You Are Here: Home » Healthcare

OPPS Final Rule Issued by CMS

The Impact on Payment Rate Updates, Hospital Price Transparency, Rural Hospital Designation, Drug Pricing, and Intensive Outpatient Program On November 2, 2023, the Centers for Medicare & Medicaid Services (CMS) released its finalized Outpatient Prospective Payment System (OPPS) for calendar year (CY) 2024. The finalized payment update increases payments to outpatient facilities and finalizes changes to ...

Read more

MPFS Final Rule Cuts Physician Payments

Praise and Patient Access Concerns Raised from the Cuts On November 2, 2023, the Centers for Medicare & Medicaid Services (CMS) released its finalized Medicare Physician Fee Schedule (MPFS) for calendar year (CY) 2024. While the finalized fee schedule cuts payments to physicians, there are a number of other (more positive) provisions in the final rule. An update to the September 2023 article on the prop ...

Read more

CMS Proposes Updates to 2024 Physician Fee Schedule

Stakeholders Welcome and Also Dispute Various Changes On July 13, 2023, the Centers for Medicare & Medicaid Services (CMS) released its proposed Medicare Physician Fee Schedule (MPFS) for calendar year (CY) 2024. In addition to the agency’s suggested cut to physician payments, the proposed rule announced changes in policies for the advancement of health equity, as well as the expansion of access to crit ...

Read more

CMS Proposes Updates to 2024 Medicare Outpatient Prospective Payment System

The Aftermath of the 2022 AHA v. Azar SCOTUS Decision On July 13, 2023, the Centers for Medicare & Medicaid Services (CMS) released the proposed rule for the Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Centers (ASCs) for calendar year (CY) 2024. The agency proposes an increase in payments to all outpatient providers, introduces a new program, and announces their solution to repa ...

Read more

MedPAC Recommends Increasing Hospital and Physician Payments for 2024

Reasons for the Recommendation and Responses On March 15, 2023, the Medicare Payment Advisory Commission (MedPAC) published its annual Report to Congress regarding the status of the Medicare program. Among other areas, the report detailed policy recommendations for the Medicare fee-for-service (FFS) payment systems, the Medicare Advantage (MA) program, and the Medicare prescription drug program (Medicare Pa ...

Read more

The COVID-19 Public Health Emergency Officially Ends

Post May 23, 2023, Developments Regarding Telehealth and Waivers Regardless of whether certain COVID-19 era waivers and flexibilities are made permanent, providers will be hard pressed to move away from what has become common practice over the past three years. A Premier Inc. survey of hospitals and non-acute providers found that 69% of respondents were still leveraging these waivers and flexibilities as of ...

Read more

2022 M&A in Review

Indications for 2023 After a record year in 2021 transactional activity, where healthcare mergers and acquisitions (M&A) were up by 56 percent, the market continued to thrive in 2022. Preliminary results revealed that 2022 M&A deals hit a record high of 2,409 deals; 150 transactions over what was observed in 2021. Despite economic challenges (e.g., rising interest rates and borrowing costs, inflatio ...

Read more

Public Health Emergency Will End in May 2023

COVID-19 Pandemic Deemed Over and Waivers Ending On January 30, 2023, President Joseph Biden announced that the public health emergency (PHE) and national emergency declaration related to the COVID-19 pandemic will finally end on May 11, 2023, after being in place for over three years. This article will discuss the changes that will take place after both declarations cease, and the implications for stakehol ...

Read more

Law Introduced to Stop Medicare Sequestration

Valuation Implications On September 13, 2022, Representatives Ami Berra (D-CA-7) and Larry Bucshon (R-IN-8) introduced the Supporting Medicare Providers Act of 2022 (H.R. 8800), which aims to infuse the Medicare Physician Fee Schedule (MPFS) with a 4.42% funding increase for 2023. With a bipartisan coalition of 12 co-sponsors, the bill would have the practical effect of negating the impending 4.42% cut to t ...

Read more

What Healthcare Provisions are Included in the Inflation Reduction Act?

Beyond Prescription Drug Costs On August 16, 2022, President Joseph Biden signed the Inflation Reduction Act of 2022 (IRA) into law. The broad bill, which covers healthcare, taxes, and climate change, had been passed around Congress in assorted versions with varying support for months, but under the specter of a record 40-year-high inflation rate, congressional Democrats ultimately came together to pass the ...

