Whether you are valuing medical practices or consulting with them, the medical practice arena represents a constantly changing dynamic with unique challenges which must be understood to effectively perform in either the valuator or consulting role. This course* is designed to enable you to generate new fee opportunities or just hone your existing skills.

Valuation Track (Days 1, 2, and 5)—You will be introduced to the primary value drivers at the practice level with a focus upon the regulatory constraints that dictate the forms of transactions that are deemed permissible for practitioners in the healthcare community to enter into. The course will cover the minimum valuation standards approved by NACVA (consistent with IRS and current AICPA guidelines) and will help you to understand the IRS, Stark, and Fraud & Abuse laws that determine permissible activities and define the government’s position on fair market value transactions. Using these basics the course will present several forms of engagement deliverables, including practice valuations, reasonableness opinions, compensation planning and structures, and on-call compensation issues—all from a fair market value perspective with many outline formats and checklists intended to assist you in developing your own reports.

Consulting Track (Days 1, 3 and 4)—The consulting track is designed to walk you through a soup-to-nuts understanding of the medical practice’s financial and operational environment. You will be introduced to the details of medical practice revenue, cost, compensation and productivity drivers, as well as the theory and practice of medical practice benchmarking through hands-on experience. Attendees will gain insight on how to help maintain and even bolster the bottom line by benchmarking the subject practice against similar practices.

Day 1—The Dynamics of Physicians and Group Practices [Consulting & Valuation Tracks]

• Minimum valuation standards applicable to healthcare transactions
• IRS, Stark, and Anti-trust regulations applicable to medical practices
• Understanding the dynamics of a full-time equivalency (FTE) measurement standard and how this directly impacts comparable compensation for the purposes of your modeling
• Developing a better understanding of healthcare risk assessment concepts applicable to your cost of capital calculations and employing sanity checks to validate your findings
• How to design a defensible valuation
• Common report errors to avoid
• The instructor who is a healthcare valuation veteran who will provide insight into how to build a healthcare medical practice niche

Day 2—The Dynamics of Physicians and Group Practices [Valuation Track] (continued)

• How best to strike a balance in the “normalization process”
• How to normalize healthcare earnings and the appropriate adjustments
• Forecasting cash flow or earnings in today’s healthcare environment
• Hands-on applications for applying the cost, market, and income approaches
• Report preparation for acute care medical practice entities
• Using Calculation of Value versus Conclusion of Value opinions. When and where each are appropriate when rendering valuation conclusions for healthcare transactions
• Discussion of the key attributes needed for a Conclusion of Value Report for a medical practice entity (using a model report)
• Goodwill vs. Going Concern concepts and their applicability to a practice valuation
• How to deal with embedded capital gains in “C” Corp valuations
• “S” Corporation valuations and other pass-through entities and tax effecting the revenue stream

Day 3 AM—Intricacies of Physician Compensation Plans and Arrangements [Consulting Track]

• Engagement letter drafting for compensation consulting
• Overview of regulatory and functional restrictions (covered in greater detail in Day 1) that impact physician compensation arrangements
• Review of the compensation planning processes and how to expand your healthcare valuation expertise to address the increasing regulatory issues impacting these arrangements
• Issuing Reasonableness Opinions in healthcare transactions with real world examples
• Discussion of compensation arrangements including employee payroll and productivity compensation, medical directorships, personal service arrangements, equipment leasing, personnel leasing, facility leasing arrangements and forms of block leasing arrangements
• Discussion of aligning compensation reimbursement strategies and tying them to specific reward mechanisms for clinical objectives and practice efficiency
• Exploration of case examples of compensation arrangements
• Using work RVUs in compensation planning
• The increasing challenges of on-call compensation arrangements and the valuator’s role in providing guidance in compliant rate setting
• A review of recent changes in on-call coverage requirements under the Emergency Medical Treatment and Labor Act (EMTALA)
• Understanding the basic implications of EMTALA for hospitals’ Emergency Departments (ED) for an on-call panel of back-up physicians
• Kinds of alternative on-call compensation arrangements currently in play
• On-call arrangements, sample analysis, data collection sheets, modeling and an example of an On-Call Table of Contents Report will be reviewed

