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.

Health Care Regulatory and Compliance Insights

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.

Health Care Transaction Insights

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.

Health Care Litigation Insights

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.

Valuation Professional Standards Insights

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