CHAPTER 15

Healthcare Services

15.1 Classification of Clinical-Related Services

15.1.1 Nonphysician Clinical–Related Services

15.2 Classification of Nonclinical-Related Services

15.3 Establishing Fair Market Value and Commercial Reasonableness

15.3.1 Fair Market Value

15.3.2 Commercial Reasonableness

15.4 Four Pillars of the Healthcare Service Industry: Regulatory, Reimbursement, Competition, and Technology

15.5 Valuation of Healthcare Services

15.5.1 Valuation of Clinical-Related Services

15.5.2 Valuation of Nonclinical-Related Services

15.6 Conclusion

15.7 Key Sources

15.8 Acronyms

Healthcare services may be classified into two general categories, that is, clinical related and nonclinical related, with nonclinical-related activities falling into three generalized subcategories: administrative, management, and/or executive. These categories can be defined by the specific tasks, duties, responsibilities, and accountabilities (TDRAs) involved in each. This chapter addresses the classification and valuation of several of the most prevalent services rendered in the healthcare services industry, within the context of the four pillars, that is, regulatory, reimbursement, competition, and technology.

As the corporatization of medicine has evolved, the provision of healthcare services has transformed from a “cottage industry,” where physicians had a more direct, personal relationship with their patients, to more of a commercial structure, where a patient may have multiple physicians, ...

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