Pinnacle Blog

  • In Case You Missed It: Valuation Considerations for Urgent Care Centers

    VALUATION CONSIDERATIONS FOR URGENT CARE CENTERSSummary.  Patient demand forurgent care centers is increasing and as a result transaction volume is also increasing.  Often with physician ownership, the fair market value of the subject center is required to determine a transaction price.  This article examines the market and demand for urgent care center services and reviews the methods to determine the fair market value of a healthcare business.

    UCC Overview.  Urgent care centers (UCCs) have operated in the U.S. for over 30 years.  There are an estimated 8,700 UCC facilities in the U.S. according to the Urgent Care Association of America, of which 4,500 are certified urgent care centers, and about 300 new facilities open each year.  The U.S. healthcare system faces issues with access to care, increasing patient needs, growing demands on primary and emergency care systems, and rising costs.  Urgent care is intended to improve access and lower costs.

    The majority of UCCs provide services in episodic primary care, occupational medicine, routine immunizations and school physicals, and at least half of them also provide lab tests, x‐rays, fracture and laceration care, and IV fluids.  UCCs are typically open significantly beyond standard 9 – 5 office hours, including nights and weekends.  Urgent care centers are owned by physicians, physicians groups, hospitals and corporations.  They are typically staffed with physicians, with approximately half also employing physician assistants and nurse practitioners as additional providers.

    Demand.  The urgent care center industry represents one of the fastest-growing segments of the American healthcare system.  With rising wait times for both primary and emergency care providers, urgent care centers have become an increasingly viable alternative for patients.  The UCC industry is expected to continue expanding over the next several years.  One of the main factors driving growth for the industry is increasing demands made on primary care providers.  Additionally, the Affordable Care Act will begin to take effect in 2014, expanding insurance coverage to millions of people by 2019, which will result in more demand for services that are offered at UCCs.

    The UCC service model is highly favored by many different user groups: college age – for those without insurance or a selected primary care physician, uninsured – because they know what the cost is up front, suburbanites with families to care for after the working day is over and seniors – who do not want the wait time they would otherwise experience in an emergency department.

    Challenges to newcomers.  Barriers to entry in the UCC industry are high.  Barriers include regulatory hurdles and the up-front costs to establish an urgent care center.  It is more difficult to enter the industry because urgent and unscheduled healthcare services require more highly trained and diverse staff, more costly equipment and more licenses than scheduled healthcare services.  Regulation can represent a major barrier for establishing urgent care centers.  The healthcare industry is subject to regulation by federal, state and local governments.  States with certificate of need programs place limits on the construction and acquisition of urgent care centers and the expansion of existing urgent care centers and services.

    Operational challenges.  UCCs are not immune from operational challenges.  Urgent care centers are affected by seasonality – busy during flu season but not as busy during healthy summer months.  UCCs are affected by the high fixed overhead costs of staffing and office space.  Similar to other healthcare facilities, lower utilization results in significantly low profits.

    Acquisitions.  UCCs may make more sense if they are owned by healthcare or hospital systems, insurance providers (e.g., Humana’s 2010 acquisition of Concentra Inc.) or large chains that can either support such businesses as a part of the overall continuum of care or absorb the overhead by running multiple facilities.  Organizations with ready access to capital are in a good position to acquire unprofitable UCCs, and occasionally, at bargain prices.  In cases where physician ownership is involved, these transactions must be consummated at fair market value to avoid running afoul of Stark and Anti-Kickback regulations.

    Fair market value.  Three-approaches to the valuation process may be applied to calculate the fair market value transaction price:  the asset-based, income and market approaches.  The income approach determines the value of the business is equal to the present value of the future benefit stream to the owners.  The asset-based approach estimates value by valuing each asset class of the business separately and then summing them up to derive the total value of the enterprise.  The market approach makes use of guideline companies traded on a public stock exchange allowing for a comparison to be made between pricing multiples of the public companies and the multiple deemed appropriate for the subject company.  Also, multiples may be determined from transactions of entire companies that have been bought or sold in the marketplace.

    The first step is to examine the historical financial statements (e.g., income statement and balance sheet).  The income statement should be studied closely to determine whether physician provider compensation is included in the expenses or if it is considered “below the line”.  If the UCC appears to be profitable before physician compensation is allocated, the business may in actuality be generating a net loss.  When a business entity, such as a UCC, is not a viable going concern it is appropriate to calculate value using the asset approach.  If the UCC is a viable going concern one would apply the income and / or market approaches to determine the entity’s fair market value.

    The asset-based approach is typically used when the business is no longer considered a going-concern business, a business that will operate into the foreseeable future, or if physician compensation consumes all of the excess profits of the business.  Assets commonly considered in the valuation of a UCC are:  medical equipment, computer hardware and software, office equipment, office furniture, leasehold improvements, supplies inventory, trained and assembled workforce in place, trade name, contracts, and real estate.  Assets typically excluded from the analysis are cash and accounts receivable since these assets typically are retained by the seller.  Medical records add marginal value and are typically not considered given the single episode nature of patients seen.

    The income approach is used when the business is considered a going concern.  The most common method under the income approach is the discounted cash flow (DCF) method, which relies on projected estimates of future benefits.  These benefits are converted to value by applying a discount rate and using present value procedures.  An advantage of using the DCF method is the ability to capture various potential outcomes such as future growth or decline, changes in reimbursement, and variable expenses such as provider staffing levels.

