ABL and Commercial Finance organizations within Credit/Risk and Portfolio/Account Management

Interested in networking with professionals in Asset Based Lending and Commercial Finance organizations for opportunities within Credit/Risk/Underwriting and Loan Portfolio/Account Management. Send inquiries to djlacasse@gmail.com

Managing Director and President - David J. Lacasse has more than 13+ years of experience in asset based lending, healthcare finance, and medical device manufacturing, and most recently managing the loan portfolio for a prior healthcare finance business.

Noteworthy:
I have 10+ years of experience in portfolio management and audit within asset based lending and lease accounting.
I have 3+ years of experience in internal audit both domestic and international.
I had been responsible for managing a portfolio of healthcare middle market asset based loans (high risk); and was successful at managing the risk and increasing fee income.
I successfully managed the loan risk/exposure for the largest hospital system insolvency in New York City (pre bankruptcy and DIP financing).
Successfully managed and trained a remote audit staff (6 Telecommuting FTEs) as a profit center.
Formerly registered with the Securities Exchange Commission, NASD & SIPC (Series 7 & 63).

Healthcare Borrowers Obtain Loans Despite Volatile Market Swings

The economic experts aren't predicting an immediate end to the current cycle of denial, hope and panic that has been causing interest rates, stock prices, commodity prices and exchange rates to fluctuate wildly since the onset of the credit crisis last summer.

"At this point, after all the lumps the markets have been taking, the recent projection by the International Monetary Fund (IMF) that the U.S. economy will tip into a modest recession this year followed by a gradual recovery in 2009 sounds almost upbeat," senior housing/healthcare funding expert Jeffrey A. Davis observes.

Davis is chairman of Cambridge Realty Capital Companies, one of the nation's leading senior housing/healthcare lenders with more than $2.75 billion in 300 closed transactions since the mid-1990s. The IMF prediction, he notes, contrasts sharply with the Bush administration's much more optimistic forecast earlier this year, which projected a 2.7% growth rate for 2008 followed by 3.1% growth in 2009.

"The IMF expects the U.S. growth rate to shrink to 0.5% in 2008 and 0.6% in 2009. Given the bleak outlook for housing, to most observers the IMF projection probably seems closer to the mark," Davis said.

He points out that the IMF's baseline projection that U.S. home prices could decline between 14% and 22% in 2007 and 2008 is unprecedented for the U.S. but not elsewhere in the world.

While most segments of the senior housing/healthcare industry are more 'recession proof' than other industries, Davis says there is now some concern that the housing slump is a factor in the lower occupancy levels for independent living communities reported by the National Investment Center for the Seniors Housing & Care Industry (NIC). Mean occupancy was up slightly during the third quarter of 2007 for assisted living, skilled nursing and continuing care retirement communities but down slightly, from 93% to 91%, for independent living communities.

"But, overall, the industry appears to be in good shape to ride out even a protracted economic downturn," Davis believes.

He points out that the Federal Reserve Board lowered short-term interest rates again in March by three-quarters of a percentage point to 2.5%. And the one-month LIBOR Index rate has declined to 2.70% from 5.32% at this time last year.

"Primarily because of the current liquidity crisis, commercial mortgage loans hardly reflect declines of this magnitude. But funds are available for viable projects, with FHA-insured HUD loans especially attractive at this time," he said.

Privately owned since its founding in 1983 as a real estate investment banker specializing in commercial real estate properties, Cambridge emerged in the 1990s as one of the nation's leading senior housing and healthcare debt and equity capital providers, closing more than 300 such transactions totaling more than $2.75 billion since then.

The company is one of the nation's leading HUD 232 FHA/MAP-approved lenders and also has an integrated debt/equity financing strategy that includes direct property acquisitions and joint ventures; sale/leasebacks for clients; conventional and mezzanine debt financing; and acquisition of distressed debt. Additionally, Cambridge offers a wide array of conventional lending options for senior housing/healthcare owners, including permanent construction and interim loans on either a floating or variable rate basis.

Link: http://www.abfjournal.com/story.asp?id=22889

Healthcare Collateral Consulting, LLC (Healthcare ABL Services)

Healthcare Collateral Consulting, LLC offers outsourced due diligence services including field examinations, credit, underwriting, risk analysis and account management for healthcare lenders, including banks, asset-based lenders, private equity and institutional investors. HCC's associates have extensive healthcare experience in credit, collateral, underwriting, audit, workout management, operations, and account management. "HCC's services are designed to provide a customized solution".

Managing Director and President - David J. Lacasse has more than 11 years of experience in asset based lending, healthcare finance, and medical device manufacturing, most recently managing the loan portfolio for a prior healthcare finance business since 2004.

Healthcare Collateral Consulting, LLC
healthcarecollateralconsulting@gmail.com
Fairfield County, Connecticut
203-610-2515

CMS PROPOSES TO EXPAND QUALITY PROGRAM FOR HOSPITAL INPATIENT SERVICES IN FY 2009

The Centers for Medicare & Medicaid Services (CMS) today proposed additional steps to strengthen the tie between the quality of care provided to Medicare beneficiaries and payment for the services provided when they are in the hospital.

CMS is proposing to expand the list of conditions which are reasonably preventable through proper care and for which Medicare will no longer pay at a higher rate if the patient acquires them during a hospital stay. In addition, CMS is adding 43 new quality measures for which hospitals will have to report data in order to receive the full annual payment update for their services.

“CMS is taking aggressive actions to ensure that beneficiaries get safe, high quality, and efficient care from their health care providers, and the actions we are announcing today build on our efforts,” said CMS Acting Administrator Kerry Weems. “The status of the Medicare Hospital Insurance Trust Fund requires us to find the best solutions to ensure that Medicare stays strong while paying providers appropriately for the care they deliver. The reforms we are proposing in this rule should lead to greater value for Medicare beneficiaries and the Medicare program.”

The proposed regulation builds on efforts across Medicare to transform the program to a prudent purchaser of health care services, paying based on quality of care, not just quantity of services. CMS is also making hospital quality and cost information available to help consumers make more informed choices. On March 28, CMS posted updated pricing and quality information at www.hospitalcompare.hhs.gov, along with the results of surveys of patients about their experience with the care they received while in the hospital.

The proposed rule would apply to services provided to patients who are discharged from the hospital during fiscal year (FY) 2009, which begins on October 1, 2008.

Full Excerpt: http://www.cms.hhs.gov/apps/media/press/release.asp?Counter=3041&intNumPerPage=10&checkDate=&checkKey=&srchType=1&numDays=3500&srchOpt=0&srchData=&srchOpt=0&srchData=&keywordType=All&chkNewsType=1%2C+2%2C+3%2C+4%2C+5&intPage=&showAll=&pYear=&year=&desc=&cboOrder=date

This link was brought to you by: Healthcare Collateral Consulting, LLC - Providing Ourtsourcing Services to Healthcare Lenders.

djlacasse@gmail.com

GE Capital to Acquire Bulk of CitiCapital

GE Capital has agreed to purchase most of CitiCapital, Citigroup's North American commercial lending and leasing business, in an all-cash transaction.

Financial terms were not disclosed and the acquisition is expected to close, pending normal regulatory approvals, by the third quarter of this year.

