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Mar 23, 2017 10:00:00 AM

2 Best Approaches to Determine FMV of a Healthcare Timeshare Agreement

Consider a small U.S. town that doesn't have local access to a cardiologist. The community can't support one on a full-time basis, so the hospital brings in a cardiologist twice a month. The physician pays to use the hospital's facilities, equipment, support staff and nurses during those two days. Patients are able to access the specialized care they need without having to travel, and the physician pays only for the space and support that he or she needs.

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Topics: FMV, Fair Market Value, Leases, Timeshare Arrangements

Mar 17, 2017 9:00:00 AM

From MU to ACI: New Acronym, Same Security Expectations

If you are one of the physicians who thought you could sit back and watch the Meaningful Use train pass by—think again. It’s back. And this time, there is a carrot and a stick.

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Topics: Data Security, Information Security

Mar 13, 2017 1:36:06 PM

What Providers Can Expect From "Repeal and Replace"

Last week House Republicans gave us a first glimpse of what they mean by “repeal and replace” of the Affordable Care Act (ACA). 

Lack of unity in the GOP and opposition from leading healthcare industry groups means the American Health Care Act (AHCA) faces significant hurdles and likely changes as it works its way through congressional committees and the budget reconciliation process. However, we can glean a few insights into how the final legislation might impact healthcare providers.

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Mar 9, 2017 10:00:00 AM

The Provider Must Become the Payer. There Can Be Only One!

A long time ago (the mid-90’s), there was a television series titled Highlander. It was a sci-fi action series whose main character, Duncan MacLeod, hailed from a race of immortals. The opening voice-over would end with the proclamation, “There can be only one!” You see, these immortals sought each other out until it was the “last man standing.” Duncan was a force for good that battled other immortals of darkness. Each episode featured an epic battle that ended with Duncan annihilating his immortal foe, whose power transferred to Duncan.

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Topics: Payment Models

Mar 3, 2017 9:00:00 AM

Catalyze Practice Transformation With Pay-For-Performance Contracting

Many physicians are subject to participation in the new Merit-Based Incentive Payment System (MIPS) through CMS’s ongoing payment model reform initiatives encouraging providers to deliver better healthcare at lower costs.

CMS is just the tip of the spear. Commercial payers are developing their own pay-for-performance contracts as they slowly transition away from fee-for-service reimbursement. Yet many independent practice physicians and even employed physicians lack a strong strategy to participate in a healthcare environment where the Triple Aim is the ultimate mission.

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Topics: Value-Based Pay, Payment Model Reform

Feb 24, 2017 9:00:00 AM

5 Key Takeaways From the ACLC/HIMSS17 Joint Conference

For the 1st time ever, HIMSS (the annual meeting place for all things health IT) and ACLC (Accountable Care Learning Collaborative) held a joint conference, in Orlando, Florida.  Suffice it to say it was a HUGE (no pun intended, Mr. President) event with over 40,000 (yes, 40K) attendees and 1,200+ exhibiting companies. 

The main topic—transforming healthcare. 

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Topics: Healthcare, ACLC, HIMSS, Repeal and Replace

Feb 23, 2017 10:00:00 AM

3 Steps to Reduce Fraud and Abuse Compliance Risks in Hospital-Physician Deals

The most astute executives in health systems are rightfully concerned about compliance risks in physician contracting. Among these risks are that a transaction or an arrangement between a hospital and a physician are consistent with fair market value (FMV) and are commercially reasonable (CR) as those terms are defined in the healthcare regulatory context.

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Topics: Physician Compensation, FMV, Compliance, CR

Feb 17, 2017 10:00:00 AM

Let CMS Pay for Your MACRA and ACO Readiness Costs

Welcome to MACRA—the Medicare Access and CHIP Reauthorization Act. MACRA represents the end of a long history of perpetually delayed Medicare physician fee schedule cuts that were to be automatically triggered under the punitive SGR formula absent Congress’ annual postponement ritual. After providing for a series of annual physician payment increases, MACRA’s reimbursement methodology transitions to a value-based model that includes two pathways—the Alternative Payment Model (“APM”) and the Merit-Based Incentive Payment System (“MIPS”).

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Topics: Healthcare, MACRA, CMS

Feb 9, 2017 11:00:00 AM

What Level of MACRA Investment Makes Sense for Rural Hospitals?

Rural hospitals have some tough decisions to make about their level of participation in the new CMS Quality Payment Program created by the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA). 

For a number of reasons, the MACRA cards are stacked against small and rural providers. Given the limited number of Advanced Alternative Payment Models (APMs) that are being approved, many providers will start out in the Merit-Based Incentive Payment System (MIPS), and that track offers limited upside potential compared with APMs.

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Topics: MACRA, CMS, Quality Payment Program

Feb 3, 2017 4:30:00 PM

3 Big Themes at the 2017 AHLA Physicians and Hospitals Law Institute

During AHLA’s Physicians and Hospitals Law Institute this week, we saw three recurring themes as sessions focused on issues affecting the industry.

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Topics: AHLA

Jan 27, 2017 9:00:00 AM

HFMA Mid-South Institute 2017 Highlights

We’re gearing up for what’s in store in the healthcare arena in 2017 by attending HFMA’s Mid-South Institute. Attendees from Missouri, Arkansas, Mississippi, and Tennessee have gathered to learn of updates in healthcare and how to embrace for the year ahead. Here are a couple of themes that were reinforced during the conference:

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Topics: Healthcare, Electronic Health Records, Cybersecurity, HFMA

Jan 26, 2017 12:00:00 PM

The Road to MACRA Success Does Not End With MIPS

It is important to recognize that the road to long-term success does not end with the implementation of the Merit-based Incentive Payment System (MIPS). In CMS’ own words, MACRA’s final rule was established, in part, to incentivize and promote participation in Advanced Alternative Payment Models (APMs). These incentives include a 5% participation bonus from 2019 to 2024 and a 0.5% annual increase above the MIPS track beginning in 2026.

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Topics: MACRA, MIPs, Payment Model Reform

Jan 20, 2017 1:00:00 PM

7 Key Steps to Take Now to Get Ahead With MACRA

Like it or not, MACRA is here. MACRA created the new Quality Payment Program (QPP), comprised of two pathways to higher quality: the Merit-based Incentive Payment System (MIPS) and Advanced Alternative Payment Models (Advanced APMs). MACRA changed the rules, leaving many to face an uncertain future. Amid the uncertainty, however, one thing is sure: passivity will be costly. Indecision will not prevent or delay physician’s placement into the quality and efficiency compensation measurements of MIPS.

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Topics: MACRA