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In one of the more dramatic series of events in healthcare reform, attempts by the U.S. Senate to repeal and replace the 2010 Patient Protection and Affordable Care Act (ACA), a/k/a Obamacare, have failed after the most recent U.S. Senate bill, a so-called "skinny repeal" of the ACA, was rejected at approximately 2:00 a.m. on July 28, 2017, after 20 hours of negotiations and debate on the Senate floor. The bill was voted down 49-51 when every Democratic senator and three (3) Republican senators, John McCain (R-AZ), Susan Collins (R-ME), and Lisa Murkowski (R-AZ) cast "no" votes. Rejection of this version of the bill follows the dismissal of a more comprehensive "repeal and replace" version of the bill, as well as a "repeal only" version of the bill. The failure to pass any one of these versions of a "repeal and replace" bill is likely to be a major setback for GOP healthcare reform efforts. This Health Capital Topics article reviews: the policy proposals included within each version of the Senate bill; the nonpartisan Congressional Budget Office's (CBO) scoring of these proposals; past milestones related to Obamacare "repeal and replace" actions in the U.S. House of Representatives; and, the response by lawmakers and industry stakeholders to each version of the Senate bill.

In one of the more dramatic series of events in healthcare reform, attempts by the U.S. Senate to repeal and replace the 2010 Patient Protection and Affordable Care Act (ACA), a/k/a Obamacare, have failed after the most recent U.S. Senate bill, a so-called "skinny repeal" of the ACA, was rejected at approximately 2:00 a.m. on July 28, 2017, after 20 hours of negotiations and debate on the Senate floor. The bill was voted down 49-51 when every Democratic senator and three (3) Republican senators, John McCain (R-AZ), Susan Collins (R-ME), and Lisa Murkowski (R-AZ) cast "no" votes. Rejection of this version of the bill follows the dismissal of a more comprehensive "repeal and replace" version of the bill, as well as a "repeal only" version of the bill. The failure to pass any one of these versions of a "repeal and replace" bill is likely to be a major setback for GOP healthcare reform efforts. This Health Capital Topics article reviews: the policy proposals included within each version of the Senate bill; the nonpartisan Congressional Budget Office's (CBO) scoring of these proposals; past milestones related to Obamacare "repeal and replace" actions in the U.S. House of Representatives; and, the response by lawmakers and industry stakeholders to each version of the Senate bill. (Read more...) 
In recent years, the rate of prescription opioid abuse has been increasing at an alarming pace. Since 1999, drug overdose deaths have nearly tripled in the U.S., of which approximately 61 percent were opioid related. In 2015, 33,091 deaths were attributed to opioid related overdoses, of which about half involved prescription opioids. An estimated two million Americans suffer from opioid use disorder (i.e., addiction) related to prescription drugs, resulting in an annual economic loss of roughly $78.5 billion. A robust understanding of this public health emergency necessitates a review of: the reimbursement models that previously incentivized the prescription use of opioids; current legislative and regulatory actions underway to combat the opioid epidemic; and, the estimated economic ramifications of opioid misuse. This first installment of the three-part series on the opioid epidemic will discuss past and present provider reimbursement models related to pain management. (Read more...) 
The U.S. healthcare industry has often been characterized as having a unique economic structure compared to other U.S. industries. Unlike most industries, the healthcare industry contains numerous barriers to free market competition, such as market controls on price and quality.  In particular, market entrance barriers tend to result in a decrease in the supply of providers, reducing price competition, thereby increasing the price of provider services to healthcare enterprises leading to demands for increased reimbursement from third party payors, which price concessions will, eventually, lead to increased expenditures by consumers (i.e., patients).  Conversely, already existing healthcare providers in these areas benefit from the restrictions, as their competition is consequently limited.  Due to the specific nature of healthcare market entrance barriers, it is imperative that valuation professionals (and those that they advise) understand the classification and valuation of these types of intangible assets in identifying and quantifying the excess benefit derived by the existing firms that arises from the existence of healthcare market entrance barriers.  (Read more...)
Artificial intelligence (AI) startup companies, AI systems, and overall use of AI within the healthcare industry are developing at an accelerated rate compared to corresponding regulatory efforts. While the need for regulation has prompted concern from the government, the delayed regulation of all forms of AI, including intelligent automation (a software such as AI or machine learning that streamlines decision-making), has benefited competition within the healthcare industry. Intensive regulation of new technology and treatments may serve to delay or disable innovation (such as AI), which may be one of the fundamental drivers of quality improvement and the underlying dynamic of an organization's ability to compete.  Therefore, it is presumed that the relative absence of AI regulation in the U.S., as of the date of publication, may be one of the reasons for the increased innovation and competition among healthcare enterprises. As a result, companies that are using AI or intelligent automation may experience increased productivity and job availability, directly impacting the competitive environment of the U.S. healthcare industry.  (Read more...)
 
ANNOUNCING
 
Advanced Distance Education to Launch in 2017

The Institute for Healthcare Valuation (IHV) & Consultants' Training Institute (CTI) are pleased to announce premier healthcare valuation training through a distance education program, the Certificate of Educational Achievement (CEA) for Advanced Education in Healthcare Valuation. The program will launch in the summer of 2017 and will bridge the interdisciplinary nature of healthcare valuation to include: the Four Pillars of Healthcare (regulatory, reimbursement, competition, and technology); the market forces shaping the U.S. healthcare industry; and the valuation of healthcare enterprises, assets, and services. Legal professionals and healthcare providers, as well as those wishing to expand their scope of activities in healthcare valuation engagements and those seeking to enhance their current healthcare valuation service lines, will gain comprehensive knowledge through completing the expansive program. The program has been developed and is being presented by industry thought leaders Robert James Cimasi, MHA, ASA, MCBA, FRICS, CVA, CM&AA, Chief Executive Officer, and Todd A. Zigrang, MBA, MHA, FACHE, ASA, President of Health Capital Consultants, alongside a blockbuster faculty of healthcare subject matter experts from the legal, federal regulatory, and valuation professions.
HCC CEO Bob Cimasi Recognized as a "Pioneer of the Profession" 
under NACVA's "Industry Titans" Awards

HCC CEO Robert James Cimasi, MHA, ASA, FRICS, MCBA, CVA, CM&AA, has been
named a "Pioneer of the Profession," by the National Association of Certified Valuators and Analysts (NACVA) and Consultants Training Institute (CTI) as part of their Silver Anniversary recognition luncheon of valuation "Industry Titans," which distinguishes those whom have had the greatest impact on the profession.  Mr. Cimasi joins valuation profession luminaries, including: Dr. Shannon P. Pratt, Chris Mercer, James R. Hitchner, Roger J. Grabowski, Richard Wise, Jay E. Fishman, Nancy Fannon, Honorable Judge David Laro, Howard Lewis, and Mel H. Abraham, along with fourteen others, in receiving this honor. Congratulations to Bob Cimasi and his fellow "Pioneer of the Profession" honorees from the HCC Team and Topics Staff!