According to a press release on GE's Web site, through the transaction, GE Capital will acquire seven CitiCapital equipment finance business lines, including Healthcare Finance, Private Label Equipment Finance, Material Handling Finance, Franchise Finance, Construction Equipment Finance, Bankers Leasing, and CitiCapital Canada. CitiCapital's Tax Exempt Finance business is not part of the transaction and will remain with Citi.

When completed, the deal will add approximately $13.4 billion in assets to GE Capital's Commercial Finance business. CitiCapital has approximately 1,400 employees and 160,000 customers throughout North America.

In addition, GE Capital and Citi are exploring strategic cross-sell relationships with commercial clients.

"This acquisition represents another significant growth opportunity for GE-one that helps us offer more to customers," said Mike Neal, GE vice chairman. "CitiCapital is a well established franchise with experienced employees, broad capabilities and a terrific customer base. It's a business we know how to grow. We acquired and successfully integrated CitiCapital's Transportation Financial Services Group in 2005."

The transaction is part of Citigroup's efforts to direct capital to core businesses and drive operational efficiency.

"This transaction allows Citigroup to release capital from non-core areas and redistribute that capital to areas with the greatest opportunities for profitable growth," said Peter Knitzer, chairman and CEO of Citibank North America. "This divestiture further streamlines our business and better positions the firm to leverage marketplace opportunities to benefit our shareholders."

http://www.abfjournal.com/story.asp?id=22791

HealthcareCollateralConsulting@gmail.com

CMS PROGRAM IDENTIFIES $371.5 MILLION IN IMPROPER MEDICARE PAYMENTS IN THREE STATES

The Centers for Medicare & Medicaid Services (CMS) today announced that $371.5 million in improper Medicare payments has been collected from or repaid to health care providers and suppliers as part of a demonstration program using recovery audit contractors (RACs) in California, Florida and New York in 2007. Nearly $440 million has been collected since the program began in 2005.

“We need to ensure accurate payments for services to Medicare beneficiaries and by taking this important step, people with Medicare can be assured they are being charged correctly for their share of their health care services,” Acting CMS Administrator Kerry Weems said. “The RAC demonstration program has proven to be successful in returning overpayments to the Trust Fund and identifying ways to prevent future improper payments. We will use the lessons we learned from the demonstration program to help us implement the national RAC program next year.”

For full press release click on Link:
http://www.cms.hhs.gov/apps/media/press/release.asp?Counter=2943&intNumPerPage=10&checkDate=&checkKey=&srchType=1&numDays=3500&srchOpt=0&srchData=&srchOpt=0&srchData=&keywordType=All&chkNewsType=1%2C+2%2C+3%2C+4%2C+5&intPage=&showAll=&pYear=&year=&desc=&cboOrder=date

CMS: GROWTH IN NATIONAL HEALTH EXPENDITURES PROJECTED TO REMAIN STEADY THROUGH 2017

HEALTH SPENDING GROWTH EXPECTED TO CONTINUE TO OUTPACE ECONOMIC GROWTH AND GROWTH IN GENERAL INFLATION

Growth in health care spending in the United States is projected to be 6.7 percent in 2007, according to a report issued today by the Centers for Medicare and Medicaid Services (CMS). Average annual growth is expected to remain near that rate through 2017, the report said.

The analysis was prepared by CMS’s Office of the Actuary and published online by the journal Health Affairs. Over the full projection period (2007-2017), annual growth in health spending is anticipated to be higher than annual growth in both the overall economy (4.9 percent) and in general inflation (2.4 percent).

As a percentage of gross domestic product, known as GDP, health care spending is projected to increase to 16.3 percent in 2007 from 16.0 percent in 2006. By the end of the projection period, health care spending in the United States is expected to reach just over $4.3 trillion and comprise 19.5 percent of GDP.

For full press release from CMS Office of Public Affairs, go to:
http://www.cms.hhs.gov/apps/media/press/release.asp?Counter=2935&intNumPerPage=10&checkDate=&checkKey=&srchType=1&numDays=3500&srchOpt=0&srchData=&srchOpt=0&srchData=&keywordType=All&chkNewsType=1%2C+2%2C+3%2C+4%2C+5&intPage=&showAll=&pYear=&year=&desc=&cboOrder=date

Link provided by Healthcare Collateral Consulting, LLC

HOME HEALTH AND INFUSION THERAPY SECTORS SET TRANSACTION VOL UME RECORDS IN 2007

TOTAL TRANSACTION VOLUME KEEPS PACE WITH 2006

PITTSBURGH, PA, February 28, 2008 --The Braff Group (TBG), a leading middle market merger and acquisition firm that specializes in the home health care, hospice, infusion therapy, specialty pharmacy, health care staffing, and home medical equipment sectors, released its year-end 2007 merger and acquisition transaction trend report today. Based upon preliminary figures, there were 225 transactions announced and/or completed in 2007, slightly down from the 227 deals recorded last year.

The two break-out sectors of the year were home health and home infusion therapy.

For the first time since 2001, when The Braff Group began tracking health care service merger and acquisition activity, a sector exceeded 100 transactions for the year as the home health industry alone accounted for a record 107 deals, up nearly 14% from the previous record of 94 posted in 2006. Moreover, buyers’ enthusiasm for the sector has not dampened, even in the face of prospective payment system reform and payment reductions attributable to reimbursement “creep.” Accordingly, “valuations for the sector not only held up in 2007, but also ticked upwards, particularly for the most attractive, sizeable, Medicare focused platform-type acquisition targets,” commented Steven Braff, TBG Managing Director for home health and hospice. “That said, after a seven year run of relative reimbursement stability since the prospective payment system was introduced, we expect that this first wave of change and cuts will encourage more sellers to test the market, setting the stage for what we anticipate to be another robust year in home health mergers and
acquisitions.”

In terms of year-over-year deal volume growth, infusion therapy led all sectors with a surge of nearly 32%, posting a record 25 transactions in 2007 versus 19 in 2006. Also noteworthy is that in terms of the largest deals of the year, while no infusion transactions cracked the top 10 in 2006, there were 4 such deals in 2007, led by Walgreens $850 million acquisition of Option Care. “The breadth, depth, and appetite of infusion therapy buyers – from strategic players, to private equity groups, to other ancillary home care providers – for acquisition candidates both large and small, has arguably never been greater,” commented Chuck Gaetano, TBG Managing Director for home infusion therapy and specialty pharmacy. “And with 2008 getting off to a roaring start with the blockbuster acquisition of Critical Homecare Solutions (CHS) by MBF Acquisition Corp, a special purpose acquisition company (SPAC) that effectively transforms CHS into a publicly traded company, we expect no let up in acquisition momentum or enthusiasm in the coming year.”

Link:
http://www.thebraffgroup.com/news/pdfs/Transaction_Volume_Q407.pdf

Healthcare Collateral Consulting, LLC - "An Innovative Outsourcing Strategy for Healthcare Lenders and Investors"

Healthcare Collateral Consulting, LLC (HCC) provides lenders in Healthcare and Life Sciences with additional insight into healthcare trade risks that cannot be provided by most other consulting or audit firms.