    As previously mentioned the market approach may be applied to determine a pricing multiple through the comparison of guideline publicly traded companies or guideline merger and acquisition transactions.  According to a publicly traded company screen using S&P Capital IQ, there are no publicly traded urgent care centers or businesses with the sole purpose of owning and operating urgent care centers.  However, there have been several guideline mergers and acquisitions in recent years according to a transaction screen using S&P Capital IQ and data available through Irving Levin Associates Inc.’s The Health Care Services Acquisition Report (published annually) and The Health Care M&A Report (published quarterly).  Although several transactions have occurred, not enough pricing information was made available to develop a multiple.  Therefore, it is common for valuation professionals not to use the market approach when valuing UCCs.

    Synergistic value.  We discuss the methods to determine the fair market value of a UCC but also want to recognize value beyond FMV.  The synergistic value is the value to a particular buyer who has the ability to create additional benefits of ownership not available to a financial buyer through synergies unique to that buyer.  Synergistic value to a healthcare system may come in the form of control over patient flow.  For a commercial insurer, patient access to healthcare is beneficial to its core business model.  Synergistic value may come in the form of economies of scale and inorganic growth for a small privately held owner and operator of (other) UCCs.

    Conclusion.  Urgent care centers should continue to see increased utilization due to their lower cost and more efficient patient throughput.  These strong growth prospects make them popular acquisition targets for larger healthcare entities.  When there is physician ownership of the UCC, it become essential that buyers have a well documented and defensible fair market value opinion to support the transaction price.

    About the author.  Jana Sizemore is a Business Valuation Consultant with Pinnacle Healthcare Consulting.  She may be contacted at 303-801-0107 or jsizemore@pinnaclegrouphc.com.  The information presented in this article is intended for general informational purposes and does not constitute the provision of legal advice.  The views set forth herein are the personal views of the author and do not necessarily reflect the views of Pinnacle Healthcare Consulting.

     

    About Pinnacle Healthcare Consulting

    Pinnacle Healthcare Consulting provides a range of strategic, financial and operational services to improve clinical and business performance for hospitals, health systems, physician groups and other healthcare organizations. Pinnacle Healthcare Consulting is a nationally recognized leader in business valuation, physician compensation, medical staff planning, performance improvement and compliance support. Other divisions of Pinnacle provide physician practice management, medical bill/coding, and technology/integration support services. Pinnacle’s array of specialized and highly responsive client services promote advanced innovation while our dynamic team solidifies strong client relationships and assists in solving your most complex challenges.

    Contact Pinnacle Healthcare Consulting Today – 303.801.0123 or kberkey@pinnaclegrouphc.com

    Visit: www.PinnacleGroupHC.com & www.PhysicianFMV.com

    Continue reading →

  • Pinnacle Healthcare Consulting wishes you a relaxing Thanksgiving with friends and family!

    Though a single day is set aside, the thankfulness is year-round. The Pinnacle Team is grateful for your friendship and business. Pinnacle Healthcare Consulting wishes you a relaxing Thanksgiving with friends and family!

    About Pinnacle Healthcare Consulting

    Pinnacle Healthcare Consulting provides a range of strategic, financial and operational services to improve clinical and business performance for hospitals, health systems, physician groups and other healthcare organizations. Pinnacle Healthcare Consulting is a nationally recognized leader in business valuation, physician compensation, medical staff planning, performance improvement and compliance support. Other divisions of Pinnacle provide physician practice management, medical bill/coding, and technology/integration support services. Pinnacle’s array of specialized and highly responsive client services promote advanced innovation while our dynamic team solidifies strong client relationships and assists in solving your most complex challenges.

    Contact Pinnacle Healthcare Consulting Today – 303.801.0123 or kberkey@pinnaclegrouphc.com

    Visit: www.PinnacleGroupHC.com & www.PhysicianFMV.com

    Continue reading →

  • Join Pinnacle Healthcare Consulting Tomorrow at CHSM’s ‘Back to the Future’ Series – Healthcare Co-Ops: Then and Now

    CHSM ‘Back to the Future’ Series
    Healthcare Co-Ops: Then and Now, 9-14-12
    What will it take to succeed in the era of reform? What can we learn from the past?

    The new Colorado Health Insurance Co-Op recently received $69 million in federal funding to establish what’s being called a new kind of health plan—by the people and for the people.  The Co-Op promises sharply competitive pricing and benefits, an obsession with customer service, a commitment to underserved rural areas, policyholder ownership and board seats for consumers.

    But is this really new?  Yes, and no …

    Join Colorado’s most knowledgeable minds on the healthcare co-op model, and leave with a solid understanding of:

    • How the new Co-Op emerged, who’s behind it and how it intends to reach its goal.
    • What’s required of co-ops from a state and federal regulatory perspective; the similarities, differences and innovations among co-ops nationally.
    • How all of this compares to Colorado’s earlier co-op experiences—what’s different this time, what were the hurdles of the past, and what advantages do new co-ops have today?

