On January 6, 2020, the U.S. Department of Justice (DOJ) intervened in a whistleblower False Claims Act (FCA) lawsuit premised on violations of the Stark Law. Indianapolis-based Community Health Network (CHN), an integrated healthcare system, is alleged to have violated the Stark Law by participating in above fair market value (FMV) compensation structures that were partly established on the referrals that the physicians made to the hospital system. This Health Capital Topics article will review CHN’s allegedly illegal compensation arrangements with its specialists and its incentive compensation structure, as well as the role of the valuation firms in the fact pattern set forth by the government. (Read more...)

Bundled payments are increasingly being criticized for not bringing about the predicted quality and cost-saving outcomes that were expected. These previously promising outcomes, especially as relates to joint replacement, have been found by recent research to be relatively meager. Further, there is no significant difference in quality realized when implementing bundled payments. This Health Capital Topics article will review the recently-published studies regarding the quality and cost effectiveness of two major bundled payment models – the Comprehensive Care for Joint Replacement (CJR) model and the Bundled Payments for Care Improvement Initiative (BPCI) Advanced program. (Read more...)  

With the federal government incapable of making meaningful improvements to the healthcare industry due to political impasses, and the systemic problems of: high and increasing costs; large deductibles; healthcare manpower shortages; and, delays in treatments and obtaining medications plaguing the U.S. healthcare delivery system, corporate America is stepping up to the task. While profit may be a motive for many of these corporations, they are also taking a more entrepreneurial path to problem-solving than existing healthcare organizations, which may result in higher quality, lower cost healthcare. This Health Capital Topics article will briefly survey some of these current private sector initiatives. (Read more...)  

The term technology can be all-encompassing in healthcare, ranging from tangible tools, to pharmaceuticals, to software. The modern ASC industry exists mainly due to advances in anesthesia and new surgical techniques and technology. Simultaneously, the increased demand for outpatient services in general has been driven by technological advances. The last installment of this five-part series on the valuation of ASCs will review some of the technology advancements that are driving ASC industry growth and evolution.  (Read more...)  
On March 11, 2020, HCC President, Todd Zigrang , will be co-presenting with Barry Herrin of Herrin Health Law , Roger Logan of Bon Secours Mercy Health, and Lisa Han of Jones Day at the American Bar Association (ABA) 21st Annual Conference on Emerging Issues in Healthcare Law . They are presenting on the topic of "Alternative Payment Model Workshop: The Nuts & Bolts of APMs."

Advanced Distance Education to Launch in 2020

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 launch in 2020 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, federal regulatory, and valuation professions.

HCC President, Todd Zigrang , and Vice President and General Counsel, Jessica Bailey-Wheaton , were recently interviewed by the National Association of Certified Valuators and Analysts (NACVA) , where they discussed the development of the distance education program along with the topics that will be covered. Click HERE to watch the entire interview.