On August 2, 2021, the Centers for Medicare & Medicaid Services (CMS) released its finalized payment and policy updates for the Medicare Inpatient Prospective Payment System (IPPS) and the Long-Term Care Hospital (LTCH) Prospective Payment System (PPS) for fiscal year (FY) 2022. Notably, CMS determined in their final rule that it would be using FY 2019 data to determine inpatient hospital utilization for FY 2022 due to aberrations in the FY 2020 data stemming from the COVID-19 public health emergency (PHE). (Read more...)

A recent study from Physicians Advocacy Institute (PAI), prepared by Avalere Health, associated the growing number of both physician practice acquisitions and employed physicians between 2019 and 2021 with the COVID-19 pandemic. To study COVID-19’s impact on physician employment trends, the June 2021 study evaluated the IQVIA OneKey database that contains physician practice and health system ownership information. To assess these trends at a national and regional level, Avalere researchers studied the two-year period from January 1, 2019 to January 1, 2021. (Read more...)

Historically, Medicare has offered value-based payment models to healthcare organizations on both a voluntary and a mandatory participation basis. Because voluntary participants could self-select into programs to reduce spending, it was assumed that they achieved greater savings than mandated participants, but until recently, no data had tested this. However, a June 2021 study in the Journal of the American Medical Association (JAMA) found no difference in risk-adjusted episodic spending between voluntary and mandatory payment model participants. (Read more...) 

In June 2021, the Association for American Medical Colleges (AAMC) released its seventh annual report on physician workforce projections. AAMC’s “Complexities of Physician Supply and Demand: Projections from 2019-2034” predicts that demand for physicians will increase over the next 15 years. Their report collected much of the data in 2019, before the COVID-19 pandemic highlighted many health disparities in the industry. To address these rapid demand increases, congressional legislation is increasing medical school and residency spots for the first time in over 20 years. (Read more...) 

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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.