From on-call coverage and medical directorships, to employment arrangements and hospital-based support payments, Stout has provided thousands of fair market value opinions. With more than 25 years of experience providing healthcare compensation valuation services, we have extensive expertise and have refined our consulting and advisory services through first-hand knowledge of actual marketplace transactions.

Since 2000, we have provided thousands of FMV and commercial reasonableness opinions for a variety of healthcare compensation transactions. Our compensation valuation experts are certified in the valuation field and credentialed through numerous professional valuation associations, including the National Association of Certified Valuators and Analysts, and the American Society of Appraisers. Utilizing a variety of resources, including proprietary valuation methodologies that take into consideration relevant guidance provided by the OIG, CMS commentary, and case law, we carefully consider the unique characteristics of each compensation arrangement and understand the nuanced Stark Law and Anti-Kickback concerns that may be implicated. We provide objective, independent, and defensible FMV opinions that cover nearly every type of compensation arrangement, for clients in every state.

Employment Arrangements

As hospitals and health systems continue to purchase independent practices and organically grow their workforce, the trend of hospital- and health system-employed physicians and advanced practice providers (APPs) is becoming more prevalent. The resulting employment arrangements frequently implicate numerous healthcare fraud and abuse laws, including the Stark Law and Anti-Kickback Statute, and therefore benefit from review by a knowledgeable, unbiased valuation expert.

Our team of compensation valuation professionals draws from hundreds of years of combined experience to produce FMV support for all types of employment arrangements. From FMV opinions for standard, single provider arrangements to those for complex employment transactions involving multiple providers, varying payment mechanisms, and diverse service offerings, we can assist with any type of employment valuation need.

Upon recognizing the need for healthcare executives to operate more quickly than the valuation industry could allow, Stout developed an easy-to-use FMV solution known as the Provider Compensation Calculator™ (formerly known as the Physician Employment Calculator™). This Calculator generates customized FMV opinions to aid in physician and APP recruitment and retention and provide defensible support for a wide range of employment transactions.

Learn more about the Provider Compensation Calculator™.

On-Call Arrangements

For more than 15 years, Stout has utilized a proprietary methodology to value on-call arrangements, through which we consider a variety of factors that we believe have an impact on the burden to the provider performing the call coverage. In numerous Advisory Opinions since our proprietary methodology was developed and implemented, the Office of Inspector General (OIG) has cited a similar set of factors, effectively confirming the validity and relevance of our proprietary methodology.

Our proprietary methodology has been refined over time, ensuring we continually produce objective and defensible FMV opinions for the hundreds of on-call coverage arrangements we value each year. For a customized call coverage application that utilizes our proprietary methodology and delivers almost immediate conclusions, we offer an easy-to-use solution referred to as the On-Call Calculator™.

Learn more about the On-Call Calculator™.

Telemedicine Arrangements

In recent years, telemedicine has become a viable patient care option, allowing physicians and APPs of various specialties to provide high-quality, affordable healthcare services to patients in remote areas.

With this ability to improve access to care, enhance the quality of value-based care and patient interaction, as well as offer substantial cost and time savings, many hospitals, health systems, physician practices, and outpatient facilities enter into telemedicine services arrangements to secure affordable coverage or supplement existing coverage. As the number of telemedicine services arrangements continues to increase, so does the need for reliable, defensible FMV opinions to ensure that the arrangements are in compliance with applicable state and federal laws.

As a relatively new healthcare delivery model, valuing telemedicine services arrangements presents distinct challenges. Stout’s team of valuation professionals possess the knowledge and experience to navigate these challenges, understanding not only the legal and regulatory issues surrounding telemedicine arrangements but also the key service components associated with these arrangements, such as telemedicine equipment and software, telemedicine program start-up costs, and reimbursement considerations.

Service Line Management

Recognizing the need for alignment strategies that more effectively promote cooperation with medical staff physicians, hospitals and health systems have begun shifting their reimbursement strategies from volume to value. Similar to the trend in physician professional services arrangements, value-based administrative arrangements are designed to reward the achievement of specific quality metrics and operational efficiencies as opposed to payment based on hours worked.

One emerging arrangement, centered on this value-based model, involves the management – either exclusively by physicians or jointly by physicians and hospital members – of an entire hospital service line. Unlike traditional medical director arrangements, these service line management arrangements can (i) facilitate working relationships with physicians across several disciplines (who may be unaffiliated with each other), and (ii) potentially offer more lucrative compensation, in the form of monies for achievement of specific outcomes, in addition to a base management fee.

Given the potential to implicate numerous healthcare laws and regulations, including the Stark Law, Anti-Kickback Statute, Civil Monetary Penalty Statute, and IRS private inurement, coupled with relatively lucrative payments, these arrangements require an intricate knowledge of the key regulatory issues and detailed understanding of the valuation process.

Stout’s team of experts possesses the knowledge and experience to meet these challenges, having valued over 2,000 service line management and co-management arrangements to date, including the arrangement mentioned in favorable OIG Advisory Opinion 12-22, the sole advisory opinion addressing service line co-management.