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University of Iowa eyes consultant to assess value of other health care entities

cigaretteman

HR King
May 29, 2001
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As the University of Iowa searches for a new top executive to lead its sprawling health care enterprise and highly-ranked college of medicine, administrators want a partner to help them assess the “fair market valuation” of a “wide range of health care settings and assets” — enabling the UI to buy another health care entity if it wants.


The Centers for Medicare & Medicaid Services, a federal agency within the U.S. Department of Health and Human Services that manages and administers Medicare and Medicaid, has regulations around “fair market value” — not just for determining compensation but property and asset transactions of health care facilities.


“It is a federal regulatory requirement to complete a fair market value assessment before purchasing health care entities or practices” said a UIHC statement to The Gazette. “UI Health Care is proactively seeking a company that specializes in this skill set through the public bid process, which will allow us to better assess purchase opportunities when they arise.”


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UIHC officials didn’t provide more details about what kinds of opportunities they might be pursuing. But through a request for qualifications from prospective firms — who must submit proposals by May 29 — UI Health Care is seeking “fair market evaluation opinions” on settings and assets like multi-specialty physician group practices; primary care group practices; ambulatory surgery centers; outpatient imaging centers; and hospital service lines.


Construction boom​


The UI Hospitals and Clinics has been growing its reach, both through an explosion of new construction and collaboration throughout the state.


UIHC is building a $525.6 million hospital in North Liberty; spending $95 million to expand its existing inpatient tower; and moving ahead with new “North Inpatient Tower” on the main UIHC campus budgeted to cost more than $620.9 million.


Among its other projects, UIHC is planning to spend up to $49 million building out an expanded neonatal intensive care unit in its Stead Family Children’s Hospital; $37 million expanding its emergency room; and $8 million to convert space in its south wing for more beds.


Outside Iowa City​


Away from the main Iowa City campus — and in addition to the North Liberty project — UIHC is looking for a design team to help plan and build a new primary care medical office building in southeast Iowa City to address a “health care access gap” in that part of town. Selection of a developer for that project remains “in progress,” according to the UI project solicitation website.


And on April 20 the university received Board of Regents approval to enter into a lease deal with the Siouxland Medical Education Foundation in Sioux City, allowing UIHC to collaborate and keep that entity’s family medicine residency program alive. The initial term of that lease expires in a decade and comes with two five-year renewal options.








The university also is seeking a property manager for the Sioux City facility. According to a request for qualifications issued May 4, with responses due Monday, UIHC wants a property manager to not only perform routine, preventive and emergency maintenance, but to “design, bid, recommend bid acceptance, award bid contracts, and provide construction phase administration and project management for all capital construction projects deemed necessary.”


New leadership​


Turnover atop the UI Health Care operation hasn’t slowed growth and expansion, which is listed among a “desired outcome” of the university’s search for a new vice president for medical affairs and dean of its Carver College of Medicine.


“Identify opportunities for partnerships, joint ventures, alliances, and other creative approaches to meeting the health needs of the population in Iowa to further the growth of UI Health Care's clinical networks,” according to one of five key outcomes the university wants from a new leader.


UI brought to campus this month two finalists for the dual leadership post — marking the second time its done so, after the chosen candidate from a first round of four finalists declined the job offer in the fall.


A 13-member search committee hasn’t said when it might announce a new vice president and dean to succeed outgoing Brooks Jackson, who’s stepping down to continue his research on the UI faculty once a successor begins.


Both finalists during their public forums took questions about the university’s growth and opportunities to expand.


The first finalist — Denise Jamieson, professor and chair for the Department of Gynecology and Obstetrics at Emory University School of Medicine and chief of gynecology and obstetrics for Emory Healthcare who also spent nearly two decades with the U.S. Centers for Disease Control and Prevention — pointed to rural Iowa as primed for UIHC expansion.


“I think the real opportunity for growth here is in rural areas,” Jamieson said. “The question is, what does that look like? And I think one of the really important pieces of this is to have conversations with other health entities. … It's really important to have frank conversations with other hospitals, other health systems, and then stakeholders.”


The second finalist — Mark Rosenblatt, executive dean of the University of Illinois College of Medicine and associate vice chancellor for physician affairs at University of Illinois Health — pointed to the surging demand for UIHC services in discussing the need and opportunity for growth and collaboration.


“The University of Iowa has a very aspirational, but I think realistic, capital plan to build capacity for the health system,” he said. “There’s a need to expand, and I think that’s part of the solution. The other issue is how can we partner with our community hospitals?”


UIHC last year offered to take over neighboring Mercy Iowa City — offering $605 million in a deal that never materialized, according to an investigation by The Gazette.


“I know that there's been some attempts by University of Iowa Health Care to create partnerships, to maybe perhaps acquire local hospitals,” Rosenblatt said. “I think that needs to be another part of the solution. Patients trust the brand of University of Iowa, they want to be taken care of by the world-class physicians and get care within the University of Iowa facilities … So that's, I think, something we need to look at.”

 
Are they looking to expand by joint venture/partnership like U of Minnesota and Fairview? Or are they just looking to expand by takeover?
 
This is not unusual. Most AMCs use third party consultants to vet deals. If they're acquiring another non-profit, they're usually not paying upfront cash.

Those types of deals are usually sole member substitutions with a capital commitment behind them.
 
Unpossible

I was told ObamaCare was going to destroy the healthcare industry...
 
If you don't do an fmv assessment, you are at risk of the consideration you pay being viewed as a kickback for referrals by the seller, particularly if the seller maintains any ongoing operational relationship with the acquired facility. This is actually quite important if you don't like jail.
 
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