    Speakers

    Marcia Benshoof is interim CEO of the Colorado Health Insurance Co-Op, the 18th co-op nationwide to be granted federal funding under the Affordable Care Act. Previously, Benshoof served as President of IMA Benefits, a division of the nation’s 11th largest privately held insurance brokerage. Prior to that, she was Chief Business Officer for Pinnacol Assurance, Colorado’s leading workers’ comp insurer. Benshoof has developed and executed legislative strategy around healthcare and insurance issues in Colorado and Washington, D.C.  She was honored in 2011 by Business Insurance as one of “25 Women to Watch in the U.S.”

    Claire Brockbank is the founder and principal partner of Segue Consulting, a healthcare strategy and business development firm. In the early ‘90s, Brockbank was Vice President and interim CEO of the Colorado Health Purchasing Alliance.  During her tenure she conceptualized, designed and implemented the nation’s first voluntary private sector healthcare insurance purchasing cooperative (Cooperative for Health Insurance Purchasing – CHIP), integrating large and small, insured and self-insured employers. Brockbank also served as an Advisory Board member of the American Academy of Health Purchasing Cooperatives.

     Barbara Yondorf, MPP is President of Yondorf & Associates, a health policy consulting firm. Barbara served as Co-Chair for the Federal Advisory Board on Consumer Operated and Oriented Plans (Co-Ops) for CMS, which was assembled to develop regulatory guidelines for the Co-Op program as authorized by the Accountable Care Act. Barbara currently serves on the board of directors of the Colorado Consumer Health Initiative. She previously held senior positions with the Colorado Division of Insurance, the National Conference of State Legislatures, and the Colorado Department of Health.

    Our Moderator
    Gary Montrose is principal of Healthcare Strategies, LLC, a consulting practice focused on business development in disease management, shared decision making, care management, long term care and other consumer engagement initiatives, supporting clients in more than 40 states over the past 25 years.

    *Help us shape this program to your interests.  Submit your questions to our moderator: board.president@chsm.org.

    Program Details
    DATE AND TIME
    Friday September 14, 2012
    7:00am – 7:45am Registration, Breakfast and Networking
    7:45am – 8:45am Panel Discussion
    8:45am – 9:15am Q&A

    LOCATION
    Doubletree Hotel Denver Tech, Ballroom
    7801 E Orchard Rd (just West of I-25)
    Greenwood Village, CO. 80111

    Click here to REGISTER NOW!

    About Pinnacle Healthcare Consulting

    Pinnacle Healthcare Consulting provides a range of strategic, financial and operational services to improve clinical and business performance for hospitals, health systems, physician groups and other healthcare organizations. Pinnacle Healthcare Consulting is a nationally recognized leader in business valuation, physician compensation, medical staff planning, performance improvement and compliance support. Other divisions of Pinnacle provide physician practice management, medical bill/coding, and technology/integration support services. Pinnacle’s array of specialized and highly responsive client services promote advanced innovation while our dynamic team solidifies strong client relationships and assists in solving your most complex challenges.

    Contact Pinnacle Healthcare Consulting Today – 303.801.0123 or kberkey@pinnaclegrouphc.com

    Visit: www.PinnacleGroupHC.com & www.PhysicianFMV.com

    Continue reading →

  • Join Pinnacle Healthcare Consulting at CHSM’s – Healthcare Innovation: Lessons from the Trenches

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    Healthcare Innovation: Lessons from the Trenches

    » Register Now

    Faced with a rapidly changing healthcare market, Dr. Vasu Rangadass founded Net.Orange in 2006 to create a virtually integrated care delivery platform that would transform the business of healthcare amid the challenges of mandated industry reform. Coordination of patient care and integration of services across multidisciplinary teams enables hospitals, physician practices, community providers, employers and support teams to effectively manage patients and information. Learn about the journey that took this timely new idea from concept to adoption by an industry that is mindful of compliance, must meet the needs of multiple stakeholders and can be resistant to change. This promises to be a fascinating event!

    When June 8th, 2012 7:00 AM – 9:00 AM
    Location Doubletree Denver Tech Center – Indigo Room
    7801 E. Orchard Road
    Greenwood Village, CO 80111-2508Map This Location
     
    Contact Phone: 303-265-9224
    Email: customer.service@chsm.org
    Program Speaker Vasu Rangadass, Ph.D., Chief Executive Officer and Founder of Orange.Net.
    Program Details Registration, Breakfast and Networking 7:00 a.m. – 7:45 a.m.
    Presentation 7:45 a.m. – 9:00 a.m.
    Pre Registration Register by June 1, 2012 to save $10.
    About Our Speaker

    Dr. Vasu Rangadass, Ph.D., CEO and Founder of Net.Orange, leads a team building applications in use by over 1000 providers treating over 2 million patients. Prior to this, Dr. Rangadass was the first employee of i2 Technologies, a global company that revolutionized the supply chain market through the unique application of Six-Sigma principles, operations research, and process optimization. He holds several patents in master data management, enterprise software, and workflow management, as well as extensive process experience with clients such as Dell, Pepsico, Samsung and Walmart. Dr. Rangadass holds a Ph.D. in computer engineering from the University of Texas.

     

    About Pinnacle Healthcare Consulting

    Pinnacle Healthcare Consulting provides a range of strategic, financial and operational services to improve clinical and business performance for hospitals, health systems, physician groups and other healthcare organizations. Pinnacle Healthcare Consulting is a nationally recognized leader in business valuation, physician compensation, medical staff planning, performance improvement and compliance support. Other divisions of Pinnacle provide physician practice management, medical bill/coding, and technology/integration support services. Pinnacle’s array of specialized and highly responsive client services promote advanced innovation while our dynamic team solidifies strong client relationships and assists in solving your most complex challenges.

