DAILY UPDATE: FQHCs Down and Healthcare Bankruptcies Up as the Markets Extend Gains

MEDICAL EXECUTIVE-POST TODAY’S NEWSLETTER BRIEFING

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Low-income communities often struggle to access healthcare services, but a new analysis of federally qualified health centers (FQHCs)—which provide quality care to patients regardless of ability to pay—has helped nail down one reason. When it comes to screening for certain cancers, these nonprofit community health centers have fallen far behind the national average, according to a study led by cancer center researchers at the University of Texas MD Anderson and the University of New Mexico.

CITE: https://www.r2library.com/Resource

Healthcare bankruptcies surged in 2023, and it turns out many of the companies that went under had one thing in common: private equity (PE) ownership. At least 21% of the 80 healthcare companies that filed for bankruptcy last year were PE-owned, according to a report from the nonprofit Private Equity Stakeholder Project (PESP).

CITE: https://tinyurl.com/2h47urt5

Warren Buffett on contemplated his own mortality at Berkshire’s meeting. Succession was the topic du jour at the Berkshire Hathaway shareholder meeting in Omaha last week. After his longtime business partner Charlie Munger died last year at 99, CEO Warren Buffett—who turns 94 in August—revealed his heir apparent, Greg Abel, will have the final say on investment decisions in his absence. Buffett ended his Q&A portion with the quip, “I not only hope you come next year. I hope I come next year.” Adding to the ominous vibes, Buffett said AI is a genie that “scares the hell out of me.”

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Here’s where the major benchmarks ended:

  • The S&P 500 index climbed 52.95 points (1.0%) to 5,180.74; the Dow Jones Industrial Average gained 176.59 points (0.5%) to 38,852.27; the NASDAQ Composite advanced 192.92 points (1.2%) to 16,349.25.
  • The 10-year Treasury note yield (TNX) fell about 1 basis  point to 4.491%.
  • The CBOE Volatility Index® (VIX) was little changed at 13.48.

Semiconductors were among the strongest performers Monday behind Micron Technology (MU), whose shares rallied 4.7% after Robert W. Baird upgraded the chipmaker to “outperform” from “neutral.” Micron Technology was the top gainer in the Philadelphia Semiconductor Index (SOX), which advanced 2.2% to near a four-week high.

Small-cap stocks also got out of the gate strong this week. The Russell 2000® Index (RUT) gained 1.2% to end at a four-week high but is still up just 1.7% for the year, while the S&P 500 has gained 8.6%.

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What is a Federally Qualified Health Center?

ABOUT F.Q.H.C.s

By Dr. David E. Marcinko MBA CMP®

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I worked at several FQHCs as a medical student and intern, back in the day, both in urban and suburban settings. But, I never was sure what this entity was, exactly. Probably because I was from an under served area, myself.

DEFINITION:

A Federally Qualified Health Center (FQHC) is a reimbursement designation from the Bureau of Primary Health Care and the Centers for Medicare and Medicaid Services of the United States Department of Health and Human Services. This designation is significant for several health programs funded under the Health Center Consolidation Act (Section 330 of the Public Health Service Act).

It is a community-based organization that provides comprehensive primary care and preventive care, including health, oral, and mental health/substance abuse services to persons of all ages, regardless of their ability to pay or health insurance status.

Thus, they are a critical component of the health care safety net. FQHCs are called Community/Migrant Health Centers (C/MHC), Community Health Centers (CHC), and 330 Funded Clinics. FQHCs are automatically designated as health professional shortage facilities.

CMS: https://www.cms.gov/Center/Provider-Type/Federally-Qualified-Health-Centers-FQHC-Center

FQHC.org: https://www.fqhc.org/what-is-an-fqhc/

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Accountable Care Organizations are Here

The Final Federal Guidelines

By Garfunkel Wild PC

http://www.garfunkelwild.com

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The much anticipated final federal regulations on accountable care organizations (ACOs) were published on October 20th, 2011. The Affordable Care Act created ACOs to deliver seamless, high quality care to traditional fee-for-service Medicare beneficiaries while reducing the cost of care to those beneficiaries. If successful, ACOs will receive a portion of the shared savings they achieve for the Medicare program.

ACO Workgroup 

The Garfunkel Wild ACO Workgroup is in the process of analyzing these final regulations, and we will be hosting a webinar in the near future to discuss ACO participation and other ways providers can move towards collaborative care.

Final Regulations

In reviewing the final regulations, it is clear CMS took public comments to their proposed regulations seriously and made significant changes that should strengthen the ACO program. Some of these changes include:

  • Allowing ACOs to participate in an upside shared savings track (without being subject to downside losses) for the first three years of participation
  • Expanding the definition of participants eligible to form ACOs to include federally qualified health centers (“FQHCs”)
  • Reducing by about half the number of quality measures ACOs have to report
  • Permitting ACOs to share in first dollar saved once a minimum savings rate is achieved
  • Creating more flexibility for start dates for ACOs beginning in 2012
  • Removing EHR readiness as a condition of participation
  • Revising the process of assigning beneficiaries to ACOs from a pure retrospective process to a prospective process that includes retroactive adjustments

Assessment

Also published with the CMS final regulations were interim final regulations published by the Office of Inspector General addressing the waiver of the application of federal fraud and abuse laws; a final policy statement issued by the Federal Trade Commission and Department of Justice outlining the agencies’ antitrust enforcement policies for ACOs, and an IRS Fact Sheet regarding tax exempt organizations participating in the Medicare Shared Savings program.

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