Healthcare Valuation Vol. 1 -- Contents -- Foreword -- Preface -- Acknowledgments -- About the Author -- Disclaimer -- Introduction -- Chapter 1 The Chronology of U.S. Healthcare Delivery: From Caduceus to Corporatization -- 1.1 Foundation of U.S. Healthcare -- 1.1.1 Origins of Medicine -- 1.1.2 Professional Practice and Status of the Physician -- 1.1.3 Rise of the Medical University -- 1.1.4 Eastern Medical Traditions -- 1.1.5 Renaissance: Revival of Anatomy and Physiology -- 1.1.6 Seventeenth Century: The Dawn of Scientific Liberty -- 1.1.7 Eighteenth Century: The Shift Toward the "Science" of Medicine -- 1.1.8 Nineteenth Century: The Rise of "the Practice of Medicine" in the United States -- 1.1.9 Diversified Schools of Medicine -- 1.1.10 Diversified Roles of Medicine -- 1.1.11 Specialization of the Sciences -- 1.1.12 Site of Care: Rise of the Hospital -- 1.2 Early 1900s -- 1.2.1 The Rise and Controversy of Physician Specialties -- 1.2.2 Introduction of Health Insurance -- 1.2.3 The Regulation of Competition in Healthcare -- 1.3 1930s-1950s -- 1.3.1 Social Security Act -- 1.3.2 Disability Insurance -- 1.3.3 Postwar Technologies -- 1.3.4 Hill-Burton Act of 1946 -- 1.3.5 The Creation of the Joint Commission -- 1.4 1960s -- 1.4.1 Creation of Medicare -- 1.4.2 Creation of Medicaid -- 1.5 1970s -- 1.5.1 Anti-Kickback Statute -- 1.5.2 Rising Costs of Healthcare -- 1.5.3 Attempted Healthcare Reform -- 1.5.4 Health Maintenance Organization Act of 1973 -- 1.6 1980s -- 1.6.1 The Graduate Medical Education National Advisory Committee (GMENAC) -- 1.6.2 Passage of the Omnibus Budget Reconciliation Act (OBRA) -- 1.6.3 Passage of Emergency Medical Treatment and Active Labor Act (EMTALA) -- 1.6.4 Development of Diagnosis Related Group (DRG) -- 1.6.5 Development of Prospective Payment Systems -- 1.6.6 Development of Resource-Based Relative Value System (RBRVS).

1.6.7 General Counsel Memorandum #39498 -- 1.6.8 Medicare and Medicaid Patient and Program Protection Act -- 1.6.9 Ethics in Patient Referral Act of 1989 (Stark Law) -- 1.7 1990s -- 1.7.1 Omnibus Budget Reconciliation Act of 1990 -- 1.7.2 Backlash against HMOs and Managed-Care Plans -- 1.7.3 Clinton Attempted Healthcare Reforms -- 1.7.4 Failure of Reform -- 1.7.5 Comprehensive Physician Ownership and Referral Act of 1993 (Stark II) -- 1.7.6 Health Insurance Portability and Accountability Act of 1996 (HIPAA) -- 1.7.7 Mental Health Parity Act of 1996 -- 1.7.8 Balanced Budget Act of 1997 -- 1.7.9 Anti-Kickback Safe Harbors of 1999 -- 1.8 2000-2010 -- 1.8.1 Final HCFA Stark II Regulations -- 1.8.2 Implementation of Medicare Hospital Outpatient Prospective Payment System -- 1.8.3 The Medicare Prescription Drug, Improvement, and Modernization Act (MMA) of 2003 -- 1.8.4 Deficit Reduction Act of 2005 -- 1.8.5 Health Opportunity Patient Empowerment Act of 2006 -- 1.8.6 Stark IV -- 1.8.7 American Reinvestment and Recovery Act of 2009 -- 1.8.8 Fraud and Abuse Initiatives of 2009 -- 1.8.9 Patient Protection and Affordable Care Act (ACA) -- 1.8.10 Health Care and Education Reconciliation Act of 2010 -- 1.9 ACA Constitutionality Challenged -- 1.10 Conclusion -- 1.11 Key Sources -- 1.12 Acronyms -- Chapter 2 Reimbursement Environment -- 2.1 Overview -- 2.2 Healthcare Revenue Cycle -- 2.2.1 Step 1: Scheduling and Registration -- 2.2.2 Step 2: Patient Encounter Forms -- 2.2.3 Step 3: Diagnostic and Procedural Coding -- 2.2.4 Step 4: Charge Entry -- 2.2.5 Step 5: Primary Insurance Billing -- 2.2.6 Step 6: Secondary Insurance Billing -- 2.2.7 Step 7: Patient Responsibility -- 2.2.8 Step 8: Claims Resolution -- 2.2.9 Step 9: Collections -- 2.3 Current Reimbursement Environment -- 2.4 Public Payors -- 2.4.1 Medicare -- 2.4.2 Medicaid and CHIP -- 2.4.3 Dual Eligibles.

