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, noninfected, and elective. This fourth installment will discuss the regulatory environment in which ASCs operate. [su_pullquote align=”right”]Resources: Valuation of Ambulatory Surgery Centers—Introduction (Part I of V) Valuation of Ambulatory Surgery Centers—Competition (Part II of V) Valuation of Ambulatory Surgery Centers—Reimbursement…
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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. [su_pullquote align=”right”]Resources:Valuation of Ambulatory Surgery Centers—Introduction (Part I of V)[/su_pullquote] 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.[1] The facilities typically provide relatively uncomplicated surgical procedures in a non-hospital setting, and most ASC cases are non-emergency, non-infected, and elective.[2] ASCs compete in an increasingly…
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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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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; however, significant barriers also exist that may limit the expansion of PE and VC in healthcare, including the requirement for specialized knowledge to understand the operations of a clinical services provider, healthcare industry specific regulatory issues, latent long…
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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 home health and hospice enterprises will review 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. Introduction…
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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 delivery environment; (3) pressure from payors; (4) patient demand; and (5) the entrance and diversification of new and different outpatient enterprises. One such example of a growing subset of outpatient enterprises includes ambulatory surgery centers (ASCs). ASCs can be affiliated with…
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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 the different buyers, motivations, and trends.
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Competition (Part Four of a Six-Part Series) The first part of this six-part series provided an overview of the due diligence imperative for valuation professionals, in the context of the Four Pillars of Healthcare Value, i.e., Reimbursement, Regulatory, Technological, and Competitive environments. The second and third installments reviewed the due diligence process related to the reimbursement and regulatory environments, respectively. This fourth installment will review the due diligence process as it relates to competition in the healthcare industry.
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Healthcare Regulatory Environment (Part III of VI) In the March/April 2018 issue of The Value Examiner, the author underscores the importance of undertaking rigorous due diligence to better understand the regulatory burdens and operational risks notwithstanding efforts to repeal and replace.
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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 orthopedic surgeons. While these factors may indicate relatively higher economic value, they do not necessarily correlate with business longevity. Here’s more: