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Valuation of Ambulatory Surgery Centers

Technology (Part V of V) As noted in the first installment of this five-part series, an ambulatory surgery center (ASC) is a distinct entity that primarily provides outpatient surgical procedures to patients who do not require an overnight stay after the procedure. ASCs typically provide relatively uncomplicated surgical procedures in a non-hospital, outpatient setting, and most ASC cases are non-emergency, ...

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Valuation of Ambulatory Surgery Centers

Regulatory (Part IV of V) As noted in the first installment of this five-part series, an ambulatory surgery center (ASC) is a distinct entity that primarily provides outpatient surgical procedures to patients who do not require an overnight stay after the procedure. ASCs typically provide relatively uncomplicated surgical procedures in a non-hospital, outpatient setting, and most ASC cases are non-emergency ...

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Valuation of Ambulatory Surgery Centers

Reimbursement (Part III of V) As noted in the first installment of this five-part series, an ambulatory surgery center (ASC) is a distinct entity that primarily provides outpatient surgical procedures to patients who do not require an overnight stay after the procedure. The facilities typically provide relatively uncomplicated surgical procedures in a non-hospital, outpatient setting, and most ASC cases are ...

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Valuation of Ambulatory Surgery Centers

Competition (Part II of V) This second installment in this five-part series on the valuation of ASCs will discuss the competitive environment of ASCs, by competitor type. As noted in the first installment of this five-part series, an ambulatory surgery center (ASC) is a distinct entity that primarily provides outpatient surgical procedures to patients who do not require an overnight stay after the procedure ...

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Valuation of Ambulatory Surgery Center

Introduction (Part I of V) Ambulatory surgery centers (ASC) grew dramatically until 2008 and during the growth period provided services previously only available at hospitals. In this five-part series, the authors first discuss the emergence and decline of ASCs, the forces driving growth and contraction, and how the ASC business model differs from that of hospitals. The remaining articles in this series dis ...

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Fair Market Value Considerations for Rural Health Clinics

Technology (Part V of V) Over the past decade, there has been a rapid adoption of technological innovations in the U.S., which has fundamentally changed the healthcare delivery system, improving the quality of patient care, as well as the efficiency of healthcare processes and practices. Research indicates that implementation of healthcare information technology (HIT) may lead to improved efficiency and qua ...

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Fair Market Value Considerations for Rural Health Clinics

Regulatory Issues (Part IV of V) As discussed in the first installment of this five-part series, rural health clinics (RHCs) are statutorily-created entities, established via the Rural Health Clinic Service Act of 1977. These providers face a range of federal and state legal and regulatory constraints, which affect their formation, operation, and transactions. This installment will discuss two important reg ...

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Fair Market Value Considerations for Rural Health Clinics

Reimbursement Environment (Part III of V) The U.S. government is the largest payor of medical costs, through Medicare and Medicaid, and has a strong influence on healthcare reimbursement. In 2017, Medicare and Medicaid accounted for an estimated $705.9 billion and $581.9 billion in healthcare spending, respectively. The prevalence of these public payors in the healthcare marketplace often results in their a ...

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Fair Market Value Considerations

For Rural Health Clinics Competition (Part II of V) As discussed in the first installment of this five-part series regarding Rural Health Clinics (RHCs), the significant proportion of RHCs operating at a loss has led to an overall reduction in the number of RHCs. Despite this decrease, the demand for RHCs continues to rise, limiting access to care for patients in rural communities. This second installment w ...

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Fair Market Value Considerations

for Rural Health Clinics (Part I of V) The first of a five-part series where the authors describe the issues encountered valuing rural health care clinics. This first article discusses fair market value considerations for rural health clinics. Introduction Rural health clinics (RHCs) are specially certified entities that were created in order to increase access to primary care services for patients located ...

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Private Equity Investment in the Healthcare Industry

Private Equity’s Fast and Furious Entry into Healthcare (Part III of III) The third of this three-part series examines why private equity and venture capital firms are targeting the healthcare industry and the issues that they encounter managing their healthcare portfolio. Private equity (PE) and venture capital (VC) firms are attracted by the potential for growth that exists in the healthcare industry; how ...

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Home Health and Hospice Enterprises

Fair Market Value Considerations (Part II of II) The first of this two-part series reviewed the unique value drivers that impact the typical valuation approaches, methods, and techniques that are often utilized in determining the value of these enterprises in the current healthcare delivery system. This second part will discuss the value drivers related to home healthcare and hospice enterprises. Introducti ...

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Home Health and Hospice Enterprises

Fair Market Value Considerations (Part I of II) The valuation of home healthcare and hospice enterprises and services are influenced by certain market forces related to the Four Pillars of Healthcare Valuation, i.e.,: (1) regulatory; (2) reimbursement; (3) competition; and, (4) technology—each of which relates to almost all aspects of the U.S. healthcare delivery system. This first of a two-part series on h ...

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Private Equity Investments in the Healthcare Industry

Introduction: The Fundamentals of Private Equity (Part I of III) Why is private equity becoming increasingly involved in the business of healthcare? How will their involvement affect the delivery of services? This first installment of a three-part series will describe the fundamentals of the private equity industry, in general, and set forth a common terminology that will be utilized throughout the series. ...

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What do Physician Business Owners Think

About the Business of Healthcare Araliya Valuation Consulting (AVC), based in Tampa, FL, surveyed over 1,000 physician business owners to find out their perspective on the current healthcare environment, in a business context. AVC team surveyed several medical specialists, including: dentists, ophthalmologists, psychiatrists and psychologists, family medicine practitioners, chiropractors, podiatrists, physi ...

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Valuation of Ambulatory Surgery Centers

In an Era of Reform: Value Drivers (Part II of II) As stated in Part I of this II-part series, as the demand for healthcare services continues to grow, the site at which these services are performed is experiencing a simultaneous transformation from the inpatient (e.g., hospital) setting to the outpatient setting—e.g., at ambulatory surgery centers (ASCs). This article will review the unique value drivers t ...

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Valuation of Ambulatory Surgery Centers

In an Era of Reform (Part I of II) As demand for healthcare services continues to grow, the site at which these services are performed is experiencing a simultaneous transformation from the inpatient (e.g., hospital) setting to the outpatient setting. This transformation is being driven by factors such as: (1) technological advancements; (2) an increasingly consumer-driven and convenience-driven healthcare ...

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The Due Diligence Imperative

Conclusion (Part Six of a Six-Part Series) The first installment of this six-part series set forth an overview of the due diligence imperative for valuation professionals, in the context of the Four Pillars of Healthcare Value, i.e., Reimbursement, Regulatory, Technology, and Competition. The second through fifth installments reviewed the due diligence process related to the reimbursement, regulatory, compe ...

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A Comprehensive Approach

to Valuation of a Healthcare Practice or Entity A valuation consultant must understand the type of healthcare entity he or she is valuing, the opportunities and risks as discussed above, the potential buyers, the marketplace, and typical valuation multiples for specific types of deals. Extensive research into these areas will lead to a significantly better and more informed valuation. The author discusses t ...

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