Healthcare system executives are well aware that physician employment agreements must be consistent with Stark and Anti-Kickback legislation requiring that they not pay more than fair market value (FMV) for any services provided or received. However, quantitative benchmarking is only part of the story. As regulatory scrutiny continues to increase, it is imperative that certain […]
Your selection of post-acute care (“PAC”) partners can make or break your value-based payment programs and care management initiatives. Even where fee-for-service is still dominant, having the right post-acute care partners can improve economic performance by reducing length of stay and minimizing acute care readmissions. Most health systems and hospitals do not own PAC facilities, […]
Karin Chernoff Kaplan writes that successful design of and transition to a new compensation model requires careful selection of the physician participants and subsequent training for those who will be involved.
John M. Harris and Molly Johnson write that smaller healthcare providers seeking to engage in population health management may well have other options other than a merger or acquisition.
The forces that transformed taxi service and video distribution are now transforming health care. In the manner of Uber and Netflix, disruptive innovators are revolutionizing how healthcare consumers access services, as well as how providers organize and deliver care. The impact can be swift and profound. In December we examined two types of disruptors in health care: revolutionized […]
Should I stay or should I go? If I go there will be trouble And if I stay it will be double. -The Clash In the next several months, more than 200 Medicare Shared Savings Program (MSSP) ACOs face a big decision. What had looked like a simple choice to “stay or go” will be […]
As a Zen master might say, “Change must come from within.” Everybody can point to fundamental problems with healthcare delivery, especially for low-income populations. But managed-care rewards and penalties and other efforts have not been enough to transform the delivery system. New York State is working to encourage “change from within” through its Delivery […]
In evaluating the fair market value (FMV) of healthcare entities, we often are asked why we do not adjust the revenue stream of the business being evaluated to reflect the payment rates of the potential buyer. The answer is based on the Stark and Anti-Kickback statutes, and in the difference between FMV and strategic […]
The transformation to a value-based healthcare system is underway, as is the spread of programs that pay physicians for improving the quality of care. Whether called value-based payment, paying for quality, or pay-for-performance, such programs are becoming a more significant aspect of compensation for employed physicians and in co-management agreements—but they are not always used […]
Consolidation in the healthcare industry is well-established and moving full-steam ahead. There were an average of 100 hospital transactions per year between 2011 and 2014, compared with 60 per year in the preceding four-year period.a More than 60 percent of U.S. hospitals are now part of a health system.b In most major metropolitan areas, the […]