Author Archives: Chris David

Before estimating an FMV rate for physician speakers or even advisors and consultants, it’s imperative that each particular HCP be properly assessed and ranked into an appropriate tier. PhRMA and AdvaMed have recommended a set of criteria and qualifications for selecting an HCP.  HVG has developed its own proprietary HCP Tiering Algo, which ranks an […]

M&A Snapshot Deal volume in 1st half of 2023 was down from 2022, which was a record year. Multiples are trending upwards, reaching 2021 values. Non-essential specialties, such as plastics, dermatology and medical devices are selling for higher multiples. Dermatology experienced one of the highest increases in multiples since 2020. The higher the EBITDA the […]

If your physician compensation plan is structured as a straight comp-per-wRVU, be careful. A unique phenomenon that’s revealed when analyzing compensation and productivity survey data is the inverse relationship between compensation-per-wRVU and total compensation level for each quartile of production.  All else being equal, as production increases, the median total compensation level increases, but the […]

In a recent enforcement action [https://www.justice.gov/usao-nj/pr/morris-county-sonography-company-enters-deferred-prosecution-agreement-agrees-pay-95000], a diagnostic testing company allegedly rented office space from a referring physician for an amount above FMV and was commercially unreasonable. The diagnostic testing business was purportedly occupying some office space in the physicians’ offices for a set number of weekly hours to perform diagnostic tests. The problem was […]

HVG has experienced an uptick in clients requesting a commercial reasonableness opinion on the compensation of laboratory sales representatives. Typically, this is in the context of a third-party “marketing company,” where an MSA is in place. As many of you know, the FMV MSO fee is most commonly calculated on a cost-plus markup basis. But what […]

In the recent case — U.S. ex. rel. Godsholl v. Covenant Healthcare – it was alleged that medical directorship roles were awarded as perks and described as “improper appointments.”  Apparently, the smoking gun for this improper financial relationship was the fact that there was no oversight or record keeping to account for the medical directorship […]

The trend in physician practice acquisitions continues. Hospitals and health systems continue to acquire physician practices to expand their networks and create integrated healthcare delivery systems. Private equity firms see potential in consolidating practices, achieving economies of scale, and optimizing operational efficiency. Private equity involvement can bring capital investment, management expertise, and resources to support […]

Physicians are facing various challenges, such as reimbursement pressures, longer hours, inflation, and high rates of work-related burnout. Medicare physician payment has seen a decline after two decades of flat payments and adjusted for inflation, and it has decreased by 22% from 2001 to 2021. These challenges are causing many medical professionals to reconsider their […]

The fair market value (FMV) of shares in a start-up ASC is almost always valued based on an asset approach. The cost approach to business valuation is a method used to determine the value of a business based on the cost required to recreate or replace its assets. This approach assumes that the value of […]