As the coronavirus (COVID-19) global pandemic has wreaked havoc on the U.S. economy generally, and the healthcare industry specifically, the previously-active healthcare transactional environment has been largely stunted. Despite (or perhaps because of) this economic turbulence, stakeholders expect that merger and acquisition (M&A) activity will soon resume with a vengeance. This potential opportunity, however, is not without pitfalls, due in part to the concern from stakeholders and regulators that well-capitalized entities may use this economic and public health crisis to prey on debilitated physician practices.
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On June 3, 2020, Seema Verma, the Administrator of the
Centers for Medicare & Medicaid Services
(CMS), announced in a
Health Affairs
article that CMS is providing significantly more flexibility for healthcare entities participating in CMS-sponsored value-based reimbursement (VBR) models for the duration of the COVID-19 pandemic. CMS has made a number of changes related to these models to provide added flexibilities to participating entities and to respond to participant concerns that VBR models will incur losses this year due to both the general disruption in operations and the greater expense associated with treating COVID-19 patients.
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On June 19, 2020 the CMS issued a proposed rule regarding
Medicaid Drug Rebate Program
(MDRP) regulations, with the aim of lowering drug prices, increasing patient access, and encouraging innovation in the insurance and pharmaceutical industries. This proposal is consistent with the Trump Administration’s
Blueprint to Lower Drug Prices
(Blueprint) released in May 2018, in which the administration highlighted its goal to “
avoid excessive pricing by relying more on value-based pricing by expanding outcome-based payments in Medicare and Medicaid
” and to “
speed access to and lower the cost of new drugs by clarifying policies for sharing information between insurers and drug makers
.”
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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 degrees of competitive pressures. This fourth installment in this five-part series on the valuation of senior healthcare will discuss the competitive environment in which these facilities operate. Due to the outsized role the nursing home industry plays in senior care, this article will focus primarily on the nursing home industry.
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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
.
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