Day 4—Healthcare Benchmarking for Increased Efficiency—An Economic Diagnosis
(Laptop required)

• Using benchmarking to quickly identify areas of a practice that are negatively impacting profitability and effectiveness (this is an extremely useful tool for anyone interested in valuing a medical practice)
• Facilitating a basic understanding of selected statistical measurements such as standard deviation, skewness, mean, median, mode and their impact upon your benchmarking data
• Understanding how to interpret the validity of your sample data
• How best to interpret productivity levels, staffing costs, overhead costs, and contribution to owners’ compensation
• How to utilize MGMA data resources to better understand profitability and cost management, productivity, capacity, and staffing, accounts receivable and collection efficiency
• Introduction to MGMA’s CD for modeling physician coding and billing trends to identify potential outliers and how to interpret that data
• The afternoon will focus upon a hands-on classroom exercise using two of the actual live ValuSource/MGMA CD ROMs: the Physician Compensation and Production CD and the Physician Cost Survey CD and applying them to real world examples. Attendees will leave with a hands-on working knowledge of these two serious modeling tools and will be provided with their own full demo CD that they can take back to their offices and use for the next 30 days for their own client modeling.

Day 5—Valuation of Healthcare Ancillary Services Enterprises [Valuation Track] • The impact of regulations on the valuation of ancillary services providers, including specialty hospitals, diagnostic imaging centers, outpatient cancer treatment centers, and dialysis facilities
• The means by which intangible assets are valued with an emphasis on the ancillary services provider industry
• How assets are classified in the healthcare and ancillary services provider industry

The program is written by nationally known NACVA member and healthcare expert Greg Reardon, CPA, CVA. President of Philadelphia-based Reardon Consulting, Inc. and Valuation Advisors, Inc., Greg brings with him over 25 years of consulting experience in physician-related issues, and experience as the past president of a regional medical center and as chairman of several public companies post Sarbanes-Oxley board committees. Mark Ashlock, CPA, CVA, of Ashlock and Valentine, CPAs, brings with him international experience from his membership in the Big Eight, plus over 25 years of experience in providing services to physicians, medical groups, hospitals, payors, and other related healthcare entities. Robert J. Cimasi, MHA, ASA, CBA, AVA, CM&AA, CMP, president of Health Capital Consultants, LLC, has over 25 years of experience in serving clients, in 49 states, with a professional focus on the financial and economic aspects of healthcare service sector entities, including valuation consulting, litigation support, business intermediary and financing services, certificate-of-need consulting, and healthcare transactions, including sales, mergers, and acquisitions. David Fein is the president and chief executive officer of ValuSource, which for over 20 years has been the leading provider of business valuation software, data, and report writers for valuators, CPAs, M&A professionals, and business owners. Since 1997, he has partnered with the Medical Group Management Association (MGMA) to develop MGMA’s interactive survey CDs, which provide data and benchmarking tools on physicians’ compensation, business costs, and coding practices.

October 25-30	Washington, DC
December 6-11	Las Vegas, NV

Click here for a list of hotel locations, room rates and reservation information.

2010 Package Pricing
(Before early registration discounts.)...........Non-Member.............Member
Individual Days..........................................................$550......................$495
Five-Day Workshop...................................................$2,750..................$2,475
Exam
Fee ..........................................................$295......................$295
First-Year NACVA Membership with Training and Exam.........................................................$300

For more information regarding refund, complaint, and/or program cancellation policies, please call our director of Member Services: (801) 486-0600.

Delivery Method	Group-Live
Program Level	Overview
Advanced Preparation	Overview
Prerequisites	None
Fields of Study	Business Management and Organization	5
	Specialized Knowledge and Applications	35
Total CPE Hours		40

For more information regarding CPE, Program Levels and Fields of Study please click here.

NACVA is registered with the National Association of State Boards of Accountancy (NASBA), as a sponsor of continuing professional education on the National Registry of CPE Sponsors. State boards of accountancy have final authority on the acceptance of individual courses for CPE credit. Complaints regarding registered sponsors may be addressed to the National Registry of CPE Sponsors, 150 Fourth Avenue North, Suite 700, Nashville, TN 37219-2417. Web site: http://www.nasba.org/