Coffee with Coker

Episode 9: Top 10 Lessons Learned from First-to-Second Generation Transactions

  • July 19, 2018

Max Reiboldt and Michael Barry join Mark to discuss the Top 10 Lessons Learned from First-to-Second Generation Transactions. Max oversees Coker Group’s services and the general operations of the firm and provides sound financial, strategic, and tactical solutions to hospitals, medical practices, health systems, and other healthcare entities through keen analysis and problem-solving. Michael is a partner in the Corporate Practice and the Healthcare Practice at Arnall Golden Gregory, LLP, and focuses his practice on healthcare transactional and regulatory law – specifically for hospitals, health systems, and other institutional providers.



Episode Synopsis

Mark, Max, and Michael discuss transitioning from a first-to-second-generation transaction and industry trends affecting hospital-physician transactions. Throughout their discussion, they touch on the top 10 lessons they have learned from these types of alignment initiatives.

Top 10 Lessons Learned from First-to-Second-Generation Transactions

  1. Physician market share does not mean success, so health systems have become more selective relative to transactions. (PSAs are much more popular now than 3 years ago.)
  2. Incurring losses in physician transactions may not be offset by downstream revenue (increased site-neutral payments).
  3. Ensure the organization’s productivity and revenue goals are being met. (Fee-For-Service still prevails.)
  4. Consider the infrastructure required to support non-productivity incentives. (Fee-For-Value payments must exist to require such.)
  5. Gradually begin tapering off productivity goals and replace them with alternative incentives. (Mirror reimbursement trends.)
  6. Tie new incentives to organizational goals, such as cost-savings, quality, etc., and prepare to respond to MACRA/MIPS requirements.
  7. Begin tying incentives to reimbursement changes, such as shared savings and/or the quality/CPIA/ACI metrics being measured for MIPS.
  8. Leverage newly prioritized metrics to reap additional reimbursement incentives (i.e., commercial or MIPS increases).
  9. Continually reassess compensation structures in light of regulatory and industry trends.
  10. Payment reform is here and real (MACRA); healthcare providers are unable to ignore the value-based reimbursement world.


AHLA Presentation – Top 10 Lessons Learned From First to Second_20180412

Second Generation Compensation Plans – Is this Alignment Armageddon? Part 1

Second Generation Compensation Plans – Is this Alignment Armageddon? Part 2

Contact Michal Barry (Arnall Golden Gregory)

Follow Max on Twitter

Connect with Max on LinkedIn

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  • Max Reiboldt, CPA

    Max Reiboldt, CPA



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