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$11.5m Sightline Health Settlement: What Can We Learn?

Earlier this year, radiation therapy provider SightLine Health reached a $11.5m settlement with the DOJ in a lawsuit alleging it knowingly violated the federal physician self-referral and anti-kickback laws. Financial Arrangement According to the complaint, SightLine’s operating model was to build a radiation therapy center in a new market, and “syndicate” ownership of the center among referring physicians (primarily urologists). Sightline would keep 20% ownership of the JV entity and receive a management fee of $30,000 per month. The referring physicians would individually purchase the remaining 80%, split among 8 to 10 physician-investors who each invested approximately $100,000. The cente

Healthcare Industry Cost of Capital: Does it Vary by Segment?

One of the things we track closely is fairness opinions that get filed with the SEC when a public company gets taken private. It's always interesting to see the revenue and adjusted EBITDA projections prepared by management, as well as the comps used in the market approach section. Also interesting, and of relevance to anyone who develops a discount rate on occasion, is the cost of capital used by the bankers who prepare the analyses. We keep a database of key information from and links to fairness opinions. We've sliced and diced the data a bit to see what factors seem to impact the cost of capital selected by the preparers the most (technical note - these represent midpoints of the range f

ACO Results for Performance Year 2017: Top 4 Insights

CMS released performance year 2017 results in August for the Medicare Shared Savings Program (MSSP). It was definitely a big year for ACOs. The following is a list of key insights from this year’s data file. The ACO Success Rate Increased The percentage of ACOs that are successful is probably the most cited statistic related to the program. In PY 2017, 162 out of 472 ACOs in the MSSP beat their minimum savings rate (MSR) and achieved shared savings, representing a success rate of over 34 percent. This represents an acceleration of the improvements in previous years. There was an even larger jump in the ACO success rate when measured by total beneficiaries (i.e. the percentage of beneficiarie

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