    Contact Pinnacle Healthcare Consulting Today – 303.801.0123 or kberkey@pinnaclegrouphc.com

    Visit: www.PinnacleGroupHC.com & www.PhysicianFMV.com

    Continue reading →

  • Drew Hoffman of Pinnacle Healthcare Consulting is now a CHFP!

     

    The Pinnacle Healthcare Consulting Team would like to congratulate Drew Hoffman, Senior Analyst, for successfully completing the Healthcare Financial Management Association (HFMA), Certified Healthcare Financial Professional (CHFP) Exam.

    The CHFP certification is designed for mid-level healthcare professionals with a minimum of three to five years of management experience in U.S. healthcare provider operations. CHFP certification demonstrates qualifications to senior management, co-workers, and the industry—highlighting commitment to the profession and to maintaining up-to-date skills and knowledge.

     

    About The Colorado Chapter of the Healthcare Financial Management Association

    HFMA Colorado is a chapter of the Healthcare Financial Management Association (HFMA), which is the premiere professional membership organization for individuals engaged in the financial management of healthcare organizations. HFMA serves and represents members by:

    • Providing professional development through education, information, certification, peer interaction, and leadership training.
    • Influencing healthcare financial management and accounting policy decisions, principles, and practices through advocacy and dissemination of information.
    • Establishing and promoting the highest standards of professional and ethical conduct.

    To find out more about the Colorado HFMA Chapter, visit Chapter Information area.

     

    About Drew Hoffman, CHFP
    Senior Analyst
    Drew joined Pinnacle Healthcare Consulting during the Summer of 2010. As Analyst, he supports Pinnacle’s healthcare physician compensation, valuation and appraisal divisions, with a focus on fair market value analysis of professional service arrangements. He additionally provides market research, financial analysis and business plan development. Prior to joining Pinnacle, Drew interned at Arthur J. Gallagher & Co., a company known as one of the world’s largest insurance brokerage and risk management service firms that provides a full range of retail and wholesale property/casualty (P/C) brokerage and alternative risk transfer services, as well as employee benefit brokerage, consulting and actuarial services. During his time at Arthur J. Gallagher & Co., he created a 401k portfolio performance benchmarking template, composed requests for proposal and insurance renewal materials and participated in a regional intern project. In his free time, Drew enjoys participating in outdoor activities such as wake boarding and playing softball. Drew additionally enjoys attending listings on the silver screen when he is not participating in Colorado’s outdoor recreation.

    Expertise
    • Physician compensation planning and analysis
    • Healthcare industry trends and policy research
    • Financial analysis, forecasting and modeling
    • Business plan development

    Professional Designations and Affiliations
    • Member, Colorado Healthcare Strategy and Management (CHSM)

    Education
    • BS, Business Administration with an emphasis in Finance, University of Colorado, Boulder
    • Minor in Economics and certificate in Quantitive Finance, University of Colorado, Boulder

    Interests
    • The Great Outdoors
    • Wake boarding
    • Playing softball

    About Pinnacle Healthcare Consulting

    Pinnacle Healthcare Consulting provides a range of strategic, financial and operational services to improve clinical and business performance for hospitals, health systems, physician groups and other healthcare organizations. Pinnacle Healthcare Consulting is a nationally recognized leader in business valuation, physician compensation, medical staff planning, performance improvement and compliance support. Other divisions of Pinnacle provide physician practice management, medical bill/coding, and technology/integration support services. Pinnacle’s array of specialized and highly responsive client services promote advanced innovation while our dynamic team solidifies strong client relationships and assists in solving your most complex challenges.

    Contact Pinnacle Healthcare Consulting Today – 303.801.0123 orkberkey@pinnaclegrouphc.com

    Visit: www.PinnacleGroupHC.com & www.PhysicianFMV.com

    Continue reading →

  • Pinnacle’s Pick: Becker’s Hospital Review – 200 Statistics on Physician Compensation

    * Content written by Bob Herman, April 30, 2012 and directly quoted from Becker’s Hospital Review – 200 Statistics on Physician Compensation.

    To View the Direct link, please visit Becker’s Hospital Review

    For hospitals and health systems, physician compensation will always be a hot-button issue. Branching out and attracting physicians is a core goal of any health organization, especially with the advent of accountable care organizations, but because physicians go through thorough and rigorous medical training to deliver the highest possible care to patients, they must be compensated appropriately. Continued

    About The Physician Fair Market Value (FMV) Program

    The Physician Fair Market Value (FMV) Program dramatically reduces the complexity of determining fair market value for physician compensation. It builds internal capacity and gives hospitals more control over the process by providing proprietary tools and powerful information to help make defensible decisions about physician relationships. Over 200 hospitals and healthcare organizations have found that the Physician Fair Market Value (FMV) Program empowers users to make smart and supportable decisions with regard to physician compensation and fair market value matters. The Physician Fair Market Value (FMV) Program’s key benefits include: Hospitals using the Physician Fair Market Value (FMV) Program immediately possess greater knowledge on which to base physician contracting decisions, the reliability of a proven physician fair market value analytical methodology and improved capacity to manage / document compensation and other contractual terms. Furthermore, Physician Fair Market Value (FMV) Program support includes: training, ongoing coaching, technical support and focused consulting (if necessary).

