Accounting/Economics

Unity Health Network: Leading with a Value-Based Care Approach

Policy and payment reforms created by The Centers for Medicare & Medicaid Services (CMS) drive much of the healthcare industry’s move toward value-based care — providing the best outcomes at an optimal price. The Medicare Access and CHIP Reauthorization Act (MACRA) of 2015 changed the way...


Tips for Fighting the Employer Shared Responsibility Payment Battle With the IRS

The IRS continues to assess substantial “pay or play” penalties to employers for not complying with the coverage mandates of the Affordable Care Act (“ACA”).

In 2014, the ACA implemented the Employer Shared Responsibility or “pay-or-play” rules. Under Internal Revenue Code §...


Being Recruited? Trump Tax Cuts Make Relocation Expenses Taxable

In a competitive market, hospitals and other health care providers often offer fringe benefits (compliant with Stark Law and the Anti-Kickback Statute, of course) to attract talented physicians. As part of a recruitment package, in-demand physicians have come to expect employers to...


OIG Posts Latest Guidance for Physician-Hospital Gainsharing Arrangements

On January 5, 2018, the Office of Inspector General posted an advisory opinion stating that it would not impose criminal or civil monetary sanctions against a physician group and hospital that agreed to implement a cost-reduction arrangement for spinal fusion surgeries performed at the hospital...


Protecting Your Interests: Why Your Medical Practice Needs a Buy-Sell Agreement

Are you a partner in an existing practice but have never seen or discussed a buy-sell agreement with your fellow partners? Let’s say you paid $1,000 to “buy-in” to the practice. That does not mean that a disgruntled partner, let alone their ex-spouse, heirs and/or creditors, will agree to accept...


Commercial Reasonableness: Practical Guidance for Healthcare Transactions

Transactions in the healthcare industry need to meet the threshold of commercial reasonableness to avoid regulatory sanctions. It is critical that healthcare entities contemplating a transaction be aware of the factors to consider and the appropriate documentation needed to ensure compliance and...


A New Small Employer’s Health Care Alternative

Beginning in 2016, the 21st Century Cures Act (the “Act”) creates an exception to the Affordable Care Act to allow certain small employers to help employees by reimbursing their individual market medical coverage premiums and certain medical expenses using a Qualified Small Employers Health...


Will Physicians Face Another Decrease in Payments?

Physicians may face a significant decrease in Medicare payments for certain services for the second year in a row. The Centers for Medicare & Medicaid Services (CMS) has again proposed to cut Medicare payments for services provided at non-excepted, off-campus provider based departments (PBDs...


The Oncology Care Model at Summa Health


Sameer Mahesh, MD, is a hematologist-oncologist with Summa Health Cancer Institute and Principal Investigator of the Oncology Care Model at Summa Health.

According to the NIH, Americans over 65 account for 60% of newly diagnosed cancers each year. In an effort to provide higher quality,...


Dramatic Proposed Changes to Impact Estate and Gift Tax Planning

Individual taxpayers should examine their estate now before changes are made that affect gift and estate taxes.

While most taxpayers are spending the summer focused on economic developments associated with the market, foreign affairs, or election year developments closer to home, high...