Healthcare Collateral Consulting, LLC offers innovative cost-saving services including field examinations, credit, underwriting, risk analysis, account management, and executive recruiting for healthcare lenders, including banks, asset-based lenders, private equity and institutional investors. HCC's associates have extensive healthcare experience in credit, collateral, underwriting, audit, workout management, operations, and account management.

Healthcare Collateral Consulting, LLC has mission to provide superior, cost effective, value added services to our clients. HCC is committed to establishing strong relationships with its clients and providing inventive outsourcing solutions with the highest quality of service.

"Many of the players in healthcare lending are focusing on booking transactions without adequate back-office and due diligence support, which has created a void in the marketplace for the type of account management and due diligence services we offer," said David J. Lacasse, Managing Director at HCC. "HCC's services are designed to provide a customized solution from healthcare finance professionals ".

HCC's services are designed to provide a customized solution and include:

• Remote Performance & Loan Compliance Reviews
• Underwriting/Due Diligence
• Collateral Exams
• Remote Financial Assessments
• Scheduling Engagements & Staffing
• UCC Research
• Monitoring Healthcare Facility Survey Results
• Best Practices Analysis
• Revolving Line of Credit Simulation
• Inventory Analysis
• Hard-asset Verifications
• Special Assets Divestitures

Executive Recruiting Service: The Assignment Division of Healthcare Collateral Consulting, LLC now accepts both retained and contingency assignments in both healthcare asset based lending and healthcare private equity marketplace. We are committed to providing confidential, professional services to our clients and candidates alike. For more infromation, email your inquiry to hcc.assignments@gmail.com .

About HCC's Management:
Managing Director and President - David J. Lacasse has more than 11 years of experience in asset based lending, healthcare finance, and medical device manufacturing, most recently managing the loan portfolio for a prior healthcare finance business since 2004.

Look forward to speaking with you,

David J. Lacasse, Managing Director
Healthcare Collateral Consulting, LLC
djlacasse@gmail.com

Healthcare Lending - Executive Recruiting Service

The Assignment Division of Healthcare Collateral Consulting, LLC accepts both retained and contingency assignments in both healthcare asset based lending and healthcare private equity marketplace. We are committed to providing confidential, professional services to our clients and candidates alike.

We engage in full range of search assignments including field audit, credit, collateral, underwriting, portfolio/account management, operations, accounting, business development, marketing, sales management, and senior management positions located throughout the nation.

To Our Clients: We know your business. At HCC's-Assignment Division, innovative recruitment for the right talent is imperative. Only after one-on-one interviews do we consider a candidate for placement. All credentials and references are thoroughly checked and validated. Your satisfaction with our candidate's level of performance is central in establishing a strong relationship and providing innovative outsourcing solutions.

• Our contingency fees are below the industry average.
• We have candidates eager to work for your organization.
• Call today or email for our rates.

To Our Candidates: We are committed to providing our candidates with prompt, confidential service. Healthcare Collateral Consulting, LLC-Assignment Division offers challenging job opportunities to help meet their personal and professional goals. The most important pledge that we make to our candidates is to represent them in a fair and honest manner.

How do you get started?

To learn more about Healthcare Collateral Consulting, LLC's executive recruiting service or to register with our division, please email hcc.assignments@gmail.com .

We look forward to hearing from you,

David J. Lacasse, Managing Director

Healthcare Collateral Consulting, LLC

Fairfield County, Connecticut

healthcarecollateralconsulting@gmail.com

Personal Note: Congratulations to National Medical Health Card Systems Inc. (NMHC)

It's always a pleasure to see one of your prior clients become acquired. Between January-2004 and Mid-2005, NMHC was one of my clients when I was Portfolio Manager within the healthcare lending industry. At the time, they were a thriving business and had taken on private equity which in turn drove the stock price to record highs. They were always a pleasure to work with and I wish them the best.

David J. Lacasse, Managing Director - djlacasse@gmail.com
Healthcare Collateral Consulting, LLC

SXCI signed a definitive agreement to acquire National Medical Health Card Systems Inc. (NMHC) for $143 million, or $7.70 in cash and 0.217 shares of SXC common stock, a 13% premium to National Medical's 20-day average closing price. SXC, a Lisle, Ill., healthcare information technology provider, expects the deal with the Port Washington, N.Y., pharmacy benefit program manager to close in the second quarter of 2008. SXC expects the acquisition to decrease earnings in fiscal 2008 and add to earnings after that. SXC said the combined company, which will be renamed InformedRx, will be based in Lisle, Ill., with Gordon Glenn as chairman and chief executive. The company said Mark Thierer of SXC will remain president and chief operating officer, and Jeff Park will remain senior vice president, chief financial officer and secretary.

Link:
http://www.marketwatch.com/news/story/sxc-health-acquire-ntl-medical/story.aspx?guid=%7B39B76FBB%2D32B3%2D493F%2DB98C%2D2BC0085C2354%7D&dist=hplatest

The Need for ABL Human Capital

In a recent Q&A with The Secured Lender, industry executives offered their reflections on the direction of asset-based lending and factoring, with an eye towards moderate growth in 2007 and 2008. As credit markets tighten, as a result of the subprime debacle, asset-based lenders are predicting additional opportunities for their sector.

Excerpt from the Article: The Need for Human Capital

Warren K. Mino, president and COO of Webster Business Credit, Mino's worry remains the need for additional seasoned professionals in the ABL sector should a serious upswing in business occur. Bill Davis, recently retired managing director of Wachovia Capital Finance agrees, noting that one of the bigger concerns for asset-based lenders is the need for more quality people to manage operations and grow portfolios. Davis says, “It’s a very tight market on the human capital side. Good people are at a premium.”

Now, those in the field are scouting out possible prospects outside of asset based lending — those with transferable skills sets. Davis notes, “We have been looking outside of the industry to recruit corporate bankers, for one, or those in investment banking. Generally, they’re looking at portfolio people who have some asset-based experience.”

Experienced people are certainly going to be in need, as industry execs do foresee a growth in business, says Jim Rothman, president of Capital Temp- Funds. He predicts a backlog of business for the ABL sector in 2008, especially as these lenders expand their operations to accommodate other services. Rothman refers to these “value-added alliances” with other industries as a critical component to growing business.

Healthcare Collateral Consulting, LLC ("HCC") offers innovative value added services including field examinations, credit, underwriting, risk analysis, account management, and executive recruiting for healthcare lenders, including banks, asset-based lenders, private equity and institutional investors. HCC's associates have extensive healthcare experience in credit, collateral, underwriting, audit, workout management, operations, and account management.

Article: Lenders predict credit crunch will bring increased business for 2008, but express concerns about the U.S. economy and the need for human capital. - By Myra A. Thomas

Link: http://www.cfa.com/documents/TheSecuredLender_Thomas_Jan08.pdf

If you are interested in learning more, Mr. David J. Lacasse can be reached at the following email address: djlacasse@gmail.com . Please included your name, title, company name and phone number.

