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Compensation for hospital c-suite executives is rising substantially, with overall median total cash compensation rising six percent from 2016 to 2017, compared to an increase of two percent from 2013 to 2014. Among these executives, presidents and chief executive officers (CEOs) experienced a 7.6 percent increase in median total cash compensation from 2016 to 2017, while chief operating officers (COOs) and chief strategy officers (CSOs) experienced median total cash compensation increases of 10 percent and 13.9 percent, respectively. Hospitals are justifying these pay raises by the increasingly complex healthcare industry, which healthcare organization decision makers, especially those executives identified above, must navigate. Factors such as increased hospital consolidations, through mergers and acquisitions, as well as the shift toward value-based reimbursement (VBR), have led to this increased complexity. Many of these compensation packages come in the form of performance-based contracts, in which value-based metrics are used to determine annual payouts. Leaders who can demonstrate an ability to integrate VBR models strategically, operationally, and clinically, experience some of the largest pay increases, according to an August 2017 survey conducted by Modern Healthcare.
Compensation for hospital c-suite executives is rising substantially, with overall median total cash compensation rising six percent from 2016 to 2017, compared to an increase of two percent from 2013 to 2014. Among these executives, presidents and chief executive officers (CEOs) experienced a 7.6 percent increase in median total cash compensation from 2016 to 2017, while chief operating officers (COOs) and chief strategy officers (CSOs) experienced median total cash compensation increases of 10 percent and 13.9 percent, respectively. Hospitals are justifying these pay raises by the increasingly complex healthcare industry, which healthcare organization decision makers, especially those executives identified above, must navigate. Factors such as increased hospital consolidations, through mergers and acquisitions, as well as the shift toward value-based reimbursement (VBR), have led to this increased complexity. Many of these compensation packages come in the form of performance-based contracts, in which value-based metrics are used to determine annual payouts. Leaders who can demonstrate an ability to integrate VBR models strategically, operationally, and clinically, experience some of the largest pay increases, according to an August 2017 survey conducted by Modern Healthcare. (Read more...) 
On August 15, 2017, the Centers for Medicare and Medicaid Services (CMS) proposed changes to their bundled payment models, including the Comprehensive Care for Joint Replacement (CJR) Model. These proposed changes include: (1) Reducing the number of geographic areas with mandatory participation in the CJR model from 67 to 34, with the rest of the geographic areas having voluntary participation. Hospitals within voluntary regions have a one-time opportunity to opt out of the model. The rules also propose that low-volume and rural hospitals located in the 34 mandatory areas may participate on a voluntary basis for CJR programs; and, (2) The cancellation of Episode Payment Models (EPMs) and the Cardiac Rehabilitation (CR) incentive payment model. These programs were originally scheduled to begin January 1, 2018; however, cancelling these models would give CMS more flexibility in developing alternative payment models (APM) that promote higher quality and better coordinated care. (Read more...) 
Healthcare reimbursement may be defined as the payment received by providers for the services that they render to patients, most of which reimbursement is received from third party payors, e.g., public (government) and private (commercial) payors. The U.S. government is the largest payor of medical costs, primarily through the Medicare and Medicaid programs; this significant market share allows the U.S. government to exert a strong influence on the healthcare reimbursement environment. In 2015, Medicare and Medicaid accounted for an estimated $646.2 billion and $545.1 billion in healthcare spending, respectively, combining for approximately 37 percent of all healthcare expenditures. The prevalence of these public payors in the healthcare marketplace often results in their acting as a price setter, i.e., being used as a benchmark for private reimbursement rates. The healthcare reimbursement environment is currently undergoing a paradigm shift, from reimbursement based on the volume of services provided, to reimbursement based on the value of services provided, which shift was recently manifested in the move away from the sustainable growth rate (SGR), and the passage of the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA). This volatility requires the analyst to conduct a thorough and robust due diligence exercise, as the reimbursement trends of the past may not hold true in the future. (Read more...)
Under the False Claims Act (FCA), it is illegal for a person to knowingly present, or cause to be presented to the government, a false or fraudulent claim for payment or approval. One way in which a person or entity files a false claim is known as an implied false claim, wherein the provider submits a claim to a government payor, such as Medicare and Medicaid, while the submitter is materially noncompliant with the government program's payment agreement. Further, a whistleblower can bring a suit alleging a violation under the FCA on behalf of the United States government through what is known as a qui tam action. Through a qui tam action, a whistleblower is entitled to a percentage of the judgment or settlement, unless the information was already publicly disclosed, in which event the action is prohibited (unless opposed by the government), i.e., the suit is subject to a public disclosure bar. (Read more...)
ANNOUNCING
 
Advanced Distance Education to Launch in 2017

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 the fall of 2017 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 leaders Robert James Cimasi, MHA, ASA, MCBA, FRICS, CVA, CM&AA, Chief Executive Officer, and Todd A. Zigrang, MBA, MHA, FACHE, ASA, President of Health Capital Consultants, alongside a blockbuster faculty of healthcare subject matter experts from the legal, federal regulatory, and valuation professions.
HCC CEO Bob Cimasi Recognized as a "Pioneer of the Profession" 
under NACVA's "Industry Titans" Awards

HCC CEO Robert James Cimasi, MHA, ASA, FRICS, MCBA, CVA, CM&AA, has been
named a "Pioneer of the Profession," by the National Association of Certified Valuators and Analysts (NACVA) and Consultants Training Institute (CTI) as part of their Silver Anniversary recognition luncheon of valuation "Industry Titans," which distinguishes those whom have had the greatest impact on the profession.  Mr. Cimasi joins valuation profession luminaries, including: Dr. Shannon P. Pratt, Chris Mercer, James R. Hitchner, Roger J. Grabowski, Richard Wise, Jay E. Fishman, Nancy Fannon, Honorable Judge David Laro, Howard Lewis, and Mel H. Abraham, along with fourteen others, in receiving this honor. Congratulations to Bob Cimasi and his fellow "Pioneer of the Profession" honorees from the HCC Team and Topics Staff!