Managing risk in today's healthcare M&A transaction.

Beyond customary business diligence, mergers in the healthcare arena must clear an array of federal and state regulatory hurdles and compliance risks that have grown more pronounced in recent years. Primary challenge are posed by: Antitrust issues. Licensing and compliance practices. Data privacy and security. Payment and revenue stability. Cultural fit and post-merger integration.

Navigating financial distress.

An effective hospital turnaround plan includes speed, transparency and legal savvy.

The truth about managed care: the silent provider discount.

At a time when many managed care organizations (MCOs) have announced improvements in administrative systems and a desire to ease provider relations and pay providers correctly and timely, many physician organizations continue to experience great difficulty in obtaining prompt and accurate claims payment. To understand this phenomenon better, physician organizations at two leading academic medical centers in the Northeast and South, respectively, compiled an analysis of their recent managed care claims payment experience. This analysis revealed substantial underpayments from MCOs, and documented the added administrative expense required to recover such underpayments.

A review of CHIN initiatives: what works and why.

A Community Health Information Network (CHIN) can generate revenue through multiple avenues and maximize efficiency for participants, including multiple payers, physicians, hospitals, labs, pharmacies, and ancillary providers. This article reviews representative CHIN initiatives over the past decade and identifies key success factors, such as provider adoption and participation in planning, multiple-payer participation, providing key transactions, and incremental implementation.