• Healthcare - QuickRead Top Story

    2026 MPFS Final Rule Increases Physician Payments: Physician Groups Express Concern Over Efficiency Adjustment and New ASM Model, and Push Towards a Value-Based Model

    January 21, 2026

    On October 31, 2025, the Centers for Medicare & Medicaid Services released its finalized Medicare Physician Fee Schedule for calendar year 2026. This article discusses the provisions contained in the MPFS final rule, as well as stakeholder reactions. On October 31, 2025, the Centers for Medicare & Medicaid Services (CMS) released its finalized Medicare Physician Fee Schedule (MPFS) for calendar year (CY) 2026, which “advances primary care management through improved quality measures, reduces waste and unnecessary use of skin substitutes, and introduces a new payment model focused on improving care for chronic disease management.”[1] This article discusses the provisions contained…

  • Healthcare - QuickRead Top Story

    2026 Proposed Physician Fee Schedule: Increases Payments

    October 15, 2025

    Earlier this year, the CMS released its proposed MPFS for 2026. In addition to the agency’s suggested increase to physician payments, the proposed rule also announces a new payment model and more telehealth flexibilities. This article summarizes the proposed fee schedule changes. On July 14, 2025, the Centers for Medicare and Medicaid Services (CMS) released its proposed Medicare Physician Fee Schedule (MPFS) for calendar year (CY) 2026. In addition to the agency’s suggested increase to physician payments, the proposed rule also announces a new payment model and more telehealth flexibilities.[1] According to CMS, the “proposed rule is one of several…

  • Healthcare - QuickRead Top Story

    2025 Proposed Physician Payment Rule

    August 7, 2024

    Valuation Implications The U.S. government is the largest payor of medical costs, through Medicare and Medicaid, and consequently has a strong influence on reimbursement to healthcare providers. The 2025 proposed fee changes are significant. This article focuses on the proposed fee changes and how these changes may affect valuations of healthcare practices. The U.S. government is the largest payor of medical costs, through Medicare and Medicaid, and consequently has a strong influence on reimbursement to healthcare providers. The prevalence of these public payors in the healthcare marketplace often results in their acting as a price setter and being used as…

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    The Due Diligence Imperative

    March 21, 2018

    Healthcare Reimbursement Environment, Part II of VI In the January/February 2018 issue of The Value Examiner, the author provides readers with an overview of the U.S. healthcare reimbursement system and details the due diligence process as it relates to reimbursement. This brief article is an excerpt, which is part of the series on healthcare reimbursement, where the author provides more in-depth explanation of the due diligence process.

  • Healthcare - QuickRead Featured

    Book Review—The Adviser’s Guide to Healthcare, Second Edition

    February 17, 2016

    An Era of Reform—The Four Pillars, Volumes I and II Since 1950, the U.S. population has doubled from just more than 152 million to an estimated 320 million. In this same period, the average life expectancy has increased from approximately 68 years to over 78 years. This increased life expectancy and accompanying rise in the incidence and prevalence of diseases, conditions, and injuries is driving demand for healthcare services. Cost concerns and a rapidly evolving regulatory and legal environment have created new opportunities in healthcare consultancy for large and small firms. This two-volume set is designed to serve as a…