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Results for “Practice Valuation and Purchase”

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PubMed2001

Improving IDS performance through group practice expense management.

IDSs can turn around an owned group practice's poor financial performance by taking steps to more effectively manage the practice's expenses. The primary areas on which an IDS should focus its expense-management efforts are physician compensation, nonprovider staffing, and facility planning. The physician compensation system, for example, should include incentives for physicians to improve performance and increase productivity, and the size of the nonprovider staff should be adjusted according to patient volumes. Other areas in which changes in strategy may be required include information system investments; budgeting, accounts-payable, and purchasing processes; and corporate allocations of practice revenues to recover practice acquisition costs.

Costs and Cost Analysis↗
PubMed2000

HCFA issues guidance and answers questions related to the provider-based status of facilities.

Over the last few years, the Health Care Financing Administration ("HCFA") has become increasingly concerned with hospital systems billing for services provided at related and affiliated sites as "provider-based" rather than independent facilities. By billing as provider-based, a hospital is entitled to charge HCFA in a slightly different manner that typically leads to higher reimbursement. In Program Memorandum to Intermediaries A-99-24, issued in May 1999, HCFA stated that, with the growth of integrated delivery systems, it has received numerous requests from entities requesting provider-based status. These requests, if approved, increase the portion of the facility's general and administrative costs supported by the Medicare program with no commensurate benefit to Medicare and its beneficiaries. Therefore, it is critical that HCFA designate as provider-based only those entities that are unquestionably qualified. On September 20, 2000, HCFA's administrator released a letter summarizing this concern over provider-based entities. The letter stated that the Department of Health and Human Services Office of Inspector General ("IG") has concluded that many hospital purchases of physician practices appear to have been designed not to ensure services are provided to participants in the most appropriate setting but, rather, simply to obtain higher Medicare payments. The IG strongly recommended that, if such arrangements continue, HCFA take steps to curtail them. The outcome of this recommendation is the proposed provider-based regulations ("Proposed Regulations") issued by HCFA on April 7, 2000.

Centers for Medicare and Medicaid Services, U.S.↗
PubMed1998

New contractual affiliations can salvage unsuccessful practice acquisitions.

Many healthcare organizations become disillusioned with their acquired medical practices within a few years of purchase because of major financial, operational, and political problems with their new networks. As postacquisition financial losses increase and relationships with physicians under contract decline, many healthcare organizations seek an escape from the situation. Three options for dealing with a failing acquisitions program are to do nothing until the physicians' employment contract expires, give the practice back to the physicians, or negotiate a contractual settlement in which the practice is returned to the physicians in exchange for a new contractual commitment to the healthcare organization. The third option offers the greatest potential for salvaging the arrangement and preserving the physician-organization relationship.

Attitude of Health Personnel↗
PubMed2000

Three strategies used by academic health centers to expand primary care capacity.

The growth of managed care in the late 1980s and early 1990s severely disadvantaged academic health centers (AHCs). The reliance on primary care gatekeeping and selective contracting by managed care plans were two contributing factors. Because most AHCs had only a modest primary care capacity, they were understandably concerned about their strategic positions. Thus, many felt it was essential to expand their primary care capacities to ensure downstream referrals, to improve contract negotiations with third parties, and to permit assumption of risk for defined populations. Among the different approaches used, three principal strategies emerged for the expansion of the primary care capacity of AHCs: (1) the "assembly strategy," in which many AHCs recruited new generalist faculty into existing clinical departments; (2) the "acquisition strategy," in which AHCs purchased established primary care practices in the community; and (3) the "affiliation strategy," in which some AHCs affiliated with primary care physicians in the community and formed networks of academic and community physicians. For each of these approaches, the author reviews the relative merits and disadvantages, and analyzes why some AHCs' original assumptions about the imperative for increasing primary care capacity may have been spurious. He concludes that recent marketplace and regulatory changes may make it less necessary for AHCs to secure substantial primary care bases in the future.

Academic Medical Centers↗
PubMed2000

Thinking about a mobile health unit to deliver services? Things to consider before buying.

Purchasing a mobile unit to deliver health-care services can be an expensive undertaking for anyone interested in pursuing this option. Yet, little information is found in the literature on planning or designing such vehicles. A set of guidelines could help administrators to make better decisions regarding this approach for delivering healthcare. This article focuses on mobile health units (MHU). It provides a synthesis of the literature in addition to information from written and oral correspondence with the chief executive officers (CEO) of firms that manufacture MHU. On-site visits to agencies using an MHU were made by one of the authors (DM) to glean their perspective. The combined sources led to the development of guidelines and checklists that can assist administrators in planning the function, design and operation of an MHU to deliver health-care services to remote rural sites.

Cost-Benefit Analysis↗
PubMed2006

Contemporary issues of veterinary practice valuation and sale transactions.

This article comprises discussions on practices with little or no salable value, the determination and measurement of the value of a veterinary practice, the evolution of the small animal practice marketplace, the costs of selling a portion of a practice, lack of marketability discount, and C corporation issues.

Animals↗
PubMed2006

Succession planning.

This article provides the reader with an appreciation of the diverse elements that go into a buy-sell, affiliation, or merger situation for veterinary practices. In the changing market place of American veterinary medicine, old paradigms no longer hold comfort. The generational differences are briefly explored herein as well as the new economic realities. A few examples are offered to illustrate just how much variability exists in the current business of veterinary medicine and the subsequent practice transitions needed to enhance value. Functioning models are explored, as well as affiliation and merger options. Practice valuation is discussed in general terms, referencing the cutting-edge factors. The six-point summary provides almost all practices a solid operational base for daily operations and succession planning.

Economic Competition↗
PubMed1999

Retirement from orthodontics: financial and psychosocial preparation and adaptation.

Retired members of the Pacific Coast Society of Orthodontists (n = 231) were surveyed with respect to their financial and psychosocial preparation for, and adaptation to, retirement. Statistical and subjective evaluation of the survey results established that the respondents used a variety of strategies in divesting themselves of their practices and other aspects of professional life. The respondents reported a relatively high level of accumulated wealth and general satisfaction with retirement as a result of a sense of financial security as well as continued active participation in diverse recreational, social, avocational, business, family, and community activities. Early anticipation of and planning for all aspects of the retirement experience enhanced the likelihood of a satisfactory outcome.

Adaptation, Psychological↗
PubMed2003

A view from the bodies corporate. 5. Integrated dental holdings plc. Interview by F. Stuart-Wilson.

My interview with David Hudaly, Chief Executive of IDH plc took place at their unassuming head office in Bolton. I make the mistake of assuming, like many, that IDH's operations are based mainly in the North. David Hudaly puts me right fairly early on in our interview. In fact IDH is not one, but two bodies corporate now with 146 practices across the UK, and incorporating the Whitecross and Petrie Tucker chains (although some of the Whitecross units have recently been sold). The business structure appears at first sight to be more complex than the other corporates I have encountered in this series; IDH floated in February 2002 and is now a plc.

Dentists↗