    About Pinnacle Healthcare Consulting

    Pinnacle Healthcare Consulting provides a range of strategic, financial and operational services to improve clinical and business performance for hospitals, health systems, physician groups and other healthcare organizations. Pinnacle Healthcare Consulting is a nationally recognized leader in business valuation, physician compensation, medical staff planning, performance improvement and compliance support. Other divisions of Pinnacle provide physician practice management, medical bill/coding, and technology/integration support services. Pinnacle’s array of specialized and highly responsive client services promote advanced innovation while our dynamic team solidifies strong client relationships and assists in solving your most complex challenges.

    Contact Pinnacle Healthcare Consulting Today – 303.801.0123 orkberkey@pinnaclegrouphc.com

    Visit: www.PinnacleGroupHC.com & www.PhysicianFMV.com

    Continue reading →

  • HCCA is Excited for the Upcoming Compliance Institute and so is Pinnacle Healthcare Consulting!

     

    HCCA is excited for the upcoming Compliance Institute and so is Pinnacle Healthcare Consulting and the Physician FMV Team!

    Come visit us at booth 511 to learn more about our services and enter to win either a free Physician FMV License or the award winning Nook Color!

     

     

    Conference Hotel

    Caesars Palace

    3570 Las Vegas Blvd

    Las Vegas, NV 89109

     

    Pinnacle Healthcare Consulting’s Services Include:

    – Fair Market Value Assessment / Opinion

    – Business Valuation / Transaction Support

    – Physician Compensation Audit / Investigation

    – Physician Practice Development & Management

    – Physician Compensation Design

    – Hospital / Physician Integration

    – Billing & Coding Audits

    – Market Research & Strategic Analysis

     

    Get a Head Start on Compliance With our Fair Market Value Checklist & Risk Assessment for Physician Contracts Tool!

     

    About The Physician Fair Market Value (FMV) Program

    The Physician Fair Market Value (FMV) Program dramatically reduces the complexity of determining fair market value for physician compensation. It builds internal capacity and gives hospitals more control over the process by providing proprietary tools and powerful information to help make defensible decisions about physician relationships. Over 200 hospitals and healthcare organizations have found that the Physician Fair Market Value (FMV) Program empowers users to make smart and supportable decisions with regard to physician compensation and fair market value matters. The Physician Fair Market Value (FMV) Program’s key benefits include: Hospitals using the Physician Fair Market Value (FMV) Program immediately possess greater knowledge on which to base physician contracting decisions, the reliability of a proven physician fair market value analytical methodology and improved capacity to manage / document compensation and other contractual terms. Furthermore, Physician Fair Market Value (FMV) Program support includes: training, ongoing coaching, technical support and focused consulting (if necessary).

     

     

    About Pinnacle Healthcare Consulting

    Pinnacle Healthcare Consulting provides a range of strategic, financial and operational services to improve clinical and business performance for hospitals, health systems, physician groups and other healthcare organizations. Pinnacle Healthcare Consulting is a nationally recognized leader in business valuation, physician compensation, medical staff planning, performance improvement and compliance support. Other divisions of Pinnacle provide physician practice management, medical bill/coding, and technology/integration support services. Pinnacle’s array of specialized and highly responsive client services promote advanced innovation while our dynamic team solidifies strong client relationships and assists in solving your most complex challenges.

    Contact Pinnacle Healthcare Consulting Today – 303.801.0123 orkberkey@pinnaclegrouphc.com

    Visit: www.PinnacleGroupHC.com & www.PhysicianFMV.com

    Continue reading →

  • Physician FMV Program – 2012 New Additions

    Physician FMV Program – 2012 New Additions

    With over 200 hospitals and health systems – and growing, the Physician FMV Program strives to create innovative and beneficial services for our licensed Program members. 

     

    79 Physician Specialties & Growing

    The Physician Fair Market Value Program pays close attention to our clients’ ever-growing needs for an expansive list of physician specialties. Physician specialties new this year include: Anatomic Pathology Specialty, Bariatric Surgery Specialty, Breast Surgery Specialty, Clinical Pathology Specialty, Hospice & Palliative Care Specialty, Nurse Practitioner (General) Specialty, Pediatric (Otolaryngology) Specialty, Surgical Podiatry Specialty and Thoracic Surgery Specialty. If your organization requires a specific physician specialty that is not currently listed, please contact a Physician FMV Program team member, who can help you find the information you need.

     

    Showing 25th, 50th, 75th and Now 90th Percentile (online only)

    The Physician FMV Program is a proven solution for supporting “in-the-box” arrangements. However, when faced with compensating highly productive physicians, contracting with Key Opinion Leaders, and working with extraordinary recruitment / retention challenges, hospitals / health systems may need to pay “above the Workbook Program” range to secure physician services. As reference, Physician FMV Online now provides 90th percentile reference information for employed physician compensation. Although Pinnacle’s third party FMV opinion does not extend beyond the 75th percentile, Physician FMV’s goal is to provide client members with flexibility through data-driven resources.