2.4.4 TRICARE (CHAMPUS) -- 2.4.5 Civilian Health and Medical Program of the Department of Veteran Affairs (CHAMPVA) -- 2.4.6 Other Public Payors -- 2.5 Private Payors -- 2.5.1 For-Profit Commercial Insurers -- 2.5.2 Not-for-Profit Commercial Insurers -- 2.6 Methods of Reimbursement -- 2.6.1 Cost of Care -- 2.6.2 Fee-for-Service (FFS) -- 2.6.3 Pay-for-Performance (P4P) -- 2.6.4 Capitation -- 2.6.5 Payor Mix and the Effect on the Revenue Cycle -- 2.7 Emerging Reimbursement Trends and the Impact of Healthcare Reform -- 2.7.1 Shift from Fee-for-Service -- 2.7.2 ACOs -- 2.7.3 Patient-Centered Medical Homes -- 2.7.4 Vermont's Single Payor Insurance System -- 2.8 Conclusion -- 2.9 Key Sources -- 2.10 Acronyms -- Chapter 3 Regulatory Environment -- 3.1 Overview and Trends -- 3.2 Tax Regulations -- 3.2.1 Individual Health Insurance Mandate -- 3.2.2 501(c)(3) Tax Exempt Organizations -- 3.2.3 Bona Fide Employees vs. Form 1099 Independent Contractors -- 3.2.4 Provider Taxes -- 3.2.5 Ad Valorem Tax and Personal Property Tax -- 3.2.6 Excise, Sales, and Use Tax -- 3.2.7 Election of Tax Status-C-Corporations vs. S-Corporations -- 3.3 Fraud and Abuse Regulations -- 3.3.1 Anti-Kickback Statute -- 3.3.2 Stark Law -- 3.3.3 False Claims Act (FCA) -- 3.3.4 Fraud and Abuse Reimbursement Monitoring Programs -- 3.3.5 ACA Initiatives Aimed at Combatting Fraud and Abuse -- 3.3.6 Racketeer Influenced and Corrupt Organizations Act (RICO) -- 3.4 Competition -- 3.4.1 Antitrust Regulations -- 3.4.2 Any Willing Provider Statutes -- 3.4.3 Certificate of Need -- 3.4.4 Covenants Not to Compete -- 3.5 Privacy Regulations -- 3.5.1 Health Insurance Portability and Accountability Act (HIPAA) -- 3.5.2 Red Flags Rules -- 3.5.3 Health Information Technology for Economic and Clinical Health (HITECH) Act -- 3.5.4 Patient Safety and Quality Improvement Act.

