Daniel has used this model to provide a vision for the growth of the company. Dr. Daniel has personally directed a number of development efforts including successful contract negotiations with HMOs, establishment and implementation of operational policies and procedures, and the design and implementation of a partnership tract for Exigence professionals.
During the evolution of these efforts, continuous improvements to the company’s financial operations and physician and staff performance have blossomed. He has introduced numerous innovations and efficiencies, including identifying strategic expansion opportunities and the introduction of incentive structures with specific criteria for attainment and measurement.
With Dr. Daniel’s guidance, Exigence has expanded its footprint, further enhanced its reputation, and is known for strong management and fiscal responsibility. With attention to detail and an eye on the future, he has stressed the importance of innovation within the company to meet emerging client needs. The Buffalo Niagara Partnership honored Exigence and Dr. Daniel with their New Minority Business of the Year Award in 2006.
Dr. Daniel earned his doctorate of medicine and a bachelor’s degree in biochemistry from the University of Wisconsin, Madison, and is licensed to practice medicine in eight states. He earned his MBA from the University of California, Irvine, and was named “Best Leader” for his class. Dr. Daniel received the 2005 Business Leadership Buffalo Niagara award.
He is a member of the board of governors for the Catholic Independent Practice Association (IPA) of Western New York, where he serves on the negotiation and compensation and utilization committees. He’s held roles in the past with the U.S. Air Force Reserves and the U.S. Amateur Boxing Federation.
Frank Lee, MD, FAAEM
Vice President of Medical Affairs
Making the connection between administration and the clinical aspects of our organization is where Dr. Frank Lee, our vice president of medical affairs, excels. Providing oversight of all clinical aspects within Exigence makes him a key figure in helping shape our future direction.
Dr. Lee quickly made a name for himself both within and outside of our organization. He was named a full general partner in 2002; three years later, as an Exigence regional director, he provided clinical and administrative expertise for our western region connections. He was named vice president in 2006.
He excels at identifying process improvement opportunities, analysis of processes, and has thorough knowledge in the implementation of electronic medical records systems.
Board certified in emergency medicine, Dr. Lee was named chair of the emergency department at St. Joseph Hospital in 2002, a position he maintains today. He spearheaded an initiative at St. Joseph’s called Project Renaissance, which has been met with high praise in the medical community. It featured the implementation of a new electronic medical records system, the first for a private ER in the region. He also led the design of the hospital’s new emergency department, which won several design element awards. The success of that effort has been measured in improvements in the patient length of stay, patient satisfaction, and increased volume.
St. Joseph Hospital recently honored Dr. Lee with the Caritas Award that recognizes outstanding service and dedication along with support to the community. He also serves on the hospital foundation’s board of directors.
Dr. Lee is a frequent lecturer to medical staffs and organizations on a range of topics related to emergency medicine. He is also certified in ultrasound. Dr. Lee continues to practice emergency medicine at St. Joseph Hospital, Mercy Hospital, Sisters of Charity Hospital, and urgent care facilities. He is also an assistant clinical professor.
He completed his residency at the University at Buffalo’s School of Medicine, earning his medical doctorate along with a bachelor’s degree in biological sciences from the University at Buffalo.
Irving Levy, CPA
Chief Financial Officer
Bringing more than 20 years of experience to Exigence along with a thorough knowledge of healthcare practice management, Irv Levy serves as Chief Financial Officer, a role he has held since 2005.
His focus on growing the business through successful financial operations returns strong results for our organization and our clients. Mr. Levy is responsible for all accounting and reporting practices, billing and collections, human resources and recruitment of new physicians.
Mr. Levy’s keen ability to adapt to the ever-changing business environment and his expertise related to issues in healthcare practice management and administration gives Exigence a CFO who knows what it takes to continuously improve our operations and expand our business. In fact, his reputation in the industry has made him a popular consultant and sought-after speaker on physician practice management issues. He regularly conducts seminars locally and nationwide for the Medical Group Management Association.
His career path and experience has provided Mr. Levy with a strong background in physician practice management. He has been involved with projects involving medical practice profit enhancement, collections enhancements and the structure, sale and acquisition of medical practices.
He joined Exigence after spending 20 years at the regional accounting firm Freed Maxick & Battaglia. He was a managing director in the auditing and accounting department, chaired its physician practice niche, and built its business advisory services division from the ground up. That division accounted for 10 percent of the firm’s volume. Mr. Levy spent 13 years as a tax consultant where he managed federal, state and international tax issues for the firm.
During that time he was also a consultant for Exigence where he assisted with building our unique and successful membership model. Both a certified public accountant and a certified financial planner, he began his career at a small accounting firm in Houston, Texas.
Mr. Levy is a graduate of Canisius College. He is a member of the Healthcare Financial Management Association, the American Institute of Certified Public Accountants and the New York State Society of Certified Public Accountants.
Joseph DiVincenzo, JD
Corporate Counsel
Joseph DiVincenzo is one of the newest members of the leadership team at Exigence. He joined us in 2007 and plays a key role in expanding the business and helping to manage our daily operations.
As corporate counsel, he is primarily responsible for the negotiation and drafting of contracts for Exigence across a number of spectrums. He manages this process for personnel within our organization, doctors who join our team, hospitals with whom we work and insurance companies. It is a pivotal position requiring a broad base of knowledge and skill.
Mr. DiVincenzo’s role also encompasses our corporate governance, providing oversight to our entities and others with whom we are contracted. Additionally, he possesses a background in accounting which allows him to examine business contracts and operations from both a legal and fiscal standpoint.
Mr. DiVincenzo specializes in contract law, healthcare, litigation and intellectual property. He has argued cases successfully in New York State and throughout the country. He was successful in an intellectual property trademark case, the results of which have been published multiple times in various journals. In addition to being admitted to practicing law in New York State, Mr. DiVincenzo is also admitted to practice in various federal courts across the U.S.
Prior to taking on this role at Exigence, he worked as counsel for Bausch & Lomb in Rochester, NY. He serviced their global manufacturing and purchasing sector, which deals with operations in both the United States and in Europe. He provided oversight on the drafting and review of contracts, negotiations with prospective business partners and corporate governance.
Mr. DiVincenzo has also worked for the Buffalo firm of Hodgson Russ, where he practiced in their business litigation group and he worked as an accountant with Price Waterhouse. In addition, he previously was a member of the Erie County Board of Ethics.
He earned his law degree from the University at Buffalo. He formerly served as the assistant executive editor of The Buffalo Law Review. In addition, Mr. DiVincenzo received a Special Services Award from the Federal Western District of New York Bench and Bar and a writing award from the National Judges Association.
