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Hosp Phy Economic Relationships
- 1. Hospital-Physician Economic Relationships – Assessing Their Fair Market Value and Commercial Reasonableness
- 3. Conceptual Overview of Hospital – Physician Economic Alignment Arrangements
- 4. Why Economic Alignment? Page Page Lifestyle preference and practice patterns Increasing specialization/aging Decreasing supply… Increasing pressure… Healthcare reform Cost and reimbursement trends
- 6. Navigating the Regulatory Environment Page Page IRS Stark Anti- Kickback
- 7. Compliance Issues Regarding Hospital-Physician Financial Relationships Page Page Fair Market Value ________________________________________________________________________ Cents ________________________________________________________________________ Scope : Range of Dollars Only Key Question : “How Much”? Commercial Reasonableness ________________________________________________________________________ Sense ________________________________________________________________________ Scope : Overall Arrangement Key Question : “Why”? Two Components
- 9. Factors in Determining CR Page Page Commercial Reasonableness Determination Business Purpose Provider Facility Resource Independence & Oversight
- 21. Case Studies: Applying the Concepts
- 71. Contact Information Page Page Knoxville - Atlanta - Tampa Bay - Austin W. James Lloyd (865) 673-0844 [email_address] John R. Holdenried (402) 636-8201 [email_address] Visit our web site at www.pyapc.com Visit our web site at www.bairdholm.com
Editor's Notes
- Key Elements under (iii): Supply and Demand of Physician Specialties Administrative Duties and Responsibilities Teaching Responsibilities The Operational and Financial Performance of the Entity for Whom the Hospital will be Contracting “ The Hassle Factor” Unionized Labor Previous Compensation Offers (bona fide offers from other institutions?) Years of Experience/Service Credentials and Specialized Training/Education Community Norms Academic Duties Cost of Living Medicare Rates for Clinical Services Profit Margin Physician Benefits Payor Reimbursement Trends (could include discussion of CMS publication/chart) Compensation Trends Consequences of Not Retaining an Individual/Entity to Perform the Contracting Services Key Elements under (iv): The Income Approach The Cost Approach (build/replacement) The Market Approach (market comp)
- Key Elements under (iii): Supply and Demand of Physician Specialties Administrative Duties and Responsibilities Teaching Responsibilities The Operational and Financial Performance of the Entity for Whom the Hospital will be Contracting “ The Hassle Factor” Unionized Labor Previous Compensation Offers (you could also mention bona fide offers from other institutions here) Years of Experience/Service Credentials and Specialized Training/Education Community Norms Academic Duties Cost of Living Medicare Rates for Clinical Services Profit Margin Physician Benefits Payor Reimbursement Trends (could include discussion of CMS publication/chart) Compensation Trends Consequences of Not Retaining an Individual/Entity to Perform the Contracting Services Key Elements under (iv): The Income Approach The Cost Approach (build/replacement) The Market Approach (market comp)
- Key Elements under (iii): Supply and Demand of Physician Specialties Administrative Duties and Responsibilities Teaching Responsibilities The Operational and Financial Performance of the Entity for Whom the Hospital will be Contracting “ The Hassle Factor” Unionized Labor Previous Compensation Offers (you could also mention bona fide offers from other institutions here) Years of Experience/Service Credentials and Specialized Training/Education Community Norms Academic Duties Cost of Living Medicare Rates for Clinical Services Profit Margin Physician Benefits Payor Reimbursement Trends (could include discussion of CMS publication/chart) Compensation Trends Consequences of Not Retaining an Individual/Entity to Perform the Contracting Services Key Elements under (iv): The Income Approach The Cost Approach (build/replacement) The Market Approach (market comp)
- Key Elements under (iii): Supply and Demand of Physician Specialties Administrative Duties and Responsibilities Teaching Responsibilities The Operational and Financial Performance of the Entity for Whom the Hospital will be Contracting “ The Hassle Factor” Unionized Labor Previous Compensation Offers (you could also mention bona fide offers from other institutions here) Years of Experience/Service Credentials and Specialized Training/Education Community Norms Academic Duties Cost of Living Medicare Rates for Clinical Services Profit Margin Physician Benefits Payor Reimbursement Trends (could include discussion of CMS publication/chart) Compensation Trends Consequences of Not Retaining an Individual/Entity to Perform the Contracting Services Key Elements under (iv): The Income Approach The Cost Approach (build/replacement) The Market Approach (market comp)
- Key Elements under (iii): Supply and Demand of Physician Specialties Administrative Duties and Responsibilities Teaching Responsibilities The Operational and Financial Performance of the Entity for Whom the Hospital will be Contracting “ The Hassle Factor” Unionized Labor Previous Compensation Offers (you could also mention bona fide offers from other institutions here) Years of Experience/Service Credentials and Specialized Training/Education Community Norms Academic Duties Cost of Living Medicare Rates for Clinical Services Profit Margin Physician Benefits Payor Reimbursement Trends (could include discussion of CMS publication/chart) Compensation Trends Consequences of Not Retaining an Individual/Entity to Perform the Contracting Services Key Elements under (iv): The Income Approach The Cost Approach (build/replacement) The Market Approach (market comp)