Reimbursements from insurers, made to healthcare facilities for the care they administer, are an essential part of the valuation of hospitals, clinics, outpatient care centers and other facilities. As if that exchange wasn’t complicated enough, it’s about to go through another transition that very well may impact the valuation of all healthcare institutions. According to a new white paper released by ...

A standard distinct from the fair market value standard The fair market value is distinct from the commercial reasonableness standard. The article highlights how these standards are applied in a healthcare transaction and why it is important to distinguish these standards. ...

Compensation for PCPs is increasing The increasing supply shortage of primary care physicians (PCPs) will have a significant impact on physician compensation. In turn; this will have an equally powerful effect on the valuation of PCP practices. ...

Four things valuators should know about medical claims and coding In this second installment of his review of medical claims coding, Mr. Moffatt sets forth his final two examples that explain the unique circumstances of the medical practice revenue cycle that affect cash flow and how they relate to the valuation of a medical practice. Part 1 of this article was published on March 4, 2014. ...

While mergers and acquisitions within the healthcare sector are expected to grow this year, the bulk of the deals will likely involve targets such as large, outpatient care centers and allied healthcare facilities, as opposed to large in-patient hospitals. This analysis comes as part of a white paper recently released by Ponder & Co. Also included were projections that nonprofit institutions will be the ...

Four things valuators should know about medical claims and coding While all valuators need to be able to cite specific factors considered in the determination of fair market value, many times the measures selected could be applied to a variety of industries. In this first of a two-part series, Jeffry Moffatt examines why revenue is most often a primary area of interest for valuation, because without revenue ...

Continued consolidations among healthcare providers and suppliers  David Jasmund examines the effect the Affordable Care Act (ACA) is having on mergers and acquisitions across the healthcare service and supply sector. Using Third Quarter data, Jasmund displays where the opportunities and challenges are occurring within the overall industry. ...

How the ACA impacts the valuation of physician-owned hospitals Nick Janiga and David Walline of HealthCare Appraisers, Inc. (HAI) examine how the Affordable Care Act (ACA) affects the valuation of physician-owned hospitals and what the future holds for the 240 such medical institutions across the country. ...

Healthcare consulting in an era of reform Part 2 In Part 1 of this article, the impact of healthcare reform on the opportunities for healthcare consulting was discussed.  In Part 2, methods utilized by healthcare consultants, as well as the phases of a typical healthcare consulting engagement, are discussed. ...

Value metrics and capital formation Robert Cimasi serves as chief executive officer of HEALTH CAPITAL CONSULTANTS (HCC). Mr. Cimasi’s firm is a nationally recognized healthcare financial and economic consulting agnecy headquartered in St. Louis, MO, serving clients in 49 states since 1993. He is author of a three-volume set that offers a comprehensive reference guide to the factors involved in consulting wi ...

Medical practice sale pitfalls There are several issues to be keenly aware of when valuing a medical practice, including sources used to evaluate the efficiency of a practice and the need to determine what a benchmark is for the doctor in the practice. It is imperative to do a common sizing calculation when comparing a practice’s performance with national practice data for the medical specialty. ...

Healthcare revenue planning challenges Beware of valuing a healthcare practice based on 2012 revenue. Reimbursement rates are lower in 2013, and penalties are being assigned by Medicare. This could further reduce a healthcare practice's value. ...

How much is that receivable really worth? Valuing receivables in a medical practice is never simply a matter of analyzing an aged receivables report. A number of factors must be considered to accurately value what could easily be the largest asset of the practice. ...

Changes in the capital markets utilized in financing healthcare transactions have transformed the way that the healthcare providers and enterprises operate within the current transactional marketplace, explains Robert James Cimasi.  These changes, particularly in recent years following the “Great Recession,”  relate to both the availability of capital sources and the types of financial instruments used.  As ...

ASCs That Have CON Protection Have Higher Value—But Less Longevity.   Todd Mello, Partner and Co-founder of HealthCare Appraisers, and Nicholas Newsad, Senior Associate at HealthCare Appraisers, opine in ASC Review that many ambulatory surgical center operators perceive increased economic value for those centers with certificate of need protection, multiple practice specialties, and the participation of ort ...

The Most Critical Challenges Confronting Medical Practices Physician practices face a common set of challenges today, and Reed Tinsley explains key issues that practice owners, valuators, and financial consultants should focus on together in order to control costs, build incentives, ease management, and strengthen growth. ...

Physicians Practices are Undergoing Consolidation. Most Often, Practices are Acquired by Hospitals—and a Prerequisite to Acquisition by a Hospital is Having a Practice Valuation Performed. Here’s Why. Physician practices are increasingly undergoing consolidation, and any acquisition requires a valuation performed by an independent third-party valuator. Here’s the low down on what valuators need and why they ...

Details Found in IRS Explanation Issued Wednesday; $20,000 Figure Based on a Family of Four.   In a final regulation issued Wednesday, January 30, 2013, the Internal Revenue Service (IRS) assumed that under Obamacare the cheapest health insurance plan available in 2016 for a family will cost $20,000 for the year.   Under Obamacare, Americans will be required to buy health insurance or pay a penalty to the I ...

Pay-for-Performance Provisions are a "Triumph of Theory Over Experience," Writes Bill Keller in "Carrots for Doctors."    "Pay for performance, or P4P in the jargon, is embraced by right and left. It has long been the favorite egghead prescription for our absurdly overpriced, underperforming health care system. The logic  . . .  If only it worked," writes former New York Times executive editor Bill Keller, ...

A Growing Willingness to Adopt a Largely Untested Payment Model Amid Increased Pressure to Curb Spending Melanie Evans at Modern Physician reports that two large Texas health systems with Medicare accountable care contracts are among the latest to enter into commercial ACOs in deals that suggest a growing willingness to adopt the largely untested payment model amid increasing pressure on providers and payer ...