Valuing Specialty Medical Practices
Recently retired and devoted to writing new books, including the Engagement Guide to Understanding and Valuing Medical Practice Specialties, nationally known healthcare valuation expert Mark Dietrich shares his “trade secrets” from a 45-year career with valuation engagements in 46 states, as well as consulting in England and Scotland.
Jayawardena v. Daka
This case involved a shareholder dispute among four shareholders of a physician practice (Ferncreek Cardiology PA) and two real estate LLCs. There were buy-sell provisions for each of the three entities. As to Ferncreek, the buy-sell provision was essentially an increase in book value provision, as the regular account determined in “good faith.” Payment provisions were also included in the agreement. The two real estate LLCs had a buy-sell provision that provided for either a single agreed-upon appraiser or three appraisers if no agreement was made. The plaintiff made the decision to exit the practice, triggering the buy-sell provisions. The parties were not able to agree on certain provisions as they worked through the buy-sell agreements. The trial court entered partial summary judgments on some claims of both parties. This appeal dealt with these partial summary judgments and was filed by the plaintiff.
North Carolina Appeals Court Affirms Decisions on Value of Businesses Under Buy-Sell Agreements
This case involved a shareholder dispute among four shareholders of a physician practice (Ferncreek Cardiology PA) and two real estate LLCs. There were buy-sell provisions for each of the three entities. As to Ferncreek, the buy-sell provision was essentially an increase in book value provision, as the regular account determined in “good faith.” Payment provisions were also included in the agreement. The two real estate LLCs had a buy-sell provision that provided for either a single agreed-upon appraiser or three appraisers if no agreement was made. The plaintiff made the decision to exit the practice, triggering the buy-sell provisions. The parties were not able to agree on certain provisions as they worked through the buy-sell agreements. The trial court entered partial summary judgments on some claims of both parties. This appeal dealt with these partial summary judgments and was filed by the plaintiff.
Stark Differences from the Inside Out: Two Key Responders Discuss The Final Stark Regulations for FMV and Commercial Reasonableness
The Stark regulations have been updated. What has changed and how does it impact value? Mark Dietrich and Tim Smith were two major contributors of public comments to the Centers for Medicare & Medicaid (CMS) for the updated Stark regulations with over 100 pages of newly written material that was influential in the development of the final regulatory definitions for FMV and commercial reasonableness. In addition, they included over a dozen chapters from the BVR/AHLA ...
Physician Compensation and Valuation: Administering Top Tier Treatment
Assessing physician compensation is a critical component in valuing a physician practice. Many external factors, including the COVID-19 pandemic and proposed changes to the Medicare Physician Fee Schedule, have had and will continue to have significant impacts on physician compensation and associated practice valuations. In this discussion, Derek Long and Katie Culver will explain how physician compensation is analyzed in the context of valuation along with various factors that can influence it, both internally and ...
Healthcare Valuation Townhall: Four Expert Panel on Covid-19 Impacts and Beyond
Bring your questions as leading experts Jerry Chang, Mark Deitrich, James Lloyd and Todd Sorensen have a conversation about the critical issues impacting healthcare. Covid-19 has impacted the healthcare industry in unique ways, and those valuation experts who practice in this high regulation environment know it is critical to keep up to date about the most pressing issues. Covering a wide range of issues from four perspectives this event delivers the insight you need in ...
Valuing Rural Healthcare Clinics
Rural health clinics (RHCs) are specially certified entities that were created to increase access to primary care services for patients located in rural communities. Demand for rural health services is expected to increase in the coming years due to the aging baby boomer population and its status as potential acquisition targets by nonprofit healthcare organizations seeking to meet their charitable mission. The number of transactions involving RHCs is expected to increase, creating an opportunity for ...
Commercial Reasonableness: Defining Practical Concepts and Determining Compliance in Healthcare Transactions for Physician Services
Financial relationships between hospitals and physicians must be both commercially reasonable and at fair market value (FMV) to meet certain regulatory requirements. Ensuring compliance with these requirements is critical--failing to do so could invoke sanctions and penalties related to the Stark Law, the Anti-Kickback Statute, the False Claims Act (FCA), and Internal Revenue Service 501(c)(3) status for tax-exempt entities. As such, a thorough understanding of these requirements is necessary to ensure compliance in transactions between hospitals and physicians, as well as other parties with referral relationships within the healthcare environment.
Goodwill-noncompete connection trips up buyer of medical practice
Ultimately, the parties reached a deal that included the sale of the building and the sale of the assets of the practice, as well as an employment contract for the doctor. The asset purchase agreement said the assets being sold included all of the practice's goodwill. At the same time, it allocated 100 percent of the purchase price to tangible assets: furniture, fixtures, equipment and supplies. The agreement also included noncompete and non-solicitation clauses.