Healthcare Collateral Consulting, LLC
healthcarecollateralconsulting@gmail.com
Fairfield County, Connecticut
203-610-2515

www.linkedin.com/in/davidjlacasse

CMS TAKES NEXT STEP TO IMPROVE QUALITY IN NATION'S NURSING HOMES

LATEST IN A SERIES OF ACTIONS TO EXPAND INFORMATION

The Centers for Medicare & Medicaid Services (CMS) today built upon historic action it took last November by making public more names of underperforming nursing homes across the country. On November 29, 2007, the agency began publishing the names of Special Focus Facility (SFF) nursing homes that had failed to improve significantly after being given the opportunity to do so.

Once a facility is selected as an SFF, state survey agencies are responsible for conducting twice the number of standard surveys and will apply progressive enforcement until the nursing home either (a) significantly improves and is no longer identified as an SFF, (b) is granted additional time due to promising developments, or (c) is terminated from Medicare and/or Medicaid.

“This is the latest in a series of steps we will be taking to improve quality and oversight in nursing homes,” said Kerry Weems, CMS acting administrator. “We are issuing more information on special focus facilities to better equip beneficiaries, their families, and caregivers to make informed decisions and stimulate robust improvements in nursing homes having not improved their quality of care.”

Between November and February, CMS worked with states to assure that the SFF list (see link provided) is current and provides consumers with the information needed to make a distinction between nursing homes that are improving and those that are not.

Today’s release includes a broader list of all nursing homes identified in the SFF initiative. This updated and expanded list identifies facilities by the category they fall within, such as:

New Additions: nursing homes added within approximately the past six months;
Not Improved: nursing homes that have failed to improve significantly in at least one survey after being named as a SFF nursing home;
Improving: nursing homes that have significantly improved on the most recent survey, including no findings of harm to any resident and no systemic potential for harm;
Recently Graduated: nursing homes that have sustained significant improvement for about 12 months, indicating an upward trend in quality improvement compared to the nursing home’s prior history of care; and those
No Longer in Medicare and Medicaid: nursing homes that were either terminated by CMS from participation in Medicare within the past few months, or voluntarily chose not to continue participation.

The SFF initiative was created by CMS in 1998 in response to the number of facilities that were consistently providing poor quality of care. Those facilities were periodically instituting enough improvement so that they would pass one survey, only to fail the next (for many of the same problems as before). Facilities with this compliance history rarely addressed underlying systemic problems that were giving rise to repeated cycles of serious deficiencies.

This link is provided to you by Healthcare Collateral Consulting, LLC:
http://www.cms.hhs.gov/apps/media/press/release.asp?Counter=2897&intNumPerPage=10&checkDate=&checkKey=&srchType=1&numDays=3500&srchOpt=0&srchData=&srchOpt=0&srchData=&keywordType=All&chkNewsType=1%2C+2%2C+3%2C+4%2C+5&intPage=&showAll=&pYear=&year=&desc=&cboOrder=date

Monitoring Healthcare Facility Survey Results: Healthcare Collateral Consulting, LLC can offer its clients facility survey results as a likely time saving opportunity. HCC can also recognize potential collateral issues with a revolving line of credit if the facility is non-compliant from its survey results. HCC has access to the Surveys, Certifications, and Reporting database – this includes facility characteristics and health deficiencies issued during the most recent state inspection and recent complaint investigations. Healthcare facilities are required to be in compliance with the State and Federal regulations, to receive payment under the Medicare or Medicaid programs. HCC can save its clients the burden of identifying non-compliant facilities and alerting them of any impending collateral issues. Healthcare Collateral Consulting, LLC can increase visibility and productivity by centralizing this survey monitoring function.

If you are interested in learning more, or would like to get in touch with Mr. David J Lacasse; He can be reached at the following email address: djlacasse@gmail.com . Please included your name, title, company name and phone number where Mr. Lacasse can reach you.

Terms of a Healthcare Provider's Revolving Line of Credit

Revolving Line of Credit

Revolving line of credit lets you draw and repay the balance repeatedly over the life of the loan. You may borrow any amount you need up to your available credit limit, and use your eligible accounts receivable to secure the loan. As your receivables are paid, the cash is used to pay down your outstanding loan balance.

Lender's committed lines of credit provide availability based on the net collectible value (reimbursement rate) of a borrower's accounts receivable, typically up to 85% (range: 80% to 90%) against receivable aged up to 180 days (range: 90 to 180 days). Self-Pay receivables are usually excluded. Commitments to these credit facilities range from one to five years (average 3 years). Lender's also includes float days (numbers of days before collections are posted) in the term sheet; the range is typically 2 to 5 days. Lender takes first lien on all accounts receivable.

Pricing on Revolving lines of credit are typically in the range of Libor plus 1.50% - 5.00% (prime rate is also used), depending on the size of the commitment, and credit quality of the borrower. A commitment fee of 0.75 – 2.00% is typical (average is 1.00%).

If you would like to compare Lender's costs; Healthcare Collateral Consulting, LLC can perform a complete analysis of a prospective borrower's proposed RLOC terms and fees. Using the lender's term sheet and historical data for the last 12 to 24 months, HCC can give the prospective borrower insight into the true cost of the revolving line of credit and allow the prospective borrower to test different fee schedule scenarios. HCC can also offer a collateral simulation to determine if the collateral supports the loan balance on any historical month. HCC will then make term sheet recommendations leading to improved cost savings, and/or the ability to obtain additional funds from untapped collateral.

How do you get started?
If you are interested in learning more, or would like to get in touch with Mr. David Lacasse; He can be reached at the following email address: djlacasse@gmail.com . Please included your name, title, company name and phone number where Mr. Lacasse can reach you.

Healthcare Collateral Consulting, LLC
healthcarecollateralconsulting@gmail.com
Fairfield County, Connecticut
203-610-2515

Healthcare Collateral Consulting, LLC - “An Innovative Outsourcing Strategy for Healthcare Lenders and Investors”

Healthcare Collateral Consulting, LLC (HCC) provides lenders in Healthcare and Life Sciences with additional insight into healthcare trade risks that cannot be provided by most other consulting or audit firms. Healthcare Collateral Consulting, LLC ("HCC") offers innovative cost-saving services including field examinations, credit, underwriting, risk analysis, account management, and executive recruiting for healthcare lenders, including banks, asset-based lenders, private equity and institutional investors. HCC's associates have extensive healthcare experience in credit, collateral, underwriting, audit, workout management, operations, and account management.

Healthcare Collateral Consulting, LLC has mission to provide superior, cost effective, value added services to our clients. HCC is committed to establishing strong relationships with its clients and providing inventive outsourcing solutions with the highest quality of service. "Many of the players in healthcare lending are focusing on booking transactions without adequate back-office and due diligence support, which has created a void in the marketplace for the type of account management and due diligence services we offer," said David J. Lacasse, Managing Director at HCC. "HCC's services are designed to provide a customized solution from healthcare finance professionals ".

