Deal Blog

$3.67 Trillion: 2018 US Healthcare Spending by Category

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Healthcare spending in the United States is projected to surpass $3.67 trillion in 2018.  Many Americans have preconceptions about how this 19.5% of our GDP will be spent. (more…)

It’s a Heyday for Healthcare Analysts

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It is a great time to be a healthcare data analyst. The U.S. government provides us with terabytes of data on healthcare organizations and individuals.  The data sources in the figure above all represent government databases that can be joined and cross referenced to extract precise business intelligence.   (more…)

10 Real Business Stories I Like

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The business sections of bookstores are full of lots of useless drivel.  Here are 10 business books that I like. (more…)

Physician Call Pay: What Does the VA Pay?

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Not all hospitals pay physician specialists to provide call coverage, but the Veteran’s Health Administration does.  In this article, HCTadvisor analyzes the fees the Veteran’s Health Adminstration pays to physician contractors for call coverage. (more…)

ASC Construction Costs Up 50%

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In 2006 the average cost to construct a freestanding 12,500 square foot ASC in the U.S. was about $3.6 million.  By 2016, the cost to reconstruct the same exact surgery center rose $1.8 million (50%) to $5.4 million.
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Free Data! BOLS Adds Physician Specialties in 2018

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The U.S. Bureau of Labor Statistics will start surveying compensation for 15 different physician specialties starting in 2018. This change is part of an update to BOLS’ Standard Occupational Classification codes. (more…)

Out-of-Network: What is FMV Compensation?

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The persistent presence of out-of-network benefits in employers’ health plans has resulted in continued disputes between insurers and providers over pricing.  Ultimately, when insurers and providers end up in court, everyone wants to know the Fair Market Value of payment for services. (more…)

Healthcare Management Arrangements: FMV Compensation

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Professional healthcare management arrangements have a long history, dating back to the founding of HCA and Tenet Healthcare in the 1960s. These arrangements are now widespread. Health systems and professional management companies are managing hospitals, physician practices, and joint ventures. (more…)

FMV of Healthcare Marketing Services

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If you are a party to a healthcare marketing arrangement that involves independent sales representatives, call center services, or internet-based lead generation, your attorney may advise getting a Fair Market Value compensation opinion for the arrangement. The federal Anti-Kickback Statute prohibits paying anything of value in exchange for a government-sponsored patient referrals, and your state’s anti-kickback laws may extend this prohibition to commercial patients. (more…)

Litigation of Physician Non-Compete Restrictions

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Interview with David J. Pivnick of McGuireWoods LLP

A non-compete provision is a contractual agreement wherein one party agrees not to compete with another party for a set period of time.  The growth in physician employment over the past decade has given rise to increased litigation risk stemming from employment contracts and practice sale agreements. (more…)

Review of Do No Harm

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British neurosurgeon Henry Marsh’s book Do No Harm gives readers a gritty look at the daily trials of practicing surgery as a consultant at St. George’s Hospital in Great Britain’s National Health Service (NHS). (more…)

Webinar Recording: Pathology Regulatory Issues & Recent Trends

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During this webinar, guest speaker Emily A. Johnson of law firm McDonald Hopkins discussed regulatory issues affecting pathologists and clinical laboratory businesses.

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Cigna Points to Tox Costs and Fraud in Quitting Florida Obamacare

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By Jeffrey L. Cohen, The Florida Healthcare Law FirmMap of Florida

Cigna just announced it is withdrawing from Florida’s Health Insurance Marketplace.  As reported by Carol Gentry in Health News Florida, Cigna blamed its decision to withdraw on fraud and abuse and on “out of network substance abuse clinics and labs.”  Interestingly, Cigna spokesman, Joseph Mondy, pointed to a recent article in the Palm Beach Post (“Addiction Treatment Bonanza:  How urine tests rake in millions”) in support of Cigna’s announcement. (more…)

Leveling the Playing Field in Your Next Office Lease Negotiation

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By Perry Bacalis, Carr Healthcare Realty

The current commercial real estate market has been dramatically affected by the economy in the past several years. This has resulted in a very favorable environment for tenants, as landlords are extremely motivated to attract new tenants and retain existing ones—especially high quality tenants such as medical practices. (more…)

$3.4 Trillion: 2016 US Healthcare Spending by Category

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Healthcare spending in the United States surpassed $3.4 trillion in 2016.  Many Americans have preconceptions about how this 19% of our GDP is spent. (more…)

Pricing Arbitrage Survives Budget Bill

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A new federal budget bill just closed the door on the Medicare arbitrage for outpatient businesses purchased by hospitals. However, research shows commercial reimbursement is still much higher for hospital-owned outpatient services. (more…)

Joint Ventures with Charitable Hospitals

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Approximately half of the community hospitals in the United States are not-for-profit organizations. These hospitals have also elected to operate exclusively for charitable purposes, having secured substantial tax benefits by being recognized accordingly as tax-exempt under Internal Revenue Code section 501(c)(3). In this article, attorneys Carlene Y. Lowry and Craig R. McPike of the law firm Snell & Wilmer in Phoenix discuss special joint venture topics pertaining to not-for-profit charitable organizations. (more…)

A Physician’s Guide to Navigating Peer Review

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Contributed by Martin Merritt

I asked Karin Zaner, a director with the Dallas law firm Kane Russell Coleman & Logan PC, to share her tips for how physicians can best deal with the hospital peer review process. (more…)

Updated: 14 Physician-Authored Books to Read

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9 Physician-Authored Books to Read
14 Physician-Authored Books to Read

In order to be successful doing business with medical professionals, you need to understand the thoughts, feelings, and lives of different types of physicians.  Here are synopses of fourteen books authored by physicians. (more…)

Largest Physician Site-of-Service Fee Differential

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In 2011, the physician coding and reimbursement for lower extremity revascularization changed.  When the professional physician service codes and payments for angioplasty, atherectomy, and stent placement were bundled, it created the largest payment differentials of any physician procedures between facility and non-facility settings. (more…)