Deciding to merge or acquire another healthcare organization is a big one. Knowing where to start or if you are ready for it can take time and effort. That’s where our Mergers & Acquisitions Assessment Service comes in. We will work with you to provide a comprehensive assessment of the organization so that you can make the most informed decision possible. Contact us today to learn more!
What is healthcare organization valuation?
A healthcare organization’s valuation determines the fair market value of acquiring that organization. This complicated process involves looking at many intangible and tangible assets.
Some intangible assets to consider are the potential revenue the organization can bring in and any risks associated with the acquisition. A comprehensive analysis of these factors is necessary for an accurate valuation.
One of the challenges in valuing a healthcare organization is that many intangible assets are often difficult to quantify. Our Mergers & Acquisitions Service helps make assessing the intangibles much easier by providing a comprehensive analysis of revenue potential and risks based on actual organization data using our proprietary smart technology tools.
This service takes into account a variety of factors depending on the organization’s billing model. So instead of relying on guesswork, incomplete data, or incomplete analysis, our Mergers & Acquisitions Service can help you make a more informed decision!
What are the different types of healthcare organization valuation?
Fee for Service (FFS) is a healthcare delivery model in which providers charge fees for each service. This valuation involves assessing providers who may be under-coding or over-coding services resulting in higher or lower reimbursements than the documentation supports.
Value-Based Care (VBC) is a healthcare delivery model in which providers are paid based on the health outcomes of their patients and the quality of services rendered. This type of valuation creates several levels of analysis, allowing for a more comprehensive view of the organization.
What goes into a Fee for Service organization valuation?
An FFS organization valuation assesses the providers’ coding of services for accurate reimbursement. This valuation can help the organization avoid potential audits and provides insights into expected performance and training needs when acquiring providers and organizations.
Medical Coding Overview
To code services accurately, providers must first understand the different types of codes used to describe them. The most common codes are ICD-10, CPT, and HCPCS. ICD-10 describes diagnoses, CPT codes are for procedures, and HCPCS codes are for supplies and equipment.
Once the provider understands which code to use, they must determine the correct coding level. The three levels of coding are base, intermediate, and advanced. Base-level coding is the simplest and most common, while advanced-level coding is the most complex.
After the provider has coded the service at the correct level, they must choose the appropriate modifier. Modifiers are added to the end of a code to give additional information about the service performed.
Finally, the provider must choose the correct place of service code. This code indicates where the service was provided, such as in an office or hospital.
After completing all these steps, the provider has the correct code for the service. This coding process is necessary to ensure accurate reimbursement for services provided.
Medical Coding Evaluation
Our innovative technology, revealMD, makes analyzing medical coding practices easy. revealMD analyzes coding activity in seconds. There is no software to install, IT resources, EHR interfacing, or training required.
What goes into a Value-based Care organization valuation?
When it comes to valuing a Value-Based Care organization, there are multiple assessments. First and foremost is a comprehensive revenue analysis of all Value-Based care contracts. Contract analysis will give you a clear picture of what the organization realizes from these arrangements versus its potential revenues.
It’s also important to look at codes used by providers where there is no Risk Adjustment Factor (RAF) score. For example, traditional Medicare fee-for-service arrangements do not reimburse providers for codes without an RAF score. As a result, organizations can lose much revenue if they have many patients with these codes.
Finally, the subsequent analysis identifies patients who have Gaps in Care. These patients have yet to be seen by a provider and may need additional care to meet their health goals. Organizations can lose revenue if they have too many patients with Gaps in Care.
What are the benefits of knowing a healthcare organization’s valuation?
There are many benefits to knowing healthcare organization valuation. Perhaps most importantly, it can help you make more informed decisions about where to invest your money. For example, if you’re considering investing in a particular hospital or health system, understanding its valuation can give you a better sense of whether or not it’s a wise investment. It can also help you negotiate better and fairer acquisition deals to meet shareholder expectations.
The healthcare industry is constantly evolving, with new challenges in valuing healthcare organizations. Our Mergers & Acquisitions Service helps make assessing the intangibles much easier by providing a comprehensive analysis of revenue potential and risks based on actual organization data using our smart technology tools.
This service takes into account a variety of factors depending on an organization’s billing model. Using our innovative technology tools to perform a detailed analysis allows us to provide a more accurate valuation of a healthcare organization than relying on guesswork or incomplete data.
Suppose you are considering acquiring a healthcare provider or organization. In that case, our Mergers & Acquisitions Service can help you make a more informed decision by comprehensively analyzing the potential revenue and risks involved.