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Medicare’s Zombie Problem

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In 2011, the Centers for Disease Control and Prevention (CDC) issued the report Preparedness 101: Zombie Pandemic as an educational guide for emergency preparedness. Now it appears the zombies are here. Medicare beneficiaries are using their Medicare benefits from beyond the grave. (more…)

Einstein for Capitation or Fee-For-Service?

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Would Albert Einstein favor capitation or fee-for-service payment?  Ninety-three years ago this November, Einstein was awarded the Nobel Prize in physics for tackling a surprisingly similar question.  (more…)

Ambulance Co-Pay Waivers Need Audited

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Local county and city governments that require independent ambulance contractors to routinely waive patient co-pays should commission an annual audit to ensure the contractors are fully reimbursed for these uncollected balances. (more…)

Telehealth & Telemedicine Legislative Activity

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Interview w/: John F. Williams, III, Michael T. Batt, and Jeffrey W. Short of Hall Render
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Telehealth is a hot issue on Capitol Hill these days.

“In ten years of working on Capitol Hill, I haven’t seen an issue get as much momentum as quickly as telehealth,” says John F. Williams, III, Managing Partner of the Washington D.C. office of Hall Render, Killian, Heath & Lyman.  “There is bipartisan support to address telehealth issues.”

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How to Overcome Rural Healthcare Recruitment Challenges

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By Jeff Beilstein, Tennison Group, Inc.

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Recruiters face several recruitment challenges when recruiting doctors to practice in rural communities. Geography, economics, culture, education, technological resources and health care resources are a main source of the recruitment challenges. (more…)

Review of The ABCs of ACOs

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By now it is well known that the number of physician-owned accountable care organizations (ACOs) exceeds the number of hospital-owned ACOs. But how are these ACOs actually formed? How does an ACO contract with provider participants? What are the requirements for ownership and governance?  (more…)

Four Simple Steps to Reduce Resignations of Key Employees

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By Jeff Beilstein of Tennison Group, Inc.

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So you hired a key player–a business partner that will help your organization reach the next level. But six months or a year later, you get notice of a resignation. You wonder what happened and more importantly, how can you avoid this scenario in the future. (more…)

2014 M&A Performance Study

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The 2014 M&A Performance Study analyzes the financial performance of 5,800 healthcare businesses before and after ownership changes.

The study subjects include 966 hospitals, 3,660 skilled nursing facilities, and 737 home health agencies certified by Medicare. It is the largest study of post-transaction M&A performance every conducted on healthcare businesses.

An expert panel of six healthcare transaction professionals reviewed the findings. (more…)

RBMA President Talks Commoditization

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Interview w/: Keith Chew, MHSA, CMPE, Pres. RBMA

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Keith E. Chew, MHSA, CMPE, President of the Radiology Business Management Association, discusses his observations on current and future trends in imaging and radiology. (more…)

Jeffrey Epstein, MD, on Serving Two Masters

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A feature interview with Jeffrey Epstein, MD


Jeffrey Epstein, MD, is well acquainted with dichotomies. For eight years from 1998 through 2005, Dr. Epstein served as a part-time medical director for Blue Cross of Philadelphia while also operating his own private internal medicine practice. By comparison, Dr. Epstein says that was a cake-walk compared to the new challenge of juggling fee-for-service and value-based payment. (more…)

9 Stats on M&A Deal Failures

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Over a 25 year period from 1981 to 1996, researchers have identified over 423 U.S. companies with assets over $500 million that have filed for bankruptcy.  This research has revealed patterned behaviors of M&A failure.  Here are nine statistics from various studies on M&A failure to consider. (more…)

OIG’s Advisory Opinion Trends in 2013 & 2014

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Half of the OIG’s last 26 advisory opinions during 2013 and 2014 have focused on just two types of arrangements.  Can you guess what two types of arrangements have drawn the most inquiries? (more…)

Independent Peer Review Removes Employed Physician Conflicts

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Interview with Jane Orient, MD, Exec. Dir., AAPS

Over the past six years, thousands of physicians have become hospital employees.  This heightens the issue of whether hospital-employed physicians are conflicted when performing medical peer review.  Jane Orient, MD, executive director of the Association of American Physicians & Surgeons, has observed a growing divide between hospital-employed physicians and community physicians. (more…)

Surgical Hospitalists Improve Outcomes, Physician Lifestyle

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Interview w/: Leon Owens, MD, FACS, CEO of SAMGI

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In 1996, Leon Owens, MD, FACS, started to design a surgical hospitalist program to assist with hospitals’ surgical call coverage needs.  Over a five year study period from 2007 through 2011, he found that this new model produced statistically significant reductions in length of stay, complication rates, and hospital costs.  Now Dr. Owens and the management company Surgical Affiliates Management Group, Inc. (SAMGI) are bringing this model to hospitals all over the United States. (more…)

Review- One Doctor: Close Calls, Cold Cases, and the Mysteries of Medicine

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In One Doctor, Brendan Reilly, MD, recounts his 40 year career as a primary care internist turned hospitalist. In many respects, Dr. Reilly’s story closely follows changes in the American medical profession during the last 40 years. (more…)

Practice Sales Muddied by Meaningful Use Audits

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An interview with Jeffrey W. Short of Hall Render

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Medicare and Medicaid Electronic Health Record (EHR) Incentive Programs provided incentive payments to eligible physicians who self-attested to their meaningful use of certified EHR technology.  Attorney Jeffrey W. Short  of Hall, Render, Killian, Heath & Lyman says Medicare’s retrospective audits are requiring some physicians to pay Medicare back the incentive payments they received.  Due to the potential for these paybacks, internal audits for these attestations should be added to due diligence for physician practice sales. (more…)

Rural Hospital Replacements Require Leap of Faith

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An interview with David H. Snow of Hall Render

Over sixty years ago, the Hill Burton Act infused over $33 billion into construction of hospital facilities in the United States.  Attorney David H. Snow of Hall, Render, Killian, Heath & Lyman says many of these now aging critical access hospitals (CAHs) are facing a serious leap of faith when building replacement facilities.

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Moneyball Medicine with Robin DiMatteo, Ph.D.

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Interview with Robin DiMatteo, Ph.D., UC-Riverside

If you haven’t read Moneyball or seen the movie, the story tells how the Oakland Athletics and New York Yankees both won 103 games in 2002, while Oakland’s payroll was $41 million and New York’s was $125 million.  In baseball, this is called playing Moneyball.

To identify how health systems, ACOs, and medical groups around the U.S. are creating Moneyball-like results, HCTA recently interviewed Robin DiMatteo, Ph.D., to gather intelligence from the cutting edge of healthcare delivery. (more…)

Webinar Recording: Co-Management Feasibility & Development

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On this August 13, 2014 webinar, HCTA co-founders Nicholas Newsad, MHSA, and Kyle Tormoehlen, ASA, MBA, discuss the structure and uses of co-management arrangements, as well as the feasibility and development process.

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New Pediatric Program Development with Co-Mgt

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A disproportionate share of pediatric services are provided by the 100 or so self-designated children’s hospitals in the United States.  Non-children’s hospitals that want to expand or enhance their pediatric services must engage independent pediatric specialists for program development. (more…)