Healthcare Valuation Blog

The Department of Justice (DOJ) news page features several noteworthy settlements related to individual physicians involved in alleged medical laboratory kickback schemes. Enforcement action is likely to continue in the medical lab industry, which is upward of $250.9 billion in size and still growing.[1] Physicians who are key to this growth may not realize the extent of their exposure to prosecution in arrangements that seem like win-wins. However, common threads throughout

Hospitals and health systems nationwide are negotiating supplemental payments with their private radiology group affiliates. These payments help ensure the radiologists are paid fair market value compensation for their hospital facility services. In our work helping facilitate discussions between radiology groups and health systems, we've observed a stumbling block: the story told by compensation surveys as to what private groups should be collecting per work RVU does not ref

Work RVUs (wRVUs) are commonly used to measure physician productivity, accounting for the technical skills, physical effort, mental effort, judgment, and the amount of time required to perform a given service or procedure. Under many physician compensation plans, a physician is paid a specific dollar amount per wRVU generated. Significant amounts of money may be tied to wRVUs, so it is important that health systems and physicians have confidence that wRVU totals accurately re

Recently, DOJ announced that pharmaceutical giant Pfizer, on behalf of its subsidiary, Biohaven Pharmaceutical Holding Company Ltd. (“Biohaven”), has agreed to pay nearly $60 million to resolve allegations that Biohaven knowingly caused the submission of false claims to Medicare and other federal health care programs by paying kickbacks to health care providers (“HCPs”) to induce prescriptions of Biohaven’s migraine drug Nurtec ODT before Pfizer acquired the company. The sett

New revenue opportunities have opened up for radiology groups with CMS’ extension of flexibilities for the virtual supervision of radiology studies performed with contrast media. The extension allows facilities to provide Level 2 diagnostic tests, including CT and MRI scans, with a remotely located supervising provider through (at least) December 31, 2025. Before the COVID-19 epidemic in 2020, CT and MRI with contrast procedures had to be supervised by onsite physicians who w

Looking ahead in 2025, the healthcare industry is set to experience a year filled with dynamic opportunities, particularly in mergers and...

January 2025 BuckheadFMV has released its updated resource for healthcare and valuation professionals, the BFMV Benchmark Report for Pre-Owned Medical Equipment Prices . Based on data collected by BFMV staff, the report provides price benchmarks for nearly 1,500 different models of pre-owned medical equipment. Benchmarks are sorted by category, manufacturer/brand, and model, making the report easy to use and saving appraisers, accountants, attorneys, equipment managers, and o

The Centers for Medicare and Medicaid Services (“CMS”) recently issued the Final Rule announcing the 2025 policy changes for Medicare, including Part B issues and payments under the Physician Fee Schedule (“MPFS”), many of which take effect in January. According to the CMS Fact Sheet , “the calendar year (CY) 2025 MPFS final rule is one of several final rules that reflect a broader Administration-wide strategy to create a more equitable health care system that results in be

The BFMV Cost of Physician Staffing Services is a publication released by BFMV in the spring of each year. The study analyzes government contracts with physician staffing companies representing 88 physician specialties across the U.S. to determine rates paid to fill physician vacancies at government facilities. After-Hours Coverage vs ED On-Call A helpful insight from the BFMV Cost of Physician Staffing Services (CPSS) shows how organizations pay physicians for providing aft

Major events of 2024 delivered heavy helpings of dispute, debate, and contention. Alongside the clashes in politics and culture,...

The Trump administration's actions relative to two pending antitrust enforcement actions will provide early insight into the new...

As part of the 2024 BFMV Physician Leaders Compensation Report , BFMV analyzed Form 990 [1] data filed by non-profit hospitals and...

In July 2023, the Federal Trade Commission (“FTC”) withdrew a 1996 policy statement: Statements of Antitrust Enforcement Policy in...

In September 2024, the Department of Justice (“DOJ”) announced that Siouxland Surgery Center LLP, doing business as Dunes Surgical...

On April 23, 2024, the Federal Trade Commission ("FTC") announced a new rule abolishing non-compete agreements for almost all workers in...