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.
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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.
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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.
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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.
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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 IRS. The news was reported by Huffington Post, CNS News, Catholic News, Investment Watch, Economonitor, Naked Capitalism, Investor Village, and more. The Journal of Accountancy offered detailed analysis of the new regulations, and NPR weighed in…
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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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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 payers to curb health spending. More:
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Many Physicians Find Personalized Service is Increasingly Popular Among Patients Elizabth O’Brien at CBS Marketwatch writes that plenty of baby boomers have done the math on so-called “concierge” medicine (also known as “boutique,” “personalized” or “private physician” practices) and deemed the investment worthy. In the typical concierge experience, a primary-care doctor accepts insurance for routine services but also charges a non-reimbursable fee that pays for amenities like 24/7 access to the doctor, same-day appointments, longer appointment times and a greater degree of personalized attention. The annual fee for such practices currently averages about $1,800. More:
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2013 California Filings: Aetna: 22 percent. Anthem Blue Cross: 26 percent. Blue Shield of California: 20 percent. Reed Abelson at the New York Times reported last week that health insurance companies across the country are seeking and winning double-digit increases in premiums for some customers, even though one of the biggest objectives of the Obama administration’s health care law was to stem the rapid rise in insurance costs for consumers. More:
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Alternatives to Hospital Employment Include Solo ‘Micropractices,’ Patient-Centered Medical Homes, and Direct-to-Pay Practices Andy Robeznieks at Modern Physician reports that medical practice innovation—including the use of technology to increase efficiency and reduce overhead—is what “holds the key to private practice being a viable alternative to salaried employment,” according to a new report from the Physicians Foundation (PDF). The 70-page report, titled The Future of Medical Practice: Creating Options for Practicing Physicians to Control Their Professional Destiny, was written by Jeff Goldsmith, associate professor of public health sciences at the University of Virginia, who was No. 77 on Modern Healthcare’s 100 Most Powerful People…
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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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Congressional Democrats have proposed financing student-loan legislation by expanding payroll taxes on subchapter S corporations and partnerships. The bill would levy Social Security and Medicare taxes on all business income if the firm is engaged in professional services, such as investment advice, or if 75% or more of the gross income of the firm is attributable to three or fewer shareholders. Investment News’ Mark Schoeff Jr. reports that in Washington parlance, the phrase “pay for” has become a noun, “payfor.” This term trends during the legislative process, as lawmakers seek “payfors” to offset spending or tax cuts contained in bills.…
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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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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…