On June 25, 2020 Atlanta’s Piedmont Healthcare, Inc. agreed to pay $16 million to the federal government to resolve two False Claims Act (FCA) allegations of kickbacks and overbilling. The relator, a former Piedmont physician, alleged Stark Law and Anti-Kickback Statute (and subsequent FCA) violations of paying an amount that was above fair market value (FMV) and commercially unreasonable in Piedmont’s 2007 acquisition of Atlanta Cardiology Group (ACG). Additionally, Piedmont’s payments settle allegations that the hospital admitted patients without medical necessity in order to bill Medicare and Medicaid for inpatient procedures that were recommended to be performed at the less expensive outpatient or observation settings.  (Read more...)

On July 7, 2020, the Lown Institute, a nonpartisan think tank, announced the initial release of its new ranking system for hospitals. Called the “ Hospitals Index ,” this ranking analyzes not just the quality of care and patient outcomes but also the hospital’s civic leadership and avoidance of overuse, ideas that harken back to the core mission and vision of the Lown Institute itself. Founded in 1973, the Institute advocates for a healthcare system that “ rejects low-value care, incentivizes healing over profits, promotes health equity, and honors the value of the clinician-patient relationship .” (Read more...)

As noted in the first installment of this five-part series, senior healthcare options have dramatically expanded in the past decade, and seniors have more long-term care choices than ever before to meet varied care needs and income levels. These myriad options also have varying operational needs that can be addressed through diverse technological solutions. The final installment in this five-part series on the valuation of senior healthcare will discuss emerging technological trends in senior care services. (Read more...)  

The call from primary care physicians for changes to the current healthcare reimbursement structure is growing louder in the face of the hardships endured as a result of the coronavirus (COVID-19) pandemic. In response, professional organizations, payor organizations, and payors themselves are answering that call, in the form of two July 2020 announcements related to innovative payment systems directly targeted at independent medical practices and primary care physicians. (Read more...)  
An article authored by Todd Zigrang , Jessica Bailey-Wheaton , and Khaled Klele was featured in the most recent issue of The Health Lawyer published by the American Bar Association . Read the article entitled, " The Path to Successful Utilization of Alternative Payment Models ."

For more recently published material written by HCC, please visit www.healthcapital.com


The  Institute for Healthcare Valuation  (IHV) &  Consultants' Training Institute  (CTI) are pleased to announce premier healthcare valuation training through a distance education program, the Certificate of Educational Achievement (CEA) for Advanced Education in Healthcare Valuation. The program will be featured during the 2020 Financial Valuation SuperConference and will bridge the interdisciplinary nature of healthcare valuation to include: the Four Pillars of Healthcare (regulatory, reimbursement, competition, and technology); the market forces shaping the U.S. healthcare industry; and the valuation of healthcare enterprises, assets, and services. Legal professionals and healthcare providers, as well as those wishing to expand their scope of activities in healthcare valuation engagements and those seeking to enhance their current healthcare valuation service lines, will gain comprehensive knowledge through completing the expansive program. The program has been developed and is being presented by industry thought leader  Health Capital Consultants , alongside a blockbuster faculty of healthcare subject matter experts from the legal and valuation professions.

For more information on the program and conference Click   HERE .