Here is a link to Healthcare Collateral Consulting, LLC's press release on ABFjournal.com. http://www.abfjournal.com/story.asp?id=20633

Healthcare Collateral Consulting, LLC has established a web-blog dedicated to Healthcare Lending and Healthcare Reimbursement. You will find this information useful in your Healthcare lending endeavors. http://healthcarecollateralconsulting.blogspot.com/

HCC's services are designed to provide a customized solution and include:

• Remote Performance & Loan Compliance Reviews
• Underwriting/Due Diligence
• Collateral Exams
• Remote Financial Assessments
• Scheduling Engagements & Staffing
• UCC Research
• Monitoring Healthcare Facility Survey Results
• Best Practices Analysis
• Revolving Line of Credit Simulation
• Inventory Analysis
• Hard-asset Verifications
• Special Assets Divestitures

Executive Recruiting Service: The Assignment Division of Healthcare Collateral Consulting, LLC now accepts both retained and contingency assignments in both healthcare asset based lending and healthcare private equity marketplace. We are committed to providing confidential, professional services to our clients and candidates alike. For more infromation, email your inquiry to hcc.assignments@gmail.com .

About HCC's Management:
Managing Director and President - David J Lacasse has more than 11 years of experience in asset based lending, healthcare finance, and medical device manufacturing, most recently managing the loan portfolio for a prior healthcare finance business since 2004.

How do you get started?
If you are interested in learning more, or would like to get in touch with Mr. David Lacasse; He can be reached at the following email address: djlacasse@gmail.com . Please included your name, title, company name and phone number where Mr. Lacasse can reach you.

We look forward to hearing from you,

David J Lacasse, Managing Director
Healthcare Collateral Consulting, LLC
203-610-2515
Fairfield County, Connecticut
djlacasse@gmail.com

Personal Note: Congratulations to Matria Healthcare Inc.

Inverness Medical to Acquire Matria in $900 Million Deal

It's always a pleasure to see one of your prior clients prosper. Matria Healthcare was one of my portfolio clients when I was Portfolio Manager within the healthcare lending industry. They were always a pleasure to work with and I wish them the best.

David J. Lacasse, Managing Director - djlacasse@gmail.com

Inverness Medical Innovations Inc. said it will acquire Matria Healthcare Inc. in a cash-and-stock deal valued at $900 million that officials hope builds on the U.S. company's core focus -- women's health, oncology and cardiology.

Matria, based in Marietta, Ga,, provides programs for managing diseases and high-risk pregnancies. Through its health-enhancement and women's and children's health divisions, Matria provides services to more than 1,000 employers and managed-care organizations. The deal values each share of Matria at $39 -- $6.50 in cash and $32.50 in Inverness preferred stock -- a 27% premium to Friday's closing price. Inverness will also assume $280 million in Matria debt.
Inverness, based in Waltham, Mass., intends to consolidate Matria with the recently acquired Alere and Paradigm businesses to form a unit that focuses on the large and rapidly growing health management market.

Link:
http://online.wsj.com/article/SB120152316911121953.html?mod=yahoo_hs&ru=yahoo

Healthcare Collateral Consulting, LLC (ABL Services)

Healthcare Collateral Consulting, LLC offers outsourced due diligence services including field examinations, credit, underwriting, risk analysis and account management for healthcare lenders, including banks, asset-based lenders, private equity and institutional investors. HCC's associates have extensive healthcare experience in credit, collateral, underwriting, audit, workout management, operations, and account management.

"HCC's services are designed to provide a customized solution".

Managing Director and President - David J. Lacasse has more than 11 years of experience in asset based lending, healthcare finance, and medical device manufacturing, most recently managing the loan portfolio for a prior healthcare finance business since 2004. Healthcare Collateral Consulting, LLC healthcarecollateralconsulting@gmail.com

Fairfield County, Connecticut
203-610-2515

Home Care 100 Executive Management Conference

February 10-12, 2008
Fairmont Scottsdale Princess Resort, AZ

For Senior Management in Home Care:

In the six years since the conference’s inception, it has become clear that home care and hospice is a much-needed transformative influence on our healthcare system – and it has also become clear that now is only the beginning. Our 2008 conference program reflects the need to build leadership throughout.

The overall theme of Home Care 100 could be termed management excellence. In other words, how can we foster the best possible climate for success in our respective organizations? How can we balance patient care with fiduciary care to achieve an optimal combination of clinical, professional and financial performance? While you may not be able to answer these questions fully in the course of one meeting, at Home Care 100 you will have access to a large number of your senior peers as well as industry speakers from around the country – a terrific resource for sharing ideas and best practices beyond the conference.

For further information please go to:
http://www.homecare100.com/

This link was provide to you by Healthcare Collateral Consulting, LLC. If you would like to advertise on this blog, please email the Public Relations Department at healthcarecollateralconsulting@gmail.com to request additional information.

CMS PROPOSES RATE YEAR 2009 PAYMENT, POLICY CHANGES FOR LONG-TERM CARE HOSPITALS

The Centers for Medicare & Medicaid Services (CMS) today issued a proposed payment rule designed to assure that long-term care hospitals (LTCHs) continue to receive appropriate payment for services provided while giving them incentives to provide more efficient care to Medicare beneficiaries. LTCHs are a type of acute care hospital that treats some of Medicare’s most severely ill or medically complex patients. The new policies and payment rates would apply to services provided to individuals who are discharged from these hospitals on or after July 1, 2008.

“The proposals announced today will help make sure Medicare beneficiaries who need longer term inpatient care get high quality services appropriate to their medical conditions,” CMS Acting Administrator Kerry Weems said. “The proposals seek increased incentives for efficient delivery of care, ensuring that beneficiaries and taxpayers get the best value for the Medicare dollar.”

The proposed rule would affect the nearly 400 LTCHs across the nation. These hospitals are generally defined as inpatient hospitals where the average length of stay for Medicare patients is greater than 25 days. These hospitals provide extended medical and rehabilitative care for patients with clinically complex conditions. Treatment provided in these hospitals typically includes weaning patients from ventilators so they can breathe without this assistance, pain management, and rehabilitation.

These hospitals have been paid under a prospective payment system (PPS) that provides a single payment to the hospital for the patient’s stay based on the patient’s diagnosis, since cost reporting periods beginning on or after October 1, 2002. Currently, patients are categorized under the Medicare Severity Long-Term Care Diagnosis Related Groups (MS-LTC-DRGs). The payment is calculated to reflect the average costs incurred by an LTCH in treating this type of patient, but does not include payment for services of physicians and nonphysician practitioners who bill Medicare separately.

CMS is proposing a standard Federal rate of $39,076.28 for the 2009 rate year. This is based on a proposed update of 2.6 percent compared with the standard Federal rate for RY 2008, as revised to comply with provisions of the recently enacted Medicare, Medicaid, and SCHIP Extension Act of 2007(“Medicare Extension Act”). The update represents a 3.5 percent increase in the hospital marketbasket (a measure of inflation in the costs of goods and services used in providing inpatient care), less a 0.9 percent adjustment to offset coding changes in RY 2006 that do not reflect real changes in the severity of the cases treated by these hospitals.

Aggregate LTCH PPS payments for RY 2009 are estimated at approximately $4.44 billion, based on the proposed changes presented in the proposed rule, an increase of approximately $124 million over estimated payments in RY 2008.

