Home Profile Services Leadership Clients News Events Contact Contact
Valuation Consulting Commercial Reasonableness Commercial Payor Reimbursement-benchmarking Litigationsupport Expertwitness Financial Analysis Modeling Intermediary Services Certificate of Need ACO Valuemetrics Strategic Consulting Industry Research Services





The 2016 Election and the ACA: 
The Future of Healthcare Reform 
(Part Two of a Two-Part Series)
During his campaign for the Office of the President of the United States, Donald Trump repeatedly attacked the Patient Protection and Affordable Care Act (ACA), a/k/a "Obamacare," as a flawed healthcare reform effort, and vowed that "on day one" of his administration, he would request that Congress "immediately deliver a full repeal of Obamacare."  However, since his victory over Democratic Party nominee Hillary Clinton on November 8, 2016, President-elect Trump has created uncertainty regarding the fate of the law, noting that he would seek to retain certain provisions of the law, including the ban on discrimination based on pre-existing health conditions and coverage extensions for children on their parents' plan until age 26.  Although legislative strategies to repeal the ACA have started to coalesce, the fate of the law, as well as the longevity of the numerous benefits spurred by it, remain in the balance. This second installment of the two-part Health Capital Topics series on the 2016 election and the ACA will discuss the potential changes to the law, as well as how and when those changes might occur.

During his campaign for the Office of the President of the United States, Donald Trump repeatedly attacked the Patient Protection and Affordable Care Act (ACA), a/k/a "Obamacare," as a flawed healthcare reform effort, and vowed that "on day one" of his administration, he would request that Congress "immediately deliver a full repeal of Obamacare."  However, since his victory over Democratic Party nominee Hillary Clinton on November 8, 2016, President-elect Trump has created uncertainty regarding the fate of the law, noting that he would seek to retain certain provisions of the law, including the ban on discrimination based on pre-existing health conditions and coverage extensions for children on their parents' plan until age 26.  Although legislative strategies to repeal the ACA have started to coalesce, the fate of the law, as well as the longevity of the numerous benefits spurred by it, remain in the balance. This second installment of the two-part Health Capital Topics series on the 2016 election and the ACA will discuss the potential changes to the law, as well as how those changes might occur.  (Read more...) 
On November 4, 2016, after input from over 100,000 physicians and stakeholders,  the Centers for Medicare and Medicaid Services (CMS) issued a final rule to implement the Medicare Quality Payment Program required by the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA), with an effective date of January 1, 2017.  As mentioned in the May 2016 Health Capital Topics article entitled, "CMS Issues MACRA Proposed Rule One Year After Passage," Congress passed MACRA, in part, to abolish the sustainable growth rate physician reimbursement methodology, as well as to implement value-based reimbursement programs. CMS estimates that approximately 600,000 physicians and clinicians will be subject to the new payment programs under MACRA; consequently, the payment reforms finalized under the rule may impact reimbursement for a large number of U.S. physicians. This Health Capital Topics article will discuss the key considerations of the legislation, as well as direct providers to resources which will help them maximize their practices' reimbursement potential through the implementation of these MACRA quality standards.  (Read more...) 
In the face of uncertain reimbursement, the rising costs of healthcare services, and value-seeking reforms pushing for higher quality care at lower prices, providers are turning to alignment, integration, and cooperation as key strategies to create high-quality and high-efficiency healthcare delivery organizations. This trend is resulting in the increased corporatization of medicine, including a greater number of physicians being employed by hospitals. Concurrently, there has been a parallel growth in the number of hospitals compensating physicians for their performance of hospital administrative functions, including medical directorships. Corresponding with the increase in the corporatization of medicine, governmental authorities have engaged in heightened regulatory scrutiny related to the legal permissibility of these arrangements, including whether physicians are actually performing the services outlined in the relevant medical directorship agreement. In light of the aforementioned trends that are creating a paradigm shift in the healthcare delivery system, it is important that valuation analysts ensure that the subject medical director services are appropriately classified and valued in order to provide a defensible opinion for  their clients. This final installment in the four-part Health Capital Topics series on the classification and valuation of compensation for healthcare services will provide a brief overview of this process for medical director services. (Read more...)
The Monte Carlo Simulation Analysis (MCSA) is a statistical technique that produces several hundreds of thousands of simulated scenarios by harnessing the ability of computers to quickly complete repetitive tasks.  As an ideal process for determining "what-if" scenarios, valuation analysts may utilize MCSA in situations where there are several distinct scenarios and/or unknowns.  This simulation-based method may be used to evaluate estimators and goodness-of-fit statistics, which then may be utilized in identifying potential problems with a financial model or alleviating problems inherent to the model, such as misspecification or sample size, among others.  MCSA methods are theoretical and based solely on empirical evidence,  and often serve as a last resort when other analytical methods fail.  The basic goal of an MCSA model in a valuation analysis is to determine the probability, in an informed manner, of those factors that affect the economic benefit accruing to the owners of an asset. From those randomly determined factors, the analyst then determines the economic benefit that would accrue. This final installment of this six-part Health Capital Topics series on statistical methods utilized in valuation reports will discuss, at a high level, the basics of the MSCA technique, how MCSA can inform healthcare valuations, and the limitations that analysts should keep in mind when utilizing this technique. (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 summer 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!