3.5.5 Custodial Rights to Patient Charts -- 3.6 Safety Regulations -- 3.6.1 Clinical Laboratory Improvement Amendments (CLIA) -- 3.6.2 Occupational Safety and Health Act (OSHA) -- 3.6.3 United States Nuclear Regulatory Commission (NRC) -- 3.6.4 Environmental Laws -- 3.6.5 Food and Drug Administration (FDA) Enforcement -- 3.7 Corporate Practice of Medicine and Related Provisions -- 3.7.1 False Advertising -- 3.8 Licensure, Certification, and Accreditation Regulations -- 3.8.1 Healthcare Facilities -- 3.8.2 Healthcare Professionals -- 3.9 Conclusion -- 3.10 Key Sources -- 3.11 Acronyms -- Chapter 4 Competition -- 4.1 Overview -- 4.2 Economics of Healthcare -- 4.2.1 Healthcare Costs and the Gross Domestic Product (GDP) -- 4.2.2 Productivity Growth Rates of Healthcare Services -- 4.3 Supply and Demand in Healthcare -- 4.3.1 Healthcare Model -- 4.3.2 Supply-Side -- 4.3.3 Demand-Side -- 4.3.4 The Physician-Workforce Shortage: Demand Outpaces Supply -- 4.4 Porter's Five Forces of Competition -- 4.4.1 The Threat of New Market Entrants -- 4.4.2 The Bargaining Power of Suppliers -- 4.4.3 Threats from Substitute Products or Services -- 4.4.4 The Bargaining Power of Buyers -- 4.5 Barriers to Free Market Competition in Healthcare -- 4.5.1 Intermediary Role of Insurance -- 4.5.2 Difficulties in Measuring Quality and Outcomes -- 4.5.3 Certificates of Need as Barriers to Entry -- 4.5.4 Physician-Owned Healthcare Facilities -- 4.5.5 Exclusionary Boycotts -- 4.5.6 Antitrust Regulations -- 4.6 Historical Reform Efforts and Their Effect on Competition -- 4.6.1 Managed Competition -- 4.6.2 Reform of the Insurance Industry -- 4.6.3 Commoditization of Healthcare -- 4.6.4 Provider Consolidation -- 4.7 Conclusion -- 4.8 Key Sources -- 4.9 Acronyms -- Chapter 5 Technology -- 5.1 Overview -- 5.2 Management Technology -- 5.2.1 Technology as "Process".

5.2.2 Electronic Health Records -- 5.2.3 Electronic Prescribing: Computerized Physician Order Entry (CPOE) -- 5.2.4 Telemedicine and Telehealth -- 5.3 Clinical Technology -- 5.3.1 Genetics, Genomics, and Genome Technology: The Rise of Personalized Medicine -- 5.3.2 Stem Cell Research -- 5.3.3 Diagnostic Technology -- 5.3.4 Therapeutic Technology -- 5.3.5 Pain Management Technology -- 5.4 Conclusion -- 5.5 Key Sources -- 5.6 Acronyms -- Chapter 6 Healthcare Reform -- 6.1 Overview -- 6.2 Initiatives Leading to Healthcare Reform -- 6.3 Drivers of Healthcare Reform -- 6.3.1 Rising Healthcare Costs -- 6.3.2 Physician Manpower and Workforce Changes -- 6.3.3 Changing Patient Populations -- 6.3.4 Shifting Reimbursement Trends -- 6.3.5 Demand for Quality Improvements -- 6.4 Patient Protection and Affordable Care Act (ACA) -- 6.4.1 Impact on Individuals -- 6.4.2 Impact on Employers -- 6.4.3 Impact on Insurers -- 6.4.4 Impact on Providers -- 6.4.5 Fraud and Abuse Initiatives -- 6.5 Paying for Healthcare Reform -- 6.5.1 Tax Revenues -- 6.5.2 Public Programs -- 6.6 Future of the ACA -- 6.7 Conclusion: Future of U.S. Healthcare Delivery in an Era of Reform -- 6.8 Key Sources -- About the Companion Website -- Index -- Healthcare Valuation Vol. 2 -- Contents -- Foreword -- Preface -- Acknowledgments -- About the Author -- Disclaimer -- Introduction -- Chapter 7 Basic Valuation Tenets -- 7.1 Economic Principles -- 7.1.1 Scarcity -- 7.1.2 Utility Theory -- 7.1.3 Expected Utility -- 7.1.4 Forward-Looking Value and Discounting -- 7.1.5 Summary -- 7.2 Financial Valuation Concepts -- 7.2.1 Standard of Value -- 7.2.2 Premise of Value -- 7.2.3 Level of Interest -- 7.2.4 Marketability Basis -- 7.2.5 Valuation Date -- 7.3 Conclusion -- 7.4 Key Sources -- 7.5 Acronyms -- Chapter 8 Valuation Approaches and Methods -- 8.1 Valuation Methodology -- 8.1.1 Income Approach.

8.1.2 Market Approaches.