To read the entire article go to:
http://www.cms.hhs.gov/apps/media/press/release.asp?Counter=2845&intNumPerPage=10&checkDate=&checkKey=&srchType=1&numDays=3500&srchOpt=0&srchData=&srchOpt=0&srchData=&keywordType=All&chkNewsType=1%2C+2%2C+3%2C+4%2C+5&intPage=&showAll=&pYear=&year=&desc=&cboOrder=date

Healthcare Collateral Consulting, LLC

Healthcare Collateral Consulting, LLC adds New Executive Recruiting Service

The Assignment Division of Healthcare Collateral Consulting, LLC accepts both retained and contingency assignments in both healthcare asset based lending and healthcare private equity marketplace. We are committed to providing confidential, professional services to our clients and candidates alike.

We engage in full range of search assignments including field audit, credit, collateral, underwriting, portfolio/account management, operations, accounting, business development, marketing, sales management, and senior management positions located throughout the nation.

“Many of the players in healthcare lending are focusing on booking transactions without adequate back-office and due diligence support, which has created a void in the marketplace for the type of due diligence, account management and job placement services we offer,” said David J. Lacasse, Managing Director at HCC. "HCC's services are designed to provide a customized solution from healthcare finance professionals ".

To Our Clients: We know your business. At HCC’s-Assignment Division, innovative recruitment for the right talent is imperative. Only after one-on-one interviews do we consider a candidate for placement. All credentials and references are thoroughly checked and validated. Your satisfaction with our candidate’s level of performance is central in establishing a strong relationship and providing innovative outsourcing solutions.

To Our Candidates: We are committed to providing our candidates with prompt, confidential service. Healthcare Collateral Consulting, LLC-Assignment Division offers challenging job opportunities to help meet their personal and professional goals. The most important pledge that we make to our candidates is to represent them in a fair and honest manner.

Healthcare Collateral Consulting, LLC (HCC) provides outsourced due diligence services including field examinations, credit, underwriting, risk analysis and account management for healthcare lenders, including banks, asset-based lenders, private equity and institutional investors. HCC's associates have extensive healthcare experience in credit, collateral, underwriting, audit, workout management, operations, and account management. Our healthcare knowledge provides lenders with additional insight into healthcare trade risks that cannot be provided by most other accounting or audit firms.

Contact Information: To learn more about Healthcare Collateral Consulting, LLC’s executive recruiting service or to register with our division as a future candidate, please email Assignments Division at hcc.assignments@gmail.com .

7th Annual Asset Based Lending in Capital Markets Conference

February 13 to 14, 2008 • Fairmont Scottsdale Princess - Scottsdale, AZ

Global Asset Based Lending in the Capital Markets Summit heads to the Scottsdale Fairmont Princess February 13-15, 2008. Mark your calendars to attend this premier annual event which focuses on high end corporates and their Funding Options in the Asset Based Finance market. Now in its 7th Year, this event provides comprehensive coverage of today’s issues in the secured debt market.

Asset Based Lending continues to be a highly-charged financing tool used by companies all across the credit spectrum and all around the globe. In M&A, Refinancings, and Raising Capital, Asset-Based Lending plays a prominent role in a company’s capital structure. This event will explain why!

Additional information on this conference can be found at:
http://www.almevents.com/conf_page.cfm?pt=includes/webpages/webwysiwyg.cfm&web_page_id=8450&web_id=1054&instance_id=25&pid=662

This link was provide to you by Healthcare Collateral Consulting, LLC. Healthcare Collateral Consulting, LLC offers outsourced due diligence services including field examinations, credit, underwriting, research, risk analysis and account management for healthcare lenders, including banks, asset-based lenders, private equity and institutional investors. HCC's associates have extensive healthcare experience in credit, collateral, underwriting, audit, workout management, operations, and account management. If you would like to advertise on this blog, please email the Public Relations Department at healthcarecollateralconsulting@gmail.com to request additional information.

HFMA’s Spring Seminar Series: Denver

Healthcare Financial Management Association’s Spring Seminar
Date
January 22-25, 2008
Location
Grand Hyatt Denver
1750 Welton Street
Denver, CO
Seminars:
Financial and Healthcare Business Management Track
Revenue Cycle Improvements Track
Consumer-Focused Practices Track
Payment Trends
Managed Care Track

Additional information on this conference can be found at:
http://www.hfma.org/events/conferences/denver.htm?panel=1

This link was provide to you by Healthcare Collateral Consulting, LLC. Healthcare Collateral Consulting, LLC offers outsourced due diligence services including field examinations, credit, underwriting, research, risk analysis and account management for healthcare lenders, including banks, asset-based lenders, private equity and institutional investors. HCC's associates have extensive healthcare experience in credit, collateral, underwriting, audit, workout management, operations, and account management. If you would like to advertise on this blog, please email the Public Relations Department at healthcarecollateralconsulting@gmail.com to request additional information.

Lenders in Complex Corporate Financings: Use Care to Protect Rights

The increasing complexity of corporate financings, coupled with market uncertainty and a credit crunch, is making it more important than ever for lenders in multicreditor deals to protect their rights and interests during negotiations, according to James C. Hale, a corporate finance partner in the Roanoke office of LeClairRyan.

Financing for mergers and acquisitions, leveraged buyouts and recapitalizations often contain components of traditional secured lending as well as mezzanine debt and equity, Hale notes, making it crucial for creditor parties to use great care when it comes to negotiating the finer points of deals.

"It is these details that pose substantial risk to each member of the lender group," Hale says. "With the volatility in the financial markets, intercreditor and subordination terms among lenders have gained new significance. Restrictions on payments and distributions, rights to collateral proceeds, standstill periods, buyout options, priorities upon distribution and their impacts on each credit provider require thorough consideration."

Given the market's increased complexity, first and subordinate lien lenders involved in multicreditor financing transactions need to pay close attention to such key issues as:

Subordination
Intercreditor and subordination agreements commonly contain provisions stating that senior lenders' loans and associated interests and rights are superior to those of sub-debt lenders. A sophisticated first lien holder may demand assurances that subordinated liens are junior in priority, regardless of the failure of the first lien holder to properly perfect its lien, the successful challenge of lien validity by a third party, or any other invalidation of the lien. Many of the relative rights of the parties are, in fact, determined by the other terms of the agreement. Lenders in multicreditor deals must pay close attention to those other terms.

Loan Modifications
Prohibitions against modification of each lender's agreement with the borrower, subject to the consent of the other credit providers, are typical. Negotiated restrictions to loan modifications will often allow a lender to make non-material modifications to an agreement without prior consent. Furthermore, express prohibitions may have a major impact on subordination of collateral, the ability to raise fees or interest, adjusting payment terms and other important issues.

Payments and Distributions
Terms dealing with debt payments and distributions of stock in repayment should be explicit about what is permissible and the conditions under which they may be made and accepted. Permitted payments may be fixed, may be tied to the financial performance of the borrower or reductions in principal outstanding, and prepayments may be prohibited. Senior lenders will often seek to prohibit payments or distributions to subordinated creditors in the event that the loan facility is in default.

Standstill
Senior lenders often require that subordinated lenders agree to a standstill period in the case of a borrower's default, meaning that the lender cannot sue for the debt, exercise rights as a secured creditor, accept payment on its debt or exercise warrants. The standstill period is often 180 days, but lenders may negotiate that time period. Lenders can create exceptions to the standstill to ensure that the senior lender acts expeditiously to protect the interests of the lender group and maximize the return to junior lenders.

