2023年,通货膨胀和高利率继续对医院净收入产生负面影响, 迫使医院系统进一步评估其业务组合以获得节省成本的机会. As a result, 医院在过去10到20年间获得的能力和设施,以增加其提供的bet8娱乐,如长期护理, home health, rehabilitation, nursing, hospice, diagnostic laboratories, and physician practices—are now being divested. 这些交易通常包括全部出售或组成合资企业出售部分业务, both of which generate additional cash for the hospital to invest in other areas.
To make the best decision for their business, hospital leaders must understand an asset’s true value, 这只能通过确保准确的支持估值和对所有费用的核算来实现. Otherwise, 医院在进入销售过程时可能对其bet8娱乐项目的价值理解不准确, potentially exacerbating their financial struggles.
Mistake One: Inaccurately Accounting for Overhead Expenses
To be compliant with Stark law and the Anti-Kickback Statute, 评估bet8娱乐项目的价值标准是公平市场价值(FMV)。. As such, 评估师必须考虑bet8娱乐线,因为它将作为一个独立的实体由假设的买方操作. This means all expenses must be fully considered, 即使医院目前以不直接计入费用的方式经营业务.
Overhead expenses encompass all management and staff costs required to operate the business; however, 医院财务业务单位的报表通常只包括与直接员工有关的费用(例如.e., clinical support staff). Financial services, billing, management, strategy, accounting, marketing, human resources, IT and EHR system, 而集团采购人员的费用通常不计入财务报表, providing a distorted view of the service line’s financials.
管理费用是核算管理费用最直接的方法, which is generally charged as a percentage of revenue. 这笔费用包括由受雇员工或管理公司提供的所有管理bet8娱乐. Alternatively, 考虑到每个员工在各自区域支持bet8娱乐线所花费的时间,医院可以完成一个完整的费用积累.
Conversely, 医院有时会通过间接拨款给bet8娱乐部门分配过多的费用, 增加bet8娱乐线的开销,如果它是一个独立的实体,则不需要这样做. An adjustment should be made in these instances to reduce the expense, thereby potentially increasing the value of the service line.
Mistake Two: Underestimating Facility Costs
根据FMV对医院业务进行估值时要考虑的另一个关键方面是设施费用. This includes rent, utilities, repairs and maintenance, and any other cost associated with maintaining and operating the space. Rent is often expensed to a system-wide account, is not captured in business unit–level financials, 而且必须加入到估值中,以反映假设的买卖标准.
To properly estimate rent expense, 医院可能需要进行市场租金研究——考虑到实际空间的大小和特征,对主题bet8娱乐区域的租金费用进行分析. 在主题空间归医院所有和/或租金未按与市场一致的水平收取的情况下,最需要这样做.
另一个常见的误区是,经营家庭保健业务的医院认为,小空间意味着不需要考虑租金. In these cases, however, 为了计算企业管理人员使用的设施,确实需要增加租金费用.
Mistake Three: Applying a Value to Downstream Revenue
以医院为基础的业务为bet8网站备用的核心业务带来更多患者的能力是其对bet8网站备用财务价值的最重要方面之一. This revenue, referred to as downstream revenue, is generated at other health system units because of the original business line.
Because of downstream revenue, bet8网站备用可能会选择将某些业务作为亏损龙头来经营,从而在系统的其他部门产生利润. The revenue from other service areas, however, 假设的买家无法获得,因此无法在公平的市场估值中得到解释. Valuators can only consider the direct revenue generated by the service line.
Mistake Four: Accounting for Strategic Value
If a business is underperforming, 潜在交易的战略价值不能被认为产生更高的现金流. 在这种情况下,估值公司通常不会使用收益法或市场法,而是使用成本法并对资产负债表上的资产进行估值.
By its nature, 在出售的情况下,成本法不太可能产生显著的价值, but that doesn’t mean those scenarios where it would be used are without benefit. Even in the absence of a significant up-front payment, hospitals may have strong rationale for selling an underperforming service line, such as enabling them to streamline operations, focus on core services, and eliminate losses.
错误五:出售少数股权时,以控制权为基础评估企业价值
通常,以医院为基础的业务是合资企业的一部分,而不是简单地出售. If the buyer will purchase a minority investment, this should be considered when determining the final value. 评估师需要了解操作条款才能得出最终意见, 因为这些将影响应应用于价值的折扣水平. 少数股东对公司的业务决策没有控制权(除非在经营协议中加入了具体的治理条款),因此不会像控股实体那样重视所有权利益.
Accurate Valuations Lead to Sustainable Futures
A complete, 全面了解医院的bet8娱乐线路是必要的,以确定潜在的剥离是否对bet8网站备用具有战略和财务意义. Once leaders correctly capture their hospital’s expenses, including overhead and rent, and remove the impact of downstream revenue, 他们可以肯定,他们将对非核心业务的表现有最准确的了解.
This view, which will be reflected in the independent valuation firm’s opinion, 能否帮助领导者在如何处理表现不佳的bet8娱乐方面做出明智的决定,以支持他们实现长期成功和持续财务稳定的目标.
Edited by: Emily Johnson
本文最初发表于2024年3月的《bet8娱乐》.
Published March 28, 2024
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