It is quite clear that economists rather generally recognize the need for a dynamic theory of economics. The reasons for this attitude are to be found in the nature of economic phenomena, which are always changing, ever in a state of Flux.1

—Charles Fredrick Roos

As this text goes to print, the U.S. healthcare delivery system is experiencing continuing uncertainty affecting providers, payors, and suppliers alike, who are attempting to navigate through the turbulence of healthcare reform, challenging economic conditions, and volatile capital markets. This “perfect storm” of circumstances, in turn, has an impact on the transactional marketplace in which these healthcare industry players operate. On the reimbursement side, there continues to be a movement from procedure volume–driven reimbursement to value-based purchasing (VBP), with an increased focus on reimbursing providers based on quality over quantity, or value over volume. These changes represent a paradigm shift in U.S. healthcare delivery, with an increasing dependence on the value metrics derived from evidence-based medicine. However, there is continued uncertainty related to whether currently proposed mechanisms for implementing this new paradigm, for example, Accountable Care Organizations (ACOs), will be able to achieve the objectives of VBP, that is, high quality and beneficial outcomes in pursuit of lower overall costs.

At the same time, increased regulatory scrutiny regarding potential anti-kickback and other ...

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