Spring 2010
Focus on Health Care
Editor for This Issue: Charles A. Wilhoite
Health Care Reform Insights
Thought Leadership Article:
Health Care Reform-The Impact on Academic Health Centers
Joseph E. Robertson, M.D., M.B.A
Academic health centers operate simultaneously in the highly
intellectual
world of academia and
the highly competitive world of health care delivery. As a result of this unique operating
circumstance, health care reform will likely exert unique impacts on academic health
centers
relative to community hospitals and independent providers. This discussion focuses on
health
care
reform from the perspective of an academic health center.
Health Care Economics Drive Need for System-Wide Reform: An Insurance Executive's
Perspective
Mark B. Ganz
The broad objectives of health care reform include achieving universal
coverage, reducing the
growth of health care costs, and improving the quality of medical care. Meaningful
health care
reform must encompass every aspect of the health care system. This discussion analyzes
health
care
reform from the perspective of an insurance company.
Health Care Reform
Andrew R. McCulloch
While increasing access to health care is the moral thing to do, true
health
care reform requires
containment of the rising costs of care. This discussion analyzes health care reform
from the
perspective of an integrated health care delivery system.
National Health Care Reform: Dream
or Reality?
Lisa H. Tran
Millions of Americans currently do not have health care benefits. In
response
to this
overwhelming need, Congress is working to reform the health care system. This discussion
summarizes the key provisions of heath care bills that were passed in the House of
Representatives
and the Senate late in 2009.
Joint Ventures Between Tax-Exempt Health Care Organizations and For-Profit Parties
LaVerne Woods, Esq., and Thomas C. Schroeder, Esq
Joint ventures between tax-exempt health care organizations and for-
profit
parties
provide a popular approach to achieve enhanced medical operations, and increased access
to-and
implementation of-new medical technologies. This discussion analyzes the maze of federal
tax
issues that must be navigated in order to achieve the potential synergies that joint
ventures
offer.
Health Care Reform, Transparency,
and Program Integrity
Barbara L. Nay, Esq.
Discussion of health care reform has filled the national press for
much of
2009, continuing into
2010. Included in the massive legislation are "program integrity provisions" addressing
business
relationships of providers, disclosure, and enforcement that will impact the health care
industry
if adopted.
Electronic Health Records: The Foundation for the Transformation of Health Care Delivery
and
Research
Bernadette M. Broccolo, Esq.
Health information technology, including electronic health records,
represents
a significant
opportunity to enhance medical treatment through more complete, accurate, and accessible
medical
information. This discussion summarizes both (1) national plans regarding investment in
health
information technology and (2) evolving demands for the creation of bio-repositories and
data
warehouses.
CMS Proposes the Medicare and Medicaid Reimbursement Rules for Earning Incentive
Payments
Daniel F. Gottlieb, Esq.
Electronic health records are viewed by many as representing a
potentially
invaluable tool with
the ability to improve the quality and affordability of health care. This discussion
summarizes
the Centers for Medicare & Medicaid Services Proposed Rule regarding incentive payments to
eligible hospitals and professionals that employ electronic health records.
Current Compliance Challenges: Managing Academic Medical Center Financial Relationships
with
Industry
Michele M. Garvin, Esq., Heather H. Pierce, Esq., and Andrew P.
Rusczek,
Esq.
The exchange of ideas and knowledge between academia and industry is
important
to the advancement
of medicine. This discussion describes requirements and codes of conduct that academic
medical
centers should consider when business and financial relationships exist between an
academic
medical center's employed clinicians and researchers and private industry.
Best Practices Article:
From Fact to Fiction-A Brief Review for Layman of the Quirky World of "Fair Market
Value"
Paul M. Torgerson, Esq.
The fair market value standard typically governs physician-hospital
transactions required to
adhere to regulatory standards. This discussion explores the concept of fair market value,
describes the process often relied upon to estimate fair market value, and examines
specific
circumstances that affect fair market value determinations.
Key Considerations in Market-Driven Collaborative Medical Services Arrangements
Charles A. Wilhoite
Though not yet enacted, health care reform legislation is viewed by
some
industry participants as
potentially setting the stage for greater demand for health care services, combined with
continuing and increasing pressure on reimbursement levels. In response to this
confluence of
conflicting market forces, many providers continue to focus on collaborative strategies
in an
effort to achieve operating efficiencies. This discussion summarizes some of the key
considerations that should be addressed when health care service providers are
contemplating
joint
venture arrangements..
Partnering in an Uncertain Environment: Consolidation, Integration, and Joint
Ventures
Jennifer Reedstrom Bishop, Esq.
A variety of industry and economic factors continue to motivate
health care
organizations to
invest in strategies aimed at enhancing long-term effectiveness and financial viability.
This
discussion presents numerous consolidation, integration and joint venture alternatives
available
to health care organizations, and it identifies the regulatory provisions that should be
considered prior to entering any such arrangement.
Valuation of Ownership Interests in Health Care Entities for Charitable
Contributions
James G. Rabe and Hestian Stoica
An income tax deduction for charitable contributions is generally
permitted
under Internal
Revenue Code § 170(a), subject to certain limitations. This discussion summarizes (1)
Internal
Revenue Service appraisal requirements for noncash charitable contributions and (2) the
judicial
factors that the U.S. Tax Court has considered in two recent decisions that involve the
valuation
of ownership interests in health care entities for charitable contribution
purposes.
The AICPA Professional Valuation Standards: Statement on Standards for Valuation
Services
Robert F. Reilly
The American Institute of Certified Public Accountants (AICPA)
Statement on
Standards for
Valuation Services (SSVS) has become the de facto professional standard within the
valuation
profession. This discussion provides an update on this AICPA professional standard since
its
issuance in 2007. SSVS is binding on certified public accountants (CPAs) who provide
valuation
services to clients. However, it has become the generally accepted valuation profession
standard
with valuation services clients, the audit and accounting community, the legal
profession, the
judiciary, financial institutions and financial intermediaries, the national taxing
authorities,
other government agencies, and the national securities regulatory institutions