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HCC CEO, Robert James Cimasi, and HCC President, Todd Zigrang, are honored to have authored the chapter entitled, "The Threshold of Commercial Reasonableness," in BVR/AHLA's newly published Guide to Valuing Physician Compensation and Healthcare Service Arrangements (2nd Edition).

The Centers for Medicare and Medicaid Services (CMS) recently released their final rules for fiscal year (FY) 2018 payment and policy updates for the: (1) Medicare Physician Fee Schedule (MPFS);  the Medicare Inpatient Prospective Payment System (IPPS);  (3) the Hospital Outpatient Prospective Payment System (OPPS); and, (4) the Ambulatory Surgical Center (ASC) Payment System.  Whereas the IPPS became effective on October 1, 2017,  the MPFS, OPPS, and ASC Payment System will become effective on January 1, 2018.  In this Health Capital Topics article, changes to these final rules will be discussed. 
The Centers for Medicare and Medicaid Services (CMS) recently released their final rules for fiscal year (FY) 2018 payment and policy updates for the: (1) Medicare Physician Fee Schedule (MPFS);  (2) the Medicare Inpatient Prospective Payment System (IPPS);  (3) the Hospital Outpatient Prospective Payment System (OPPS); and, (4) the Ambulatory Surgical Center (ASC) Payment System.  Whereas the IPPS became effective on October 1, 2017,  the MPFS, OPPS, and ASC Payment System will become effective on January 1, 2018.  In this Health Capital Topics article, changes to these final rules will be discussed.  (Read more...) 
A growing number of private equity (PE) groups are approaching large physician-held groups and other healthcare service enterprises, including hospitals and outpatient enterprises, seeking investment opportunities in the clinical services industry. This influx of PE investment is not only ameliorating a dearth of financial capital available to healthcare service enterprise's, but are also allowing these provider groups to "step up" to the next phase of growth by providing the management capital (e.g., resources, knowledge, skills, and ability) to facilitate the provider's transition to value-based reimbursement.  (Read more...) 
With the passage of the 2010 Patient Protection and Affordable Care Act (ACA), i.e., "Obamacare," providers are facing even more extensive regulatory scrutiny, much of which attention is focused on the increasing number of rules and the strict prosecution of fraud and abuse violations. Although significant efforts have been expended attempting to "repeal and replace" the ACA, the landmark legislation remains standing, and the sweeping nature of the ACA will continue to drive ongoing changes in the structure and financial operation of many healthcare provider enterprises, likely resulting in an even further increase in the pace of hospital/physician practice integration/transactional activities, as well as an increase in the number of U.S. This third installment will review the due diligence process as it relates to the healthcare regulatory environment.  (Read more...)
On October 26, 2017, the Wall Street Journal announced that CVS Health Corporation is in discussions with Aetna Inc. regarding a prospective acquisition.  This transaction would potentially give CVS a strategic marketplace advantage over one of its main competitors, Amazon,  which is expected to enter the pharmacy business after having acquired licenses in several states to operate as a pharmacy wholesaler.  The acquisition would join Aetna's insurance division with CVS's pharmacy benefit management (PBM) division,  allowing CVS to expand on and secure the number of members for its PBM,  as well as providing the entity with more leverage over pharmaceutical manufacturers when negotiating the cost of drugs.  The consolidation could happen as early as December 2017,  and would be the largest business transaction of the year,  totaling more than $70 billion.  However, the Department of Justice (DOJ) may challenge this acquisition, given the large market shares held by both Aetna and CVS, and the acquisition's potential negative effects on consumers.  (Read more...)
ANNOUNCING
 
Advanced Distance Education to Launch in 2018

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 2018 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!