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Healthcare Valuation Book

Accountable Care Organizations Book
In this issue
President Obama Signs Bill to Permanently Repeal SGR
President Obama signed the landmark bill, titled "Medicare Access and CHIP Reauthorization Act of 2015" (MACRA), on April 16, two days after the bill passed the U.S. Senate by an overwhelming margin of 92 to 8, and approximately one month after the U.S. House of Representatives voted to pass the bill by a vote of 392 to 37. The bill repeals the SGR and prevents any further application of the 21% cut to physician payments under the Medicare physician fee schedule that began occurring April 1, 2015.

PDF Icon Small President Obama Signs Bill to Permanently Repeal SGR
In October 2014, Cleveland Clinic convened its 12th Annual Medical Innovation Summit to unveil their "Top 10 Innovations for 2015." The top innovations were determined based on interviews with more than 110 Cleveland Clinic experts in all major medical specialties. The process yielded almost 150 emerging technologies, which were then pared down to a final list of ten innovations that may have an immediate impact on health in 2015. In addition to the innovation summit hosted by Cleveland Clinic, the 2014 TedMed Conference also explored medical innovations, seeking to "seed the innovations in health and medicine of today, making the breakthroughs of tomorrow possible." In this forum, both well-known and undiscovered leaders, innovators, and explorers converged to discuss the possibility of a healthier future and the novelties that may advance that ideal. The first installment of this two-part series on medical innovations will discuss some of the revolutionary industry developments that were showcased at these two conferences and have the ability to significantly impact the healthcare sector throughout 2015. (Read more...)

PDF Icon False Claims Act: FY 2014 in Review
The False Claims Act (FCA) continues to grow in strength as the government increases its use of the law to recover billions of dollars from companies that violate the Act's provisions. The FCA is the government's primary tool to hold companies or individuals liable for defrauding the government through civil monetary penalties or sanctions. For fiscal year 2014, the government reported its highest recovery amount in history through its use of the FCA. (Read more...)

PDF IconSenior Housing Concerns for 2015
The senior housing market, which the American Seniors Housing Association defines as consisting of senior apartments, independent living communities, assisted living residencies, and continuing care retirement communities, experienced a sizable downturn during the recent U.S. housing market collapse and subsequent recession. However, the 76 million baby boomers that recently began turning 65 are expected to cause a surge in demand for senior housing in the near future. As the market begins to adjust to an aging population, investments in senior housing options are becoming increasingly attractive, with demand expecting to grow steadily without reaching its peak for an estimated 15-20 years. Industry stakeholders are focusing on maintaining state (in contrast to federal) oversight of senior housing and limiting tax reform that would have adverse effects on the senior housing industry. (Read more...)

PDF IconHospitals Fight Back against Proposed Site Neutral Payment Policy
Medicare pays different rates to providers based upon the medical setting where services are rendered (i.e., inpatient physician services, outpatient physician services, etc.). The Centers for Medicare & Medicaid Services and Medicare Payment Advisory Commission (MedPAC) have been exploring options to completely eliminate this payment differential. One prominent recommendation was unveiled in MedPAC's March 2014 report to Congress; "Site-Neutral Payment," which is a reflection of the commission's position that CMS should not pay more for care in one setting than in another if the care can safely and effectively be provided in a lower cost setting. Hospital leaders and organizations such as the American Hospital Association (AHA) have criticized the site-neutral proposals as "threaten[ing] access to care." (Read more...)

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