Transcript Slide 1

Healthcare Appraisers
General Overview
 Founded in 2000
 Two offices (in Florida and Colorado)
 Hundreds of clients across the country; thousands of completed
projects
 “Founded” in providing FMV analysis for the hospital sector
(e.g., HCA’s CIA)
 Currently, clients include the entire healthcare constituency
 HAI’s staff includes a heavy emphasis on valuation and financial
credentials (e.g., ASA, AVA, CFA, CPA) and healthcare and
health law experience
 We actively develop and contribute to the healthcare valuation
body of knowledge (through articles, surveys, presentations)
HAI’s Professional Staff
Principals:
Daryl P. Johnson, MAcc, AVA
Todd J. Mello, ASA, AVA, MBA
Fred M. Lara, CFA, AVA
Scott M. Safriet, MBA, AVA
Professional Staff:
Curtis H. Bernstein, CPA/ABV, CVA, MBA
Christopher W. David, CPA/ABV, ASA, MBA
Albert D. Hutzler, J.D., MBA
Andrea Ferrari, J.D., MHA
Paul E. Risner, J.D.
Melissa R. Keehn, MPA.
Karen Bairstow, MBA
Barbara Landy, MBA, MHA, FACHE
Ann S. Brandt, Ph.D.
Adam S. Polsky, MBA
Jim D. Carr, MBA
Terika L. Haynes, MHA
Richard E. Chasinoff, MBA, MHA
Kyle M. Tormoehlen , MBA
Valuation Approach
 Our projects are tailored to client-specific engagements.
 Engagements may address (i) selected compensation
arrangements or (ii) systematic programs for establishing FMV.
 We do not publish or provide “canned” FMV guidance.
 We apply traditional valuation methodologies, modified as
required to comply with applicable healthcare regulations.
 Our approaches insure that conclusions are not based upon
“tainted” market values and that other common healthcare
valuation pitfalls are avoided.
The Healthcare Valuation
Risk Continuum
More
Risk
Less
Risk
No formal
valuation process
Payment rates
are based upon:
Market
surveys
Physician
“demands”
Use of independent,
credentialed appraiser
Strict compliance with the
FMV definition
Formal documentation
process
Use of accepted
valuation approaches
Applicable market data is
free from bias
Logical, defensible,
reproducible conclusions
Implications of the FMV Standard
 FMV involves a hypothetical scenario
 FMV is distinctly different from investment
value (which considers synergies among the
parties)
 FMV is not established through…
 Earnest negotiations
 An amount that is requested
 Opportunity cost
 Reliance upon “tainted” market values
Relevant Arrangements
Payments to physicians for personally performed
services
 Thought Leader / Medical Director / Promotional
Presentations / Educational Programs
 Physician participation in clinical studies (e.g.,
principal investigator, etc.)
 Licensure / royalty payments
 Payments involving intellectual property
Our Mantra
A reliable and comprehensive valuation approach
should provide:
 An evaluation methodology that analyzes each parameter in an
objective, consistent and repeatable way.
 Adherence to accepted valuation theory, as modified to comport
with healthcare regulations.
 A FMV outcome that can be supported via independent market
data.
 A comprehensive written work product that documents the
valuation approach(es) and the FMV findings.
Example: Determining The FMV of
Thought Leader Compensation
 Determine extent of the services (i.e., how many
hours).
 The nature of the specialty.
 Credentials/qualifications of the thought leader.
 The specific services contemplated by the
arrangement.
A Cost Approach: The Thought Leader
Compensation Algorithm
 Utilizes survey benchmark compensation data, by
medical specialty, as the starting point.
 Considers multi-year data.
 Compensation data is adjusted for taxes/benefits.
 Makes a series of adjustments to the benchmark data
based on:
 The extent of thought leader time required.
 Specific requirements of the position.
 The skills/experience of the specific thought leader.
Considers Specific Duties and
Responsibilities
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Number of hours associated with each duty and/or
responsibility.
The specific duties & responsibilities of the position.
The complexity of each duty and/or responsibility.
Level of leadership required.
Specific objectives and deliverables.
Potential impact of thought leader/consultant on
organizational and/or product success.
Considers Thought Leader Qualifications
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Educational credentials and specialized training.

Professional certifications.
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Leadership experience.
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Academic appointments.
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Research experience and funding history.
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Invited presentations.
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Publication history.
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Other professional leadership activities / recognition in
the healthcare community.
How We “Score” the Thought Leader
Algorithm
 Establish relative weightings for the pertinent
factors.
 Identify interdependencies among the factors
(e.g., extent of time requirement vs.
qualifications of thought leader).
 Consider potential redundancy of qualifications.
The Market Approach
 Places reliance upon “non-tainted” data.
 Considers physician compensation
arrangements that are free from referral bias.
 “Crosswalks” the arrangement to nonhealthcare settings.
Our Approach To Non-Tainted Market Data
 Fees paid to physicians who are not in a
position to refer:
 Expert witness fees
 Physician consultants
 Fees paid to comparably qualified nonphysicians:
 Consultants
 Attorneys
75 NW 1st Avenue, Suite 201
Delray Beach, FL 33444
561-330-3488
858 Happy Canyon Road, Suite 240
Castle Rock, CO 80108
303-688-0700
www.healthcareappraisers.com
Daryl Johnson
Ann Brandt
[email protected]
[email protected]
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