     

    Blended Call Arrangement Estimator Tool

    Physician FMV Online introduces our new Blended Call Arrangement Estimator. This tool is intended to assist hospitals with an estimate of reasonable daily compensation for blended call coverage arrangements (those arrangements that combine restricted / in-house call with unrestricted / beeper call). The calculation derived by this model proportionally combines FMV Hourly Compensation data for restricted time with the Unrestricted Call data for unrestricted time. The calculation provides a useful starting point  to evaluate FMV compensation for more complex call arrangements.

     

    Compensation Per Work RVU

    Physician compensation and benchmarking models continue to rely on productivity metrics, especially physician work relative value units (WRVUs). Contract negotiations, incentive plans and the success of physician compensation strategies often hinge on WRVU measurements. Payor mix issues can be mitigated through the utilization of WRVUs to balance individual physician production and declining unfavorable reimbursement levels. With survey sources now providing more robust compensation to WRVU data, the Physician FMV Program is making compensation to WRVU data by specialty available for reference.

     

     

    About The Physician Fair Market Value (FMV) Program

    The Physician Fair Market Value (FMV) Program dramatically reduces the complexity of determining fair market value for physician compensation.  It builds internal capacity and gives hospitals more control over the process by providing proprietary tools and powerful information to help make defensible decisions about physician relationships. Over 200 hospitals and healthcare organizations have found that the Physician Fair Market Value (FMV) Program empowers users to make smart and supportable decisions with regard to physician compensation and fair market value matters.  The Physician Fair Market Value (FMV) Program’s key benefits include: Hospitals using the Physician Fair Market Value (FMV) Program immediately possess greater knowledge on which to base physician contracting decisions, the reliability of a proven physician fair market value analytical methodology and improved capacity to manage / document compensation and other contractual terms.  Furthermore, Physician Fair Market Value (FMV) Program support includes: training, ongoing coaching, technical support and focused consulting (if necessary).

     

    About Pinnacle Healthcare Consulting

    Pinnacle Healthcare Consulting provides a range of strategic, financial and operational services to improve clinical and business performance for hospitals, health systems, physician groups and other healthcare organizations.  Pinnacle Healthcare Consulting is a nationally recognized leader in business valuation, physician compensation, medical staff planning, performance improvement and compliance support.  Other divisions of Pinnacle provide physician practice management, medical bill/coding, and technology/integration support services.  Pinnacle’s array of specialized and highly responsive client services promote advanced innovation while our dynamic team solidifies strong client relationships and assists in solving your most complex challenges.

    Contact Pinnacle Healthcare Consulting Today – 303.801.0123 orkberkey@pinnaclegrouphc.com

    Visit: www.PinnacleGroupHC.com & www.PhysicianFMV.com

     
    Continue reading →

  • Pinnacle Healthcare Consulting Looks Forward to Seeing You at the Upcoming Colorado HFMA Annual Conference – April 18-20th, 2012

     

    We look forward to seeing you at the upcoming  Colorado HFMA – Annual Conference  

    April 18-20th, 2012 

    Be sure to stop by and visit Pinnacle Healthcare Consulting at our exhibit booth!

    This year’s Annual Conference focuses on the changes taking place in healthcare. Speakers will address such issues as Leadership, Healthcare Reform, Revenue Cycle, and Accounting. Last but not least, an interactive Point/Counter Point discussion on Healthcare Reform from both political sides of the issue should generate some lively discussion.

     

    Hotel Information:

    Marriott Denver South at Park Meadows

    Park Meadows Drive, Lone Tree, CO

     

    Annual Conference Agenda

    Wednesday April 18, 2012

    Certification Coaching Course- Registration details on Program. This course is designed to help you in taking the HFMA Certification Exam as well as the self-study materials you need to purchase in advance of the course.

     

    Thursday April 19, 2012

    Keynote Presentation: “Challenges Facing Hospitals and Strategy that PVHS is Building to Ensure Success”

    Speaker: Rulon Stacey PhD, FACHE, President and CEO, Poudre Valley Health System, Fort Collins, CO

    Rulon Stacy has been CEO of Poudre Valley Health System since 1996 and has led the transformation of PVHS into a health system with more than 5,300 employees and a dozen facilities in three states. He has found ways to align incentives with regional providers in order to maximize value to patients, developed nearly 20 joint ventures which focus on quality outcomes and in the process quadrupled the net revenue and net assets of the health system. He will share how this has been accomplished along with the leadership skills he used to make it happen.

    Rulon has received numerous awards including the Young Healthcare Executive of the Year from the American College of Healthcare Administrators (ACHE) and the 100 Most Influential People in Healthcare by Modern Healthcare. He served on the governing board of ACHE and was the 77th Chairman of their board. In 2008, PVHS was recognized by the President of the United States as the only health system in the United States to receive the Malcolm Baldrige National Quality Award.

    You will want to hear his message on how he has led this organization to excellence and what you need to do to lead your organization in these challenging times.

     

     

    General Session: “Creating an Exquisite Patient Revenue Cycle Experience Growing Your Bottom Line and Market Share”

    Speaker: Bobette Gustafson, Founder, President and CEO, Gustafson & Associates, Nakomis, FL

    HCAHPS along with the more sophisticated and demanding patient/consumer require that financial executives and revenue cycle professionals protect the lifetime revenue value of each patient served. But, a mere “patient-focused” approach is no longer enough. Quality clinical experiences must be enhanced by truly exceptional revenue cycle touch point outcomes – from pre-access through account closure. Therefore, the organizational culture and process, technology and people models must be fully transformed. An essential strategy of all other industries except healthcare… Customer Relationship Management (CRM)… is the key.

