Hospital M&A: 3 Key Considerations to Reach a Fair Deal

by Daniel M. Grauman, Managing Director & CEO
and Kevin Cope, Manager

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Board members of not-for-profit community hospitals face enormous pressure to protect their community’s access to care. Even when the economic reasons for hospital mergers and acquisitions (M&A) are compelling, the decision to cede control to another system cannot be made based on purchase price alone. It’s just one reason why not-for-profit board members must understand […]

Compensation to Employed Physicians for Providing On-Call Coverage

by Karin Chernoff Kaplan, Director

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Hospitals are increasingly challenged to meet their Emergency Department (ED) and trauma center coverage requirements. This challenge has been enhanced by the shortage of specialty physicians in certain markets, and the increasing number of physicians unwilling to provide the coverage, due to quality-of-life issues, reimbursement pressures, and increased malpractice liability related to emergency care. Therefore, […]

Anatomy of a Deal Series No. 2:
Thinking Strategically About the RFP Response

by Daniel M. Grauman, Managing Director & CEO
and Scott Stuecher, Manager

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The search for a partner typically begins with a request for proposals (RFP). It’s a process designed to solicit interest from other organizations and narrow the field to two to three candidates that could prove to be a good fit. For health systems that respond to an RFP from an independent hospital, the goal is […]

Is Your Provider Compensation Program Comprehensive?

by Karin Chernoff Kaplan, Director

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As one of the largest health system cost centers and one with significant regulatory implications, physician compensation should be top priority. A comprehensive approach to physician compensation enables the organization to recruit and retain physician talent, align physician incentives with those of the organization to drive performance, and maintain an infrastructure to mitigate risk associated […]

Are You Developing Financial Projections?

by Daniel M. Grauman,, Managing Director & CEO
and Jessica Stack, Senior Manager

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Are you developing financial projections for business planning or an upcoming valuation?  During COVID-19, each organization was uniquely impacted by management decisions, state and local policy, and specialty-specific challenges or opportunities, etc. Normalizing financials moving forward should proceed with these considerations. Click here to view how various factors impact these projections.

Choosing the Optimal Strategic Relationships

by Mark Dubow, Director
and John Harris, Director

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Your organization’s near-term success is dependent on emerging from COVID in full sprint to address critical strategic initiatives and new opportunities. Strategic relationships can provide access to capabilities, expertise and speed to market that are superior to a “build” or “buy” approach. While traditional relationships (other hospitals/systems, health plans, etc.) offer a degree of support, […]

Making Sense of the Ever-Changing Medicare Physician Fee Schedule

by Karin Chernoff Kaplan, Director,
and Richard Chasinoff, Principal
and Jack Lacy, Senior Associate

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By now you’ve probably read (whether published by Veralon or another source) that there were significant changes made to the 2021 Medicare physician fee schedule (PFS). The entire program was originally intended to be budget neutral, but reimbursement was restructured to increase payments to cognitive specialties (such as primary care and other medical specialties) and […]

3 Questions Every System Should Answer Following the Medicare Hospital Outpatient Prospective and ASC Payment System Final Rule

by Lynda Mischel, Principal
and Meredith Inniger, Manager

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One of the most impactful final rules released by CMS in recent months is the CY 2021 Medicare Hospital Outpatient Prospective Payment System and Ambulatory Surgical Center Payment System Final Rule (CMS-1736-FC). This rule includes several important policy changes, most notably the elimination of the Inpatient Only List on a phased schedule through CY2024 (when […]

Radiation Oncology Alternative Payment Model: 3 Things to Do Now

by Lynda Mischel, Principal
and Scott Stuecher, Manager

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CMS is launching a Radiation Oncology Alternative Payment Model (“RO Model”) that will profoundly affect radiation oncology economics, with a target start date of January 1, 2022. The RO Model will apply (or at least test) a bundled payment methodology affecting about 30% of eligible radiation oncology episodes. Revenue reductions may be as high as […]