Read more

Update on 2023 Proposed Healthcare Payment Rules

Valuation Implications Over the past couple of months, the Centers for Medicare & Medicaid Services (CMS) released the proposed rules for several of its payment schedules, indicating the state of healthcare reimbursement for the next year. This article briefly summarizes these proposed payment rules and discusses their significance to healthcare valuation professionals. The U.S. government is the larges ...

Read more

Declining Popularity and Uncertain Outlook for SPACs

A Shake-up in the Evolution of the Healthcare Industry? As covered in a May 2021, NACVA QuickRead article, special purpose acquisition companies (SPACs) began tremendous growth in 2020 and looked to be a new mainstream avenue of investing. Two years later, the growth of SPACs across all industries, including healthcare, has plateaued and appears to be dropping in some industries. This article will examine h ...

Read more

2021 Healthcare M&A in Review

Indications for 2022 After an understandable slowdown in 2020, due to the onset of the COVID-19 pandemic, merger and acquisition (M&A) activity in the healthcare industry accelerated in 2021, and the industry is expected to continue the high number of deals and high deal volume in 2022. This article will review the U.S. healthcare industry’s M&A activity in 2021 and discuss what these trends may mea ...

Read more

Study Finds Most Physician Plans to be Productivity-Based

RAND Corporation 2022 Study Published in JAMA A study conducted by the RAND Corporation and published in the January 2022 issue of the Journal of the American Medical Association (JAMA) seeking to determine whether health systems primarily incentivize volume or value in their physician compensation models found that almost all physicians are still compensated through a volume-based model that rewards produc ...

Read more

Update on 2022 Healthcare Payment Rules

Center for Medicare & Medicaid Publishes Proposed and Final Rules on Medical Reimbursement Rates The U.S. government is the largest payor of medical costs, through Medicare and Medicaid, and consequently has a strong influence on physician reimbursement. The prevalence of these public payors in the healthcare marketplace often results in their acting as a price setter and being used as a benchmark for p ...

Read more

Recent Settlement Highlights Importance of FMV Physician Compensation

This article discusses the recent settlement of National Spine and Pain Center signed with the U.S. Department of Justice and provides the basis to discuss the importance of obtaining an opinion regarding the FMV physician compensation. On August 6, 2021, the U.S. Department of Justice announced that it had reached a settlement with National Spine and Pain Center, LLC (NSPC), a Maryland physician management ...

Read more

Are Disappointing Healthcare PE Deals a Sign to Come?

Analysis of Deal Stats Pre- and Post-COVID-19 This article will review PE activity generally, and in the healthcare industry, during the COVID-19 pandemic, and discuss what is expected for the remainder of 2021, as the economy evolves in response to a post-pandemic America. The involvement of private equity (PE) in the healthcare industry in the first quarter of 2021 disappointed investors after the number ...

Read more

StraightTalk Webinar Series–April 29, 2021

Healthcare Valuation 2021 Update The COVID-19 pandemic has impacted nearly all businesses and is poised to continue to do so through at least the end of 2021. In healthcare, there has been additional issues due to the industry’s unique position at the crossroads of the front line of care and policy response. As of January 19, 2021, important updates have gone into effect concerning the two most significant ...

Read more

What is Behind the Soaring Popularity of Healthcare SPACs?

An Alternative to the IPO The popularity of special purpose acquisition companies (SPACs) has been soaring in recent years. There are 35 times as many SPACs operating in 2020 as in 2010, and these companies seem poised for greater exponential growth in the future. While many experts are predicting a continued, rapid increase in SPACs, this article will also examine the factors that could possibly slow SPAC ...

Read more

Changes to Stark Law’s Foundational Terminology

Valuation Implications On November 20, 2020, the Centers for Medicare & Medicaid Services (CMS) issued a final rule to modernize and clarify the Stark Law. The Stark Law governs those physicians (or their immediate family members) who have a financial relationship with an entity, and prohibits those individuals from making Medicare referrals to those entities for the provision of designated health servi ...

Read more

©2024 NACVA and the Consultants' Training Institute • Toll-Free (800) 677-2009 • 1218 East 7800 South, Suite 301, Sandy, UT 84094 USA

event themes - theme rewards

Scroll to top
G-MZGY5C5SX1
lw