Once the matchmaking aspect of a healthcare M&A is complete and the parties involved agree on what partnership might look like, the next step is due diligence. Performing due diligence can seem like a “check the boxes” exercise—but it’s much more than that. It’s an opportunity to explore the strategic implications of a proposed merger […]
Shifting a $1 trillion dollar industry from confidential contracts to publicly published pricing is a massive transformation. In the middle of recovering from the COVID-19 crisis, hospitals are responding to this transformation. Background: The hospital price transparency rules require consumer-friendly tools to help individuals shop for hospital services based on price. They also require hospitals […]
By recategorizing procedures previously designated inpatient only, CMS is actively redirecting a significant number of cases to Hospital Outpatient Department (“HOPD”) and community-based ambulatory surgery center (“ASC”) settings. We have discussed the impact this will have on outpatient surgery, and strategies to prepare. This outpatient shift will also affect cardiac services, creating both risks and […]
The changes in Work RVU (WRVU) values contained in the 2021 Medicare Physician Fee Schedule have the potential for wholesale disruption to productivity-based physician compensation models. To date, the response has varied among health systems, but for the most part, due to pandemic distractions and the sheer complexity of the impact, organizations have kicked the […]
Rapid evolution in diagnostics and treatment for cancer care, innovation through genomics and predictive analytics, the continuing shift toward value-based care are hastening the migration of oncology from hospital settings to community-based centers. This raises the question: Is now the right time to invest in a community oncology center? The experiences of multiple health systems […]
So you’ve made it through the request for proposals (RFP) process, an ordeal that can amount to a great deal of (usually digital) paperwork and a series of check-the-box demands, with little, if any, one-to-one discussion with the issuer. Now comes the interesting part: discussions between the healthcare organization that is seeking a partner, and […]
Surgery has long been a key driver of hospital profitability. Effectively handling the new Medicare outpatient surgery rule[1] and subsequent care shift to outpatient settings is critical to long term financial success. This rule includes several important policy changes, most notably the elimination of the Inpatient Only List on a phased schedule through CY2024 when […]
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 […]
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, […]
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 […]