Distribution Upon Liquidation
Intercreditor and subordination agreements should be very explicit as to the distribution of proceeds of collateral securing the financing facilities upon the liquidation of assets of the borrower. The order and priority in which the proceeds are distributed is called the "waterfall." Lenders should insist that a waterfall provision be inserted in the agreement, and that the order, allocation, special treatment of certain collateral, and other terms of distribution upon liquidation are unambiguous.

Bankruptcy
The interests of a senior lender can be vastly different from those of junior lender in a bankruptcy or reorganization. Although often requested, sub-lenders need to be careful about transferring authority to the senior lender in an insolvency proceeding. Treatment of collateral, approval of a plan of reorganization, and permitting debtor-in-possession financing affect each lender differently. A sub-debt lender may insist on a buyout option of the senior credit facility. The terms of the buyout are negotiable, but would allow the junior lender to control its destiny in the event bankruptcy is pending or threatened.

"In today's environment, the implications of the agreement among lender parties have gained substantial significance," Hale notes. "Every deal requires a different risk calculus and allocation. As lending covenants and conditions change with the market, so too should the terms and relative interests of credit parties in a multi-tiered financing transaction."

"Each credit party must thoroughly evaluate the manner in which the credit will be administered by each of the lending parties throughout the term of the facility - when the financing is in good standing and, more particularly, in the event that the borrower becomes distressed or in default," he concludes.

A uniquely structured, business-minded law firm, LeClairRyan specializes in developing legal solutions to its clients' business challenges.

Source:
http://www.abfjournal.com/story.asp?id=21799

Commercial Finance Association (CFA) - Educational Program Schedule

FIELD EXAMINER SCHOOL - Los Angeles, CA
Monday-Friday, January 28 - February 1, 2008
The Field Examiner School is a comprehensive five-day program covering every aspect of field examination techniques and practices. Through discussion, simulation and case-study participants learn to evaluate collateral and detect possible fraud by analyzing accounts receivable, inventory, cash, fixed assets, financial statements, internal controls and accounts payable. Emphasis is placed on the field examiner's role in the credit function through real-world examples and "war stories".

ABL BASICS WORKSHOP - New York, NY
Monday-Tuesday, March 3-4, 2008
ABL and Factoring Basics for New Business Development Staff is a two-day workshop designed to provide marketing personnel in entrepreneurial organizations with the essential product knowledge necessary for successful sales. Topics include Basic Understanding of Asset Based Lending and Factoring; Basic Credit Skills; Due Diligence; Operations; and Salesmanship.

ADVANCED LEGAL ISSUES WORKSHOP - Chicago, IL
Monday-Wednesday, April 14-16, 2008
The Advanced Legal Issues Workshop is a three-day forum covering a variety of major legal concerns for asset-based lending professionals. Designed specifically for non-attorneys, the Workshop aims to increase participants' working knowledge of the legal principles that affect their jobs. Combining interactive discussion with both real-life and hypothetical casework, the program covers Multi-lender Transactions, Subordination, Documentation, Fraudulent Conveyance, Bankruptcy, Lender Liability and many other issues. A "Hot Topics" section is included to cover pertinent cases and developments in commercial law and regulation.

CFA LEADERSHIP INSTITUTE - Atlanta, GA
Monday-Wednesday, April 28-30, 2008
The CFA Leadership Institute is designed to provide high-potential staff with the leadership skills required to assume managerial responsibilities in the Asset Based Financial Services Industry. During the three-day program, entitled "Earning The Right To Lead", participants learn: Their roles as leaders within their organizations;how to manage relationships to maximize results; and how to apply these skills in action.

WORKOUTS & BANKRUPCTY WORKSHOP - Washington, D.C.
Tuesday-Thursday, May 6-8, 2008
The Workouts & Bankruptcy Workshop is a three-day program in which participants hone their skills in anticipating, analyzing and evaluating problem situations and developing strategies for either rehabilitation or liquidation. Participants learn the art of crisis management, workout scenarios and realistic liquidation procedures. In the process they explore both the internal and external resources required to implement solutions and resolve client problems. The workshop also leads participants through the legal maze that surrounds crisis loan management, loan restructuring, client rehabilitation and bankruptcy. Case studies utilize group analysis to focus on realistic problems.

FRAUD AWARENESS WORKSHOP - Los Angeles, CA
Wednesday-Friday, May 21-23, 2008
The Fraud Awareness Workshop is a three-day program presenting best practices in the prevention and detection of borrower fraud. The workshop addresses recommended fraud prevention procedures for a variety of ABL disciplines: Account Management, Field Examination, Underwriting, Operations and others. The goal of the program is for participants to understand their roles in mitigating the risk of fraud within their organizations, and to take away specific approaches and techniques in fraud prevention/detection.

Additional information on these programs can be found at:
http://www.cfa.com/Education_Programs/education_schedule.asp#ABL

This link was provide to you by Healthcare Collateral Consulting, LLC. Healthcare Collateral Consulting, LLC offers outsourced due diligence services including field examinations, credit, underwriting, research, risk analysis and account management for healthcare lenders, including banks, asset-based lenders, private equity and institutional investors. HCC's associates have extensive healthcare experience in credit, collateral, underwriting, audit, workout management, operations, and account management.

If you would like to advertise on this blog, please email the Public Relations Department at healthcarecollateralconsulting@gmail.com to request additional information.

CMS REPORTS U.S. HEALTH CARE SPENDING GROWTH ACCELERATED ONLY SLIGHTLY IN 2006

BUT STILL FASTER THAN ECONOMIC GROWTH AND GENERAL INFLATION

Health care spending growth in the United States accelerated slightly in 2006, increasing 6.7 percent compared to 6.5 percent in 2005, which was the slowest rate of growth since 1999. Health care spending, however, continues to outpace overall economic growth and general inflation, which grew 6.1 percent and 3.2 percent, respectively, in 2006.

In 2006, health care spending reached a total of $2.1 trillion, or $7,026 per person, up from $6,649 per person in 2005, according to a report by the Centers for Medicare & Medicaid Services (CMS). The health spending share of the nation’s Gross Domestic Product (GDP) remained relatively stable in 2006 at 16.0 percent, up by only 0.1 percentage point from 2005.

“The cost of health care continues to be a real and pressing concern. Making sure we are paying for high quality health care services, not just the number of services provided, is just one of the most critical issues facing the American public and the federal government now and in the future,” said CMS Acting Administrator Kerry Weems. “This review of health care spending reminds us that we need to accelerate our efforts to improve our health care delivery system to make sure that Medicare and Medicaid are sustainable for future generations of beneficiaries and taxpayers."
Out-of-pocket spending grew 3.8 percent in 2006, a deceleration from 5.2 percent growth in 2005.

This slowdown is attributable to the negative growth in out-of-pocket payments for prescription drugs, mainly due to the introduction of the Medicare Part D benefit. Out-of-pocket spending accounted for 12 percent of national health spending in 2006; this share has steadily declined since 1998, when it accounted for 15 percent of health spending. Out-of-pocket spending relative to overall household spending, however, has remained fairly flat since 2003.