    Attendees Will Be Able to:

     – Quantify the financial impact of the total patient experience and the lifetime revenue value of current and future volumes

    •  – Define the critical revenue cycle patient touch points and their relationship to clinical touch points; more effectively and objectively assess patients’ current total revenue cycle satisfaction level and gain specific insight into their expectations that must be met or exceeded to ensure their unquestionable future loyalty

    •  – Identify and eliminate avoidable revenue cycle processing costs; secure future patient lifetime revenues by crafting a CRM-based, patient-preference driven, and clinically integrated revenue cycle process, technology, and people model; and prepare for successful implementation by identifying and mitigating cultural and other organizational risks.

     

     

    General Session: “PPACA from the Perspective of the Health Plan”

    Speakers: Donna Lynne, DrPH, Group President, Kaiser Foundation and Kaiser Foundation Health Plan. President, Kaiser Foundation Health Plan, Denver, CO

       What have been impacts of PPACA to date?

    •  – Age 26 dependents=more members

    •  – Changes in preventive services=higher costs short term

    •  – Lifting of annual and lifetime max=higher costs/premiums

    •  – Medical Benefits Ratio (MBR)=more dollars devoted to benefits

    •  – Medicare Five Star/P4P=more money to plans with high ratings, and more focus on quality and service

    •  – HIT/payments for meaningful use=more money to plans, faster adoption of IT, improved quality and service and more affordability

       What challenges are ahead of us?

    •  – Accountable Care Organizations (ACOs): will they save money, what unintended consequences are there?

    •  – Health Exchanges: being ready for 2014/building capabilities

    •  – Dealing with hundreds of thousands of newly insured in Colorado

         o Integrating safety net providers

         o Building a sustainable financial model

         o Educating new members about being good users of coverage

         o Making movement in and out of exchange and Medicaid seamless

    •  – Payment reform

    •  – Uncertainty about PPACA being upheld

     – How is Kaiser Permanente dealing with these challenges; what about other health plans?

     

     

    General Session: Brian Fellner, Senior Vice President & CFO, American Enterprise Group, Des Moines, IA

    “So you think the insurance company (payer) was fun to deal with prior to the Affordable Care Act (ACA)? What’s next????”

    The regulatory and competitive landscape is changing rapidly for health care insurers. These changes will result in new product designs and new reimbursement strategies that will impact providers. Hear the inside story from a health insurance company perspective.

    Presentation Takeaways:

    1. Understand the impacts of health insurer consolidation

    2. Review of contracting and reimbursement trends

    3. Discuss health insurance product trends

     

     

    Finance Track PFS Track

    “Healthcare Market Update, Rating Agency Outlooks and Pricing Data”

    Speaker: Will Douglas, Jr., Director, Wells Fargo Securities, Denver, CO

    This session will review the current status of credit markets for various healthcare borrowers. Included will be a historical perspective on interest rate trends, rating agency viewpoints and concerns, general economic and healthcare specific statistics and outlooks for capital access. Participants will learn the current state of credit markets, future concerns that may affect the cost of capital and what can be done to best position their respective organizations in the event accessing capital is needed within the next year or two.

    Medicare Part A Updates and Overview Partners in Compliance”

    Speaker: Steven Milward, Project Administrator, TrailBlazer Health Enterprises, LLC, Denison, TX

    An overview of the 2012 Medicare Part A updates and changes will be provided along with an overview of Partners in Compliance that includes Recovery Audit Contractor (RAC) Program.

     

    Panel Discussion: “How to use your collection agency as a resource and evaluating their performance”

    Panelists: Ruth Benton, MBA, CEO, New West Physicians, Golden, CO, Larry Dupper, FHFMA, CFO, Valley View Hospital, Glenwood Springs, CO and Ron Feret, CHFP, CFO, HealthOne Clinic Services, Denver, CO

    The panel will make some opening comments regarding issues they are facing as CFO’s in their organizations and then open it up for an interactive discussion between the panelists and attendees. from four collection agencies addressing the topic above and answering questions from attendees

    Panel Facilitator: Tim Brainerd, CEO, Revenue Enterprises, LLC

    Panelists:

    · Mike Yont, Managing Principal, Integral Healthcare Solutions, Inc.

    · Pilar Mank, Director of Revenue Cycle Services, Healthcare Management, LLC

    · Jerry Peer, Vice President Collections, Professional Finance Company

    · Terri Boettcher, Vice President Collections, BC Services, Inc.

     

     

    Friday April 20, 2012

    General Session –“Creating Bolder, Smarter Partnerships in Health Care”

    Speaker: Bruce Schroffel, CEO, University of Colorado Hospital, Aurora, CO

    Bruce Schroffel, newly appointed president of University of Colorado Health, will review the transitions the industry is going through and discuss in detail the rational that drove him to form a new partnership with Poudre Valley Health System. He’ll explain the long-term lease with Memorial Health System. He will also state why he thinks this new model of bringing together the best in academic medicine with the best in community will not only work, but thrive in a chaotic industry.

     

     

    Point/Counter Point Presentation – “Healthcare Reform Act: The View from Two Political Perspectives”

    Speakers: Jeanne Scott Matthews, Talking Head in Chief, Health- Politics.com, Gold Canyon, Arizona and Linda Gorman, Director, Healthcare Policy Center, Denver, CO

    The two experts will provide their insights from the left and right of the political spectrum on the healthcare reform law. Each of them will give a presentation and then take questions from each other and the audience.

