After an understandable slowdown in 2020, due to the onset of the COVID-19 pandemic, merger & acquisition (M&A) activity in the healthcare industry accelerated in 2021, and the industry is expected to continue the high number of deals and high deal volume in 2022. This Health Capital Topics article will review the U.S. healthcare industry’s M&A activity in 2021, and discuss what these trends may mean for 2022. (Read more...)
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On February 1, 2022, the U.S. Department of Justice (DOJ) announced their recovery of $5.6 billion in settlements and judgments from civil cases involving fraud and false claims for fiscal year (FY) 2021. Over $5 billion was recouped from the healthcare industry for federal losses alone, and included recoveries from drug and medical device manufacturers, managed care providers, hospitals, pharmacies, hospice organizations, laboratories, and physicians. This figure is more than double the amount of healthcare-related recoveries secured in FY 2020, which totaled $1.8 billion. (Read more...)
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A study conducted by the RAND Corporation and published in the January 2022 issue of the Journal of the American Medical Association (JAMA) seeking to determine whether health systems primarily incentivize volume or value in their physician compensation models found that almost all physicians are still compensated through a volume-based model that rewards productivity over the value of care provided. These study results are in direct contradiction to the longstanding narrative that the U.S. healthcare delivery system is shifting away from volume-based reimbursement and toward VBR. (Read more...)
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Home health agencies (HHAs) are primarily engaged in providing “a wide range of health care services that can be given in [a] home for an illness or injury.” There are three types of services that typically fall under the umbrella of home healthcare: (1) home healthcare enterprises, which provide medical and supportive care; (2) home care aide enterprises, which provide nonmedical care or custodial/non-meal care; and (3) hospice enterprises, which provide end-of-life care.2 Additionally, two of the main types of home healthcare services are: (1) infusion therapy and (2) respiratory therapy. (Read more...)
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"Valuation of Telemedicine: Competition (Part IV of V)" authored by HCC President, Todd A. Zigrang, MBA, MHA, FACHE, CVA, ASA, and, HCC Vice President and General Counsel, Jessica Bailey-Wheaton, Esq., was published by the National Association of Certified Valuators and Analysts (NACVA) in The Value Examiner.
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This one-hour webinar provides legal and valuation perspectives on the finalized changes to the Stark Law and the Anti-Kickback Statute. Specific issues covered include:
- The changes to the “big three” requirements – Fair Market Value, Commercial Reasonableness, and the Volume or Value Standard;
- The new exceptions and safe harbors for value-based arrangements, including where the Stark Law and Anti-Kickback Statute final rules differ; and
- Other new and modified exceptions and safe harbors included in the final rules.
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