The Failed “Doc Fix” The Centers for Medicare & Medicaid Services (CMS) released its finalized Medicare Physician Fee Schedule (MPFS) for calendar year (CY) 2025. The finalized fee schedule cut payments to physicians, and Congress declined to step in and mitigate the cuts in its last-minute legislation to fund the federal government for another three months. This article discusses the provisions contained in the MPFS final rule and the failed “doc fix” legislation. On November 1, 2024, the Centers for Medicare & Medicaid Services (CMS) released its finalized Medicare Physician Fee Schedule (MPFS) for calendar year (CY) 2025, aiming “to…
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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 discuss: 1) the regulatory environment of the ASC industry; 2) the reimbursement environment of the ASC industry; 3) the competitive environment of the ASC industry; and 4) the technological environment of the ASC industry. These provide a brief…
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of the Current Marijuana Business (Part II of II) In November of 2018 there are some 28 thousand marijuana/cannabis businesses in operation and employing about 150,000 people in the United States and they manage and control some nine billion dollars in essentially cash revenues. This industry continues to grow. In this second part, the author illustrates the importance of choice of entity, provides an overview of the taxation of a cannabis business, and provides readers a high-level breakdown of the patchwork of state laws.
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of the Current Marijuana Business (Part I of II) In November of 2018, there are some 28,000 marijuana/cannabis businesses in operation, employing about 150,000 people in the U.S., and they manage and control some $9 billion in essentially cash revenues. This industry continues to grow. In this two-part article, the author provides a brief overview of the history of this industry and tax issues CPAs and consultants must know. In the second part of this series, the author illustrates the importance of choice of entity and provides an overview of the state laws governing possession, sales, and distribution of cannabis.
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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 with and valuing healthcare practices. In this article, Mr. Wandtke reviews Volume Two, Professional Practices. See http://www.healthcapital.com/advisersguide.
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Royalty Rates in the Life Sciences are Under Increased Scrutiny. But Has That Caused Rates to Decline? Several medical manufacturers were accused of violating federal kickback statutes. Federal enforcement prompted many companies in the industry to review and revise the terms under which they collaborate with and pay healthcare professionals for contributions of time, know-how, and intellectual property. Ed Gold and the Invotex team examine how this has affected royalty rates.
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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, here writing for the Times’ opinion page. More:
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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…