Physician Groups Express Concern Over Efficiency Adjustment and New ASM Model, and Push Towards a Value-Based Model 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…
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An Overview of the Physician Compensation Surveys Beginning in late May each year, numerous industry normative benchmark physician production and compensation surveys begin publishing the most recent year’s reports. When consulting benchmarking survey data for assessing physician compensation arrangements for FMV, it is important to understand and critically evaluate the quality of the data. This article provides and overview of these surveys. It is the most wonderful time of the year—Survey Season! Beginning in late May each year, numerous industry normative benchmark physician production and compensation surveys begin publishing the most recent year’s reports. These healthcare and specialty specific surveys…
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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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Patchwork Approach Continues in Congress On March 9, 2024, President Biden signed into law a $460 billion spending package to continue funding the federal government for the remainder of the 2024 fiscal year. Contained within the spending package was legislation to cut in half the 2024 Medicare physician payment update of approximately -3.4%. This article discusses the payment update, other healthcare provisions contained in the bipartisan spending bills, and responses from stakeholders. On March 9, 2024, President Biden signed into law a $460 billion spending package to continue funding the federal government for the remainder of the 2024 fiscal year.[1]…
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The Structure of Physician Compensation The structure of compensation for hospital/health-system employed physicians is a constant struggle for administrators with the rise of physician practice acquisitions and subsequent employment of these physicians. Based on estimates from Jackson Healthcare1, approximately 35 percent of all physicians are employed by a hospital/health-system. As a result, the issue of how to structure and benchmark physician compensation has emerged as a leading topic among both valuators and hospital/health-system administrators. In this article, the author discusses the pros and cons of the work RVU compensation model, the most popular model.
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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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Medical practice sale pitfalls There are several issues to be keenly aware of when valuing a medical practice, including sources used to evaluate the efficiency of a practice and the need to determine what a benchmark is for the doctor in the practice. It is imperative to do a common sizing calculation when comparing a practice’s performance with national practice data for the medical specialty.
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Few Business Owners Seem to Even Know How to Make a Good Guess at What Their Business is Worth. NY Times Introduces Technology to Help—and Certified Advisers Provide Extra Value. Mark Cohen, at The New York Times Small Business Guide, reports: “At 53, Joe Ritz is old enough to remember a time when many of the classic cars that now pull into his specialized repair shop were new. “It’s one field where it pays to be a senior citizen,” he said. It’s Critical for a Business Owner to Know the Value of His Business; Here are Tips on Technology, Advisors,…
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Tips Medical Professionals Can Use to Face the Public with Confidence Sue Jacques at Physicians Practice reports: Being a skilled medical professional doesn’t necessarily mean that you’re comfortable speaking in public, especially when it comes to talking to a group of peers. If the mere thought of addressing even a small audience causes your knees to knock, you’re not alone. This universal anxiety is provoked by a number of factors, including lack of experience, poor preparation, and discomfort being the center of attention. Effective verbal communication is essential for personal and professional success, yet getting your messages across clearly can…
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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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The Most Critical Challenges Confronting Medical Practices Recently, the Medical Group Management Association (MGMA) published results of its member survey and listed the top challenges facing physician practices today. Reed Tinsley recaps results. Here are critical factors physician executives should focus on to control costs, build incentives, ease management, and strengthen growth.
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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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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.