Value-Based Reimbursement: Mastering the Behemoth (Part Three of a Three-Part Series)
Over the past twenty years, government and commercial payors and regulators in the U.S. have designed and implemented an increasing number of value-based reimbursement programs, displacing the traditional fee-for-service method of paying for healthcare services with a model that emphasizes reimbursing healthcare providers according to the value, rather than the volume, of services rendered. As discussed in Part Two of this three-part series, this trend towards value-based reimbursement models has accelerated since the passage of the Patient Protection and Affordable Care Act (ACA) in 2010, and announcements of landmark value-based reimbursement programs by federal regulators over the past year indicate that the increasing emphasis on value-based reimbursement will continue for the next several years. This Health Capital Topics article, the third and final installment of the Value-Based Reimbursement Trends series, will briefly examine some of the major announcements of value-based reimbursement programs over the past year, before proceeding discuss whether value-based reimbursement can provide high quality, cost efficient care without sacrificing accessibility, based on an examination of the relevant academic literature. (Read more...)

Valuation of Telemedicine Services (Part Four of a Four-Part Series)
As highlighted in Part One of this four-part series, the use of telemedicine services has grown considerably in the recent years. With regulatory and reimbursement shifts on the horizon, the future of telemedicine is uncertain. One thing that remains clear is that policy decisions will ultimately affect the value that telemedicine services bring to hospitals, practices, and patients. The unique impact that telemedicine has is that it has the ability to affect all avenues of care. This Health Capital Topics article, the fourth and final installment in the Valuation of Telemedicine series, will examine the economic significance of the trends in the reimbursement, regulatory, competitive, and technological environment of the telemedicine industry. (Read more...)

Tax-Exempt Status: Illinois Hospital Loses Tax-Exempt Status - Again (Part One of a Two-Part Series)
Over the past year, tax-exempt healthcare organizations have faced increasing scrutiny regarding a central aspect of their organization structure: non-profit status. After a June 2015 decision from a New Jersey court revoking the state property tax exemption for Morristown Memorial Hospital, other courts and regulators have provided additional insight into the issue of tax-exempt status for healthcare organizations. In a notable decision on this issue, on January 5, 2016, the Illinois Fourth District Court of Appeals issued its opinion in Carle Foundation v. Cunningham Township, which maintained the 2004 revocation of the state property tax exemption for Carle Foundation Hospital, a hospital located in Urbana, Illinois. As another example of recent challenges to hospitals' property tax exemptions, the Carle Foundation case serves as further evidence of growing scrutiny regarding the tax-exempt status of many healthcare enterprises across the U.S. In this first article of a two-part series examining the trend of regulatory scrutiny into the tax-exempt status of healthcare enterprises, this Health Capital Topics article will detail the Carle Foundation decision, as well as discuss how the Carle Foundation decision fits into the overall regulatory landscape regarding state-level scrutiny of tax-exempt status in healthcare. (Read more...)

2016 Supreme Court Healthcare Cases: Post Scalia
Several healthcare commentators have noted that there are a number of pressing matters before the Supreme Court of the United States (SCOTUS) in 2016 that may be impacted by the February 13, 2016 passing of Associate Justice Antonin Scalia. In the wake of Justice Scalia's death, SCOTUS has been reduced to an eight-member court, which, as a bench with an even number of judges, holds the potential for an equally divided court. Amongst the entirety of SCOTUS's caseload for this term, decisions of the eight-member Court may significantly affect the landscape of healthcare issues affecting actors in the healthcare industry, including the False Claims Act (FCA). This Health Capital Topics article will briefly describe the procedures and standards for SCOTUS associated with an eight-member bench, as well as detail the potential impact of split rulings on healthcare-related cases SCOTUS will consider this term. (Read more...)