Structuring Competitive Physician Compensation Models Healthcare financial executives need to understand valuation methodology to ensure legal and regulatory compliance. Specifically, when developing and reviewing their physician compensation programs, healthcare organizations should understand the market data, test outcomes of incentive plans for fair market value, and check total compensation for fair market value and reasonableness.
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Metropolitan Corporate Counsel interviews Monte I. Dube, Partner, and Elizabeth M. Mills, Senior Counsel, of Proskauer’s Health Care Department in Chicago. Excerpts: What are the current trends in M&A within the healthcare industry? Dube: Increasingly and for multiple reasons, U.S. hospitals and healthcare systems of all types are looking for potential partnerships or affiliations. Financially distressed organizations are seeking capital and expertise to help them weather the storm, and governmental hospitals are looking to privatize, often for the purpose of monetizing assets or balancing the budget. We’re also seeing strong and vibrant hospitals and healthcare systems conclude that they need…
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Far fewer small employers claimed the health insurance tax credit for small businesses in the health care reform law than were eligible, according to a new government report. So reports Michael Cohn at Accounting Today: The Small Employer Health Insurance Tax Credit was included in the Patient Protection and Affordable Care Act of 2010 as a way to help small businesses pay for the cost of health insurance. But the complexities of claiming the credit contributed to a relatively low popularity for the tax credit among both small businesses and their tax preparers. While 170,300 small employers claimed the…
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Americans with employer-sponsored insurance had fewer hospital stays and visited outpatient clinics less frequently from 2009 to 2010, but prices for inpatient and outpatient care rose by about 10% or more, according to a Health Care Cost Institute analysis of more than 3 billion claims for medical care. The average price of generic drugs fell over the same period, but prices for brand-name drugs rose, the analysis found. The Washington Post opines that “Data Trove May Shed Light on Healthcare Uncertainties”: How much do hospitals and doctors actually charge insurers for their services? How much and which of those services…
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Becker’s ASC Review, a site that provides Practical Business, Legal, and Clinical Guidance for Ambulatory Surgery Centers, recently published an article on benchmarks that ASC administrators often neglect. These are important benchmarks not just for ASCs, but for any physician executives, healthcare practice managers, and the valuators and consultants they work and plan with. An excerpt: Chance Sherer, manager with VMG Health, discusses several benchmarks that ASC administrators often forget to include in their data collection efforts. Q: Could you discuss several benchmarks that surgery center leaders overlook or under-use in their benchmarking efforts? Chance Sherer: All ASCs are different. They…
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Medical Practice Benchmarking, Financial Performance, and Quality Care Benchmarking physician practices is an important way to assess practice value by comparing a practice’s norms to peer practices in similar specialties or in the same geographic reason. Most physician practices, according to experts, can benefit substantially from benchmarking. Moreover, it’s pretty easy to do! Here David Fein discusses what he’s discovered about the process and its benefits.
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What Data Valuators Need from Physician Practices—and Why! Physician practices are increasingly undergoing consolidation. Often that means being acquired by a hospital, and a prerequisite of being acquired is having a valuation performed by an independent, third-party valuator. Here’s information on the sort of data that valuators need (and that physician practices should be collecting today), an explanation of why valuators need that information, and how they use it.
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New Medical Billing-Code Provides Precision; Nine Codes for Macaw Mishaps Today, hospitals and doctors use a system of about 18,000 codes to describe medical services in bills they send to insurers, Anna Wilde Matthews reported in the Wall Street Journal not too long ago. Apparently, that doesn’t allow for quite enough nuance.: A new federally mandated version will expand the number to around 140,000—adding codes that describe precisely what bone was broken, or which artery is receiving a stent. It will also have a code for recording that a patient’s injury occurred in a chicken coop. (See code.) Indeed, health plans…
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Three Practice Management Trends for 2012 For the third year, the MGMA has published the State of Medical Practice in MGMA Connexion. It’s an overview of issues and industry perspectives that will shape medical practice this year. The Association collected information from healthcare professionals about the ways in which EHRs increase revenue, as well as what affects your compensation and practice collections, among others. Here are three of the 12 practice management trends: 1. Collections vs. compensation: Setting matters Your practice’s ownership may directly affect your physicians’ pay. Collections for professional charges (i.e., patient visits, procedures) are higher in physician-owned…
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Practice Management Companies Look to ACOs for Growth Physician practice management companies are forging ahead with expansion plans into new areas of hospital-based medicine as they position themselves to participate in accountable care organizations and other aspects of health system reform, reports Victoria Stagg Elliott at American Medical News. The companies are not buying primary care and other outpatient practices right now, although they are expanding into areas of hospital-based medicine that have not traditionally been their focus. This is in part to improve their ability to reduce readmissions and receive bonuses for improving quality and decreasing costs within an…
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Adjusting, More M.D.’s Add M.B.A. Under heavy pressure from government regulators and insurance companies, more and more physicians across the country are learning to think like entrepreneurs, reports Milt Freudenheim at the New York Times: “All physicians need some kind of business training,” she said. “For example, some physicians with large research grants don’t know how to manage the money.” As for the nation’s troubled health system, “we are not running the business side very well,” Dr. Chandler said. “Part of the problem is we don’t have physicians sufficiently involved. They have a fuller insight about what is needed.” “Cue…
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Medical Group Management Association (MGMA) Survey Reports Top Challenges MGMA members were asked to identify top management challenges, and the results of the 2011 survey are in: See what MGMA members had to say about the results in the July MGMA Connexion. Compare this year’s results with previous years. Read the story behind the numbers and see how challenges are ranked by applicability.
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The Accountable Care Fiasco That’s what the Wall Street Journal calls the state of developing real-world guidelines for “the Accountable Care Organizations that are supposed to be the crown jewel of cost-saving reform.” The theory for ACOs, as they’re known, is that hospitals, primary-care doctors and specialists will work more efficiently in teams, like at the Mayo Clinic and other top U.S. hospitals. ACOs are meant to fix health care’s too-many-cooks predicament. The average senior on Medicare sees two physicians and five specialists, 13 on average for those with chronic illnesses. Most likely, those doctors aren’t coordinating patient care. This…