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A Case Study: Application of Analytical Thresholds in the Exempt Organization Commercial Reasonableness Analysis

 A Case Study: Application of Analytical Thresholds in the Exempt Organization Commercial Reasonableness Analysis
CPE Credit

Program Type: Recorded Webinar (Audio, PPT)
Program Level: Intermediate
Prerequisites: Previous training or research on subject matter being taught.
Advanced Preparation: None
Delivery Method: Group Internet-Based
CPE Credits: Two (2) Hours
Fields of Study: Accounting
Item Number: 14PHC1201
Shipping Weight: 0lbs. 0oz.
Price: $110.00
Program Description

This webinar will present a case study of an exempt healthcare organization—a cardiac clinic—and will provide step-by-step guidance as to addressing each of the thresholds of commercial reasonableness as it applies to healthcare transactions involving enterprises, assets, and services—a trend which has seen significant growth in recent years. Commercial reasonableness, a threshold that is related to, but distinct from, fair market value, has emerged as a focus of regulatory scrutiny for healthcare transactions. The discussion will focus on the qualitative and quantitative analysis undertaken to meet the applicable regulatory pronouncements required for establishing commercial reasonableness as well as the interplay between fair market value and commercial reasonableness in healthcare transactions.

Learning Objectives

After completing this Webinar, attendees will be able to:

- Define the thresholds of commercial reasonableness, as derived from statutory and regulatory pronouncements, as well as relevant case law and other sources
- Articulate the interplay (from the appraiser’s standpoint) between fair market value and commercial reasonableness in the context of hospital/physician practice acquisition transactions
- Identify and differentiate the qualitative and quantitative analysis undertaken to determine whether the anticipated transaction is legally permissible under the threshold of commercial reasonableness

Who Should Attend

Appraisers, healthcare consultants, attorneys, hospital and health system C-suite executives (e.g., CEOs, CFO, COO)


?Robert James Cimasi, MHA, ASA, FRICS, MCBA, CVA, CM&AA
Mr. Robert James Cimasi serves as chief executive officer of HEALTH CAPITAL CONSULTANTS (HCC), a nationally recognized healthcare financial and economic consulting firm headquartered in St. Louis, Missouri, serving clients in 49 states since 1993. Mr. Cimasi has over 30 years of experience in serving clients, with a professional focus on the financial and economic aspects of healthcare service sector entities, including valuation consulting and capital formation services; healthcare industry transactions, including joint ventures, mergers, acquisitions, and divestitures; and certificate-of-need and other regulatory and policy planning consulting.

Mr. Cimasi holds a masters in health administration from the University of Maryland as well as several professional designations. He is the author of several books, the latest of which include Accountable Care Organizations: Value Metrics and Capital Formation [2013 - Taylor & Francis, a division of CRC Press] and Healthcare Valuation: The Financial Appraisal of Enterprises, Assets, and Services [2014 - John Wiley & Sons]. Mr. Cimasi is a nationally known speaker on healthcare industry topics; the author of numerous additional chapters in anthologies, books, and legal treatises; published articles in peer-reviewed and industry trade journals; research papers and case studies; and is often quoted by healthcare industry press.

Todd A. Zigrang, MBA, MHA, FACHE, ASA
Mr, Todd Zigrang is the President of Health Capital Consultants (HCC), where he focuses on the areas of valuation and financial analysis for hospitals and other healthcare enterprises. Mr. Zigrang has significant physician integration and financial analysis experience, and has participated in the development of a physician-owned multi-specialty MSO and networks involving a wide range of specialties; physician-owned hospitals, as well as several limited liability companies for the purpose of acquiring acute care and specialty hospitals, ASCs and other ancillary facilities; participated in the evaluation and negotiation of managed care contracts, performed and assisted in the valuation of various healthcare entities and related litigation support engagements; created pro-forma financials; written business plans; conducted a range of industry research; completed due diligence practice analysis; overseen the selection process for vendors, contractors, and architects; and, worked on the arrangement of financing.

Mr. Zigrang holds a Master of Science in Health Administration and a Master of Business Administration from the University of Missouri at Columbia. He is a Fellow of the American College of Healthcare Executives, and serves as President of the St. Louis Chapter of the American Society of Appraisers (ASA). He has co-authored “Research and Financial Benchmarking in the Healthcare Industry” (STP Financial Management); “Healthcare Industry Research and its Application in Financial Consulting” (Aspen Publishers); and, “Reimbursement Environment of the Healthcare Industry in an Era of Reform” (Business Appraisal Practice). He has additionally taught before the Institute of Business Appraisers and CPA Leadership Institute, and has presented healthcare industry valuation related research papers before the Healthcare Financial Management Association; the National CPA Health Care Adviser’s Association; Association for Corporate Growth; Infocast Executive Education Series; the American Society of Appraisers; and, Physician Hospitals of America.