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Fair Market Value Determinations and Acquisition Challenges for Medical Practices

 

The Current Environment

 

Physicians are becoming employees of the Hospital or hospital enterprise. The level of reimbursement challenges and Practice hassles have combined to change the concerns of purchasers from “how much should we pay for the Practice” to “how can we be sure that we are paying appropriately and billing compliantly.” Increased Practices are being purchased, but the private practice approach by the physician may be hard to meld easily with the Hospital environment.

 

Their concerns are not always the same as the Hospital, yet there needs to be an understanding and agreement of how specific issues should be handled—such as staffing, patient care coverage, documentation, coding and billing.

 

Specific Issues Being Faced:

 

Fair Market Value of Amount

How to base compensation initially and fairly set rates for the future. Understanding and implementing features to measure individual productivity (including bundling of services) and use of non-physician providers in RVU methodologies.

Medicaid Requirements Different than Medicare

In some states, Medicaid will not pay for a professional fee and the facility fee billed on separate claims—UB and Form 1500. Determine if the billing is provider-based, and what methodology is compliant for each payer.

Documentation of Services Provided

Moving the physician to needed standards is challenging dependent upon the way the physician has been documenting in private practice.

Selection of Codes/Services to Be Billed

This is always a key component of any physician compliance plan. We provide an unique approach creating understanding and improvement to address ongoing income considerations of pricing and contract needs to be evaluated.

 

Approach to Improvements

 

The philosophical approach to compliance and operations is to evaluate the details while understanding the global problems, and implement understandable guidance and specific tools to allow our providers to succeed.

 

KOHLER HealthCare Consulting, Inc. (KHC) Charlotte L. Kohler, President of KHC is a health care consultant and CPA who is also a Certified Valuation Analyst (CVA). She has over 25 years of Valuation experience.

 

The certification as a CVA is earned by testing, but the understanding of the underlying businesses of healthcare has been gleaned from the many years of working within medical practices and other healthcare organizations. Add to this the understanding and knowledge of how they function, the changes in healthcare reimbursements and an acute insight into published statistics and data regarding each type of health care organization.

 

Because she believes that an appraiser needs to understand the medical practice business that is being valued, she limits her services to:

  • Medical and Surgical Practices:
    all specialties
  • Associated Health Care Providers:
    DME, ASC, IV Therapy, Physical
    Therapy, Audiology, Behavioral
    Health and Home Care.
  • Determination of Fair Market Value compensation for employed
    physicians/providers.

 

Contact us to help

put the pieces together

Charlotte Kohler

(443) 956 − 1434

 

Collaboration + Knowledge = Sustainable Results

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