Regulatory Issues (Part IV of V) As discussed in the first installment of this five-part series, rural health clinics (RHCs) are statutorily-created entities, established via the Rural Health Clinic Service Act of 1977. These providers face a range of federal and state legal and regulatory constraints, which affect their formation, operation, and transactions. This installment will discuss two important regulatory issues affecting RHCs: licensure requirements, and fraud and abuse law compliance. As discussed in the first installment of this five-part series, rural health clinics (RHCs) are statutorily-created entities, established via the Rural Health Clinic Service Act of 1977.[i] These providers…
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Reimbursement Environment (Part III of V) The U.S. government is the largest payor of medical costs, through Medicare and Medicaid, and has a strong influence on healthcare reimbursement. In 2017, Medicare and Medicaid accounted for an estimated $705.9 billion and $581.9 billion in healthcare spending, respectively. The prevalence of these public payors in the healthcare marketplace often results in their acting as a price setter and being used as a benchmark for private reimbursement rates. This is particularly true for RHCs, which tend to serve a disproportionately large Medicare population. This third installment in the five-part series on RHCs will…
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For Rural Health Clinics Competition (Part II of V) As discussed in the first installment of this five-part series regarding Rural Health Clinics (RHCs), the significant proportion of RHCs operating at a loss has led to an overall reduction in the number of RHCs. Despite this decrease, the demand for RHCs continues to rise, limiting access to care for patients in rural communities. This second installment will review the competitive environment of RHCs. As discussed in the first installment of this five-part series regarding Rural Health Clinics (RHCs), the significant proportion of RHCs operating at a loss has led to…
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for Rural Health Clinics (Part I of V) The first of a five-part series where the authors describe the issues encountered valuing rural health care clinics. This first article discusses fair market value considerations for rural health clinics. Introduction Rural health clinics (RHCs) are specially certified entities that were created in order to increase access to primary care services for patients located in rural communities.[1] RHCs were established via the Rural Health Clinic Service Act of 1977, which law was promulgated to address the increasing shortage of healthcare services in rural areas.[2] These clinics are specially licensed healthcare organizations through…