     

     

    Closing General Session: “Professional Ethics: A Preventive Maintenance Approach”

    Speaker: Chris Bauer, PhD, Ethics Expert and Grin Inducer, Bauer Ethics Seminars

    This won’t be a review of the ethics code, case studies, or case law! Instead, it will be a unique program designed to help assure that you and your entire organization are able to more easily “walk the talk” of great ethics. This oftenhumorous program will show us ethics risks we never even knew we had and what can be done right now to make sure those risks don’t turn into costly ethical and legal problems on the job. You will also learn how even a slightly changed focus on ethics can significantly build your organization’s bottom line. Ethics and fun aren’t words you normally hear in the same sentence. However, Dr. Christopher Bauer has been making professional ethics both straightforward and fun for international audiences for more than 25 years. He will present ethics differently than you have probably ever experienced them before. The tone will be conversational and the ideas immediately applicable. You will leave with easy, practical ideas and tools to reduce your risk for ethics difficulties while simultaneously reducing the risk of your colleagues, coworkers and entire organizations.

     

    About Pinnacle Healthcare Consulting

    Pinnacle Healthcare Consulting provides a range of strategic, financial and operational services to improve clinical and business performance for hospitals, health systems, physician groups and other healthcare organizations. Pinnacle Healthcare Consulting is a nationally recognized leader in business valuation, physician compensation, medical staff planning, performance improvement and compliance support. Other divisions of Pinnacle provide physician practice management, medical bill/coding, and technology/integration support services. Pinnacle’s array of specialized and highly responsive client services promote advanced innovation while our dynamic team solidifies strong client relationships and assists in solving your most complex challenges.

    Contact Pinnacle Healthcare Consulting Today – 303.801.0123 or kberkey@pinnaclegrouphc.com

    Visit: www.PinnacleGroupHC.com & www.PhysicianFMV.com

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  • Pinnacle Healthcare Consulting Sponsors Health Care in Your Future Summit

     

    Pinnacle Healthcare Consulting was excited to sponsor Fort Collins Area Chamber of Commerce yesterday at the Health Care in Your Future Summit. Over 280 people were in attendance to discuss developments in health care, the outlook for the health care industry in the Fort Collins region and actions that could strengthen the health care sector.

     If you missed yesterday’s event, presentations can be found online and will continue to be added at:  http://bit.ly/FCChamberHealthCare

     

    Yesterday’s Agenda Included:

    What’s the Problem with Health Care and How Did We Get Here? – Dr. Rulon Stacey, CEO of University of Colorado Health

     

    Where You Stand on Health Care Reform Depends on Where You Sit: What Does All This Change Mean to Me?

            By David May, Fort Collins Area Chamber of Commerce President & CEO

            Yvonne Myers, Columbine Health Systems Director

            Jim Sampson, Flood & Peterson Benefits Executive

            Dr. Jim Sprowell, Associates in Family Medicine, Executive Director

            Kevin Unger, Poudre Valley Hospital President & CEO

            David Speights, Zila CEO, A Tolmar Company

     

    This is Getting Old Fast: Aging in Northern Colorado – Elizabeth Garner, State of Colorado Demographer

           By Evan Hyatt, Pathways Hospice CEO

           Mike Maguire, Home Instead Senior Care Owner

           Yvonne Myers, Columbine Health Systems Director

     

    All This Reform Stuff Sounds Expensive: Who Pays?

            By Dr. Jandel Allen-Davis, Kaiser Permanente, Vice President of Government and External Relations

            Janet Pogar, Anthem Blue Cross Blue Shield Vice President

            Cynthia Palmer, Colorado Choice Health Plans CEO

            Carl Smith, Poudre Valley Health System Vice President, Payor Relations

    Money and Jobs: What Does All This Change Mean to the Economy of Northern Colorado? – Dr. Martin Shields, Colorado State University Regional Economist

     

    UPCOMING EVENT!

    Fort Collins Area Chamber of Commerce’s next major event is Celebrating Small Business day on March 25th – including a luncheon with a speaker, a spring showcase and an after hours.  Information can be found here

    For additional comments or questions about Fort Collins Area Chamber of Commerce Events, Please contact:

             Ann Hutchison, CAE
            Executive Vice President
            Fort Collins Area Chamber of Commerce
            ahutchison@fcchamber.org
     

     

    About Pinnacle Healthcare Consulting

    Pinnacle Healthcare Consulting provides a range of strategic, financial and operational services to improve clinical and business performance for hospitals, health systems, physician groups and other healthcare organizations.  Pinnacle Healthcare Consulting is a nationally recognized leader in business valuation, physician compensation, medical staff planning, performance improvement and compliance support.  Other divisions of Pinnacle provide physician practice management, medical bill/coding, and technology/integration support services.  Pinnacle’s array of specialized and highly responsive client services promote advanced innovation while our dynamic team solidifies strong client relationships and assists in solving your most complex challenges. 

    Contact Pinnacle Healthcare Consulting Today – 303.801.0123 or kberkey@pinnaclegrouphc.com

    Visit: www.PinnacleGroupHC.com & www.PhysicianFMV.com

     

    Continue reading →