Choosing the Optimal Strategic Relationships

by Mark Dubow, Director
and John Harris, Director

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Your organization’s near-term success is dependent on emerging from COVID in full sprint to address critical strategic initiatives and new opportunities. Strategic relationships can provide access to capabilities, expertise and speed to market that are superior to a “build” or “buy” approach. While traditional relationships (other hospitals/systems, health plans, etc.) offer a degree of support, […]

Making Sense of the Ever-Changing Medicare Physician Fee Schedule

by Karin Chernoff Kaplan, Director,
and Richard Chasinoff, Principal
and Jack Lacy, Senior Associate

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By now you’ve probably read (whether published by Veralon or another source) that there were significant changes made to the 2021 Medicare physician fee schedule (PFS). The entire program was originally intended to be budget neutral, but reimbursement was restructured to increase payments to cognitive specialties (such as primary care and other medical specialties) and […]

3 Questions Every System Should Answer Following the Medicare Hospital Outpatient Prospective and ASC Payment System Final Rule

by Lynda Mischel, Principal
and Meredith Inniger, Manager

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One of the most impactful final rules released by CMS in recent months is the CY 2021 Medicare Hospital Outpatient Prospective Payment System and Ambulatory Surgical Center Payment System Final Rule (CMS-1736-FC). This rule includes several important policy changes, most notably the elimination of the Inpatient Only List on a phased schedule through CY2024 (when […]

Radiation Oncology Alternative Payment Model: 3 Things to Do Now

by Lynda Mischel, Principal
and Scott Stuecher, Manager

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CMS is launching a Radiation Oncology Alternative Payment Model (“RO Model”) that will profoundly affect radiation oncology economics, with a target start date of January 1, 2022. The RO Model will apply (or at least test) a bundled payment methodology affecting about 30% of eligible radiation oncology episodes. Revenue reductions may be as high as […]

Hospital M&A Series Part 6: Hospital M&A: Is This a Fair Deal? What to Consider

by Daniel Grauman, Managing Director & CEO
and Kevin Cope, Manager

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Board members of not-for-profit community hospitals face enormous pressure to protect their community’s access to care. Even when the economic reasons for hospital mergers and acquisitions (M&A) are compelling, the decision to give up control to another system cannot be made based on purchase price alone. It’s just one reason why not-for-profit board members must […]

4 Myths of Physician Compensation

by Karin Chernoff Kaplan, Director
and Richard Chasinoff, Principal

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There are a number of common beliefs about setting physician compensation that are pervasive. When closely examined, they turn out to be untrue. Once you know the facts, you can do a better job of establishing appropriate compensation structures and levels.   Contact the Authors: Karin Chernoff Kaplan, Director, kkaplan@veralon.com Richard Chasinoff, Principal, rchasinoff@veralon.com

Hospital M&A Series Part 5: Hospital M&A During COVID-19: 3 Considerations in Determining the Right Affiliation Model

by Daniel M. Grauman, Managing Director & CEO

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Hospital mergers and acquisitions (M&A) slowed down during the pandemic, with M&A volume declining each quarter and sinking to a 10-year low as management teams focused on the immediate operational priorities of the pandemic. Now, as the initial shock of the pandemic wears off, leaders who were leaning toward partnership before the pandemic are left […]