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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CBO: Partial Repeal of ACA Could Lead to 18M People Losing Insurance Some 18 million people could lose health insurance in the first year after a partial repeal of the Affordable Care Act, and the number could grow to 32 million by 2026, according to a Congressional Budget Office report. However, Sen. Orrin Hatch, R-Utah, said the analysis represented “a one-sided hypothetical scenario” that did not account for reforms lawmakers could implement. To read the full article in The New York Times, click: Health Law Repeal Could Cost 18 Million Their Insurance, Study Finds.
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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…
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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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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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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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Some Schools Cut Hours of Hard-Pressed Adjuncts to Avoid Rules on Insurance Mark Peters and Douglas Belkin at the Wall Street Journal report that the federal health-care overhaul is prompting some colleges and universities to cut the hours of adjunct professors, renewing a debate about the pay and benefits of these freelance instructors who handle a significant share of teaching at U.S. higher-education institutions:
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Ahead of the new health-care law, small firms worry about crossing the crucial 50-person threshold — and about rising premium rates Emily Maltby at the WSJ Law blog reports on increasing concerns about the forthcoming healthcare laws among small business owners. This seems to be a prominent issue and concern among small business owners, and has been noted in most every major media outlet in recent weeks, from the New York Times to Forbes, CNN, US News & World Report, FoxNews, The Economist, The Hill, the Washington Post, and 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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Health Costs on His Mind, Small Factory Owner Looks for Ways to Cope With New Law Emily Maltby and Sarah E. Needleman at The Wall Street Journal talk with a small business owner outside of Chicago who’s considering ways to manage growth, preserve profit, and comply with the new healthcare law. Automation Systems, with with sales of about $1.6 million for 2012, currently employs 40 full-time workers, mostly low-paid employees who monitor the factory equipment. If sales were to continue to rise, the plant could, conceivably, employ 50 full-time workers in 2014. Under the new health-care law, the Affordable Care Act,…
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Spotlight On Payment Reform, Alternative Care Models, and Physician Employment Agreements Debra Beaulieu at Fierce Practice Management weighs in with Top 10 Physician Practice Trends to watch in 2013, a year that will not only be a watershed for the U.S. healthcare system, but, for many physician practices, a pivotal one professionally—where the’ ability to adapt and evolve may make the difference for many physicians between folding and thriving in a post-health-reform world. Here’s what Ms. Beaulieu foresees as key trends:
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CBO Details Penalties For Being Uninsured Under The Patient Protection And Affordable Care Act The non-partisan Congressional Budget Office recently reported an estimated six million people would be subject to the Obamacare tax, approximating $7 billion in taxes in 2016 with each of the 6 million people paying at least $695.
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Booming Demand for Nurses and Physician Assistants; Huge Need for Primary-Care Physicians An estimated 30 million people will gain insurance as a result of the Affordable Care Act, asserts Aubrey Westgate at Physicians Practice. At the same time, the Association of American Medical Colleges anticipates a shortfall of 45,000 primary-care physicians and 46,000 specialists in the coming decade. More: “We’ve seen [demand for nurse practitioners (NPs) and physician assistants (PAs)] steadily climbing throughout the year and we don’t anticipate it changing or flattening off any time soon,” Tricia Pattee, director of product management at HealtheCareers Network, told Physicians Practice. “This is due to…
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The Big Picture: Medicaid Impact, Patient Demand, Physician Pay, and More. Physicians Practice, a leading practice management resource, has examined the implications of the historic Supreme Court healthcare decision. Eschewing opinion about John Roberts or the impact on insurance company stock prices, the coverage helps physicians understand what it means for them. Offering commentary as well as analyzing the impact on practicing physicians, highlights from its analysis include:
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Mandate Survives as a Tax. Limits on How Widely Feds Can Control States Medicare. No Other Limits. Brent Kendall, Louise Radnofsky, and Jess Bravin of the Wall Street Journal report the news:
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Far fewer small employers claimed the health insurance tax credit for small businesses in the health care reform law than were eligible, according to a new government report. So reports Michael Cohn at Accounting Today: The Small Employer Health Insurance Tax Credit was included in the Patient Protection and Affordable Care Act of 2010 as a way to help small businesses pay for the cost of health insurance. But the complexities of claiming the credit contributed to a relatively low popularity for the tax credit among both small businesses and their tax preparers. While 170,300 small employers claimed the…