The CMS found that overall private spending growth slowed in 2006. Private health insurance premiums grew 5.5 percent in 2006, which was the slowest rate of growth since 1997. Benefit payment growth also slowed, from 6.9 percent growth in 2005 to 6.0 percent in 2006. The slower growth reflects, in part, a decline in private health insurance spending on prescription drugs. The ratio of net cost of private health insurance (the difference between premiums and benefits) to total private health insurance premiums was 12.3 percent in 2006, slightly lower than 12.7 percent in 2005.

At the aggregate level in 2006, businesses (25 percent), households (31 percent), other private sponsors (3 percent), and governments (40 percent) paid for about the same share of health services and supplies as they did in 2005. However, spending shifts did occur within major sponsor categories due to implementation of the Medicare Part D benefit. Medicare’s share of federal spending increased from 29 percent in 2005 to 34 percent in 2006, while Medicaid’s share decreased from 45 percent to 40 percent. For households, the share of Medicare spending attributable to payroll taxes and premiums increased slightly in response to first-time Medicare Part D premiums. Conversely, the out-of-pocket spending share decreased slightly due, in part, to the newly available prescription drug coverage through Medicare Part D.

Total Medicaid spending declined for the first time since the program’s inception, falling 0.9 percent in 2006. The introduction of Medicare Part D, which shifted drug coverage for dual eligibles from Medicaid into Medicare, contributed to the decline in Medicaid spending growth. Other reasons for the decline include continued cost containment efforts by states and slower enrollment growth due to more restrictive eligibility criteria and a stronger economy.

Hospital spending, which accounts for 31 percent of total health care spending, grew 7.0 percent in 2006, a decrease of 0.3 percentage points from 2005 and a continued deceleration from 2002 (when growth was 8.2 percent). The 2006 growth rate was partially driven by lower utilization of hospital services, especially within Medicare as fee-for-service inpatient hospital admissions declined.

Spending for physician and clinical services also slowed, increasing 5.9 percent in 2006, which is 1.5 percentage points slower than in 2005 and the slowest rate of growth since 1999. The slowdown was driven by a deceleration in price growth, fueled by a near freeze on Medicare payments to physicians (whose fee schedule update was 0.2 percent in 2006) that influenced private payers as well.

In addition, spending growth for both nursing home and home health services slowed. For freestanding nursing homes, spending grew 3.5 percent in 2006—a deceleration from 4.9 percent in 2005 and the slowest rate of growth since 1999. This deceleration is partially attributable to a reduction in nursing home price growth. Spending growth for freestanding home health care services decelerated from 12.3 percent in 2005 to 9.9 percent in 2006, also partially due to a reduction in price growth. Despite the 2006 deceleration, home health care continues to be the fastest growing component of all personal health care spending.

Source:
http://www.cms.hhs.gov/apps/media/press/release.asp?Counter=2810&intNumPerPage=10&checkDate=&checkKey=&srchType=1&numDays=3500&srchOpt=0&srchData=&srchOpt=0&srchData=&keywordType=All&chkNewsType=1%2C+2%2C+3%2C+4%2C+5&intPage=&showAll=&pYear=&year=&desc=&cboOrder=date

The health care spending data can be found on the CMS Web site at http://www.cms.hhs.gov/NationalHealthExpendData/01_Overview.asp.

Healthcare Private Equity and Institutional Investors

"A New Outsourcing Strategy for Healthcare Private Equity and Institutional Investors", Healthcare Collateral Consulting, LLC (HCC) has been founded. Our healthcare knowledge provides lenders in Healthcare and Life Sciences with additional insight into healthcare trade risks that cannot be provided by most other accounting or audit firms.

“Many of the players in healthcare lending are focusing on booking transactions without adequate back-office and due diligence support, which has created a void in the marketplace for the type of due diligence and account management services we offer,” said David J. Lacasse, Managing Director at HCC. "HCC's services are designed to provide a customized solution from healthcare finance professionals. Something the traditional competing firm can not provide".

Healthcare Collateral Consulting, LLC has mission to provide superior, cost effective, value added services to our clients. HCC is committed to establishing strong relationships with its clients and providing innovative outsourcing solutions with the highest quality of service.

How do you get started?
If you are interested in learning more, or would like to get in touch with Mr. David Lacasse; He can be reached at the following email address: djlacasse@gmail.com . Please included your name, title, company name and phone number where Mr. Lacasse can reach you.

We look forward to hearing from you,

Healthcare Collateral Consulting, LLC
healthcarecollateralconsulting@gmail.com
Fairfield County, Connecticut
203-610-2515

press release on ABFjournal.com.

http://www.abfjournal.com/story.asp?id=20633

Healthcare Asset Based Lending (ABL Services)

Healthcare Collateral Consulting, LLC offers outsourced due diligence services including field examinations, credit, underwriting, risk analysis and account management for healthcare lenders, including banks, asset-based lenders, private equity and institutional investors. HCC's associates have extensive healthcare experience in credit, collateral, underwriting, audit, workout management, operations, and account management.

HCC's services are designed to provide a customized solution and include:

• Remote Performance & Loan Compliance Reviews
• Underwriting/Due Diligence
• Collateral Exams/Reimbursement Analysis
• Remote Financial Assessments
• Scheduling Engagements & Staffing
• UCC Research
• Monitoring Healthcare Facility Survey Results
• Best Practices Analysis
• Revolving Line of Credit Simulation
• Inventory Analysis
• Hard-asset Verifications
• Special Assets Divestitures

About HCC's Management:
Managing Director and President - David J. Lacasse has more than 11 years of experience in asset based lending, healthcare finance, and medical device manufacturing, most recently managing the loan portfolio for a prior healthcare finance business since 2004.

Healthcare Collateral Consulting, LLC
healthcarecollateralconsulting@gmail.com
Fairfield County, Connecticut
203-610-2515

Happy New Year from Healthcare Collateral Consulting, LLC

The New Year offers us a special opportunity to extend our personal thanks to our clientele, and our very best wishes for the future. So it is that we now gather together and wish to you a very Happy New Year. We consider you a good friend and extend our wishes for a prosperous year and good cheer. It is people like you who make being in business such a pleasure all year long. Our business is a source of pride to us, and with customers like you, we find going to work each day a rewarding experience.

Thanks again for a wonderful year.

David J. Lacasse, Managing Director
Healthcare Collateral Consulting, LLC
203-610-2515

GE Confirms Merrill Lynch Capital Acquisition

GE Capital has agreed to purchase most of Merrill Lynch Capital, the wholly owned middle-market commercial finance business of investment bank Merrill Lynch & Co. Under the transaction, GE Capital will acquire Merrill Lynch Capital's corporate finance, equipment finance, franchise, energy and healthcare finance units, but will not buy the commercial real estate finance unit. The deal is expected to close in the first quarter of fiscal year 2008. Financial terms of the deal were not disclosed.

Merrill Lynch, which is expected to incur huge write-downs on subprime mortgage-related securities in the fourth quarter, noted that the sale would enable it to redeploy $1.3 billion of capital into other parts of its business. GE Capital said that the acquisition would add more than $10 billion in assets and $5 billion in commitments to GE Capital Commercial Finance's base of $260 billion. Commenting on the deal, Mike Neal, vice chairman of GE said, "These strong units fit perfectly with existing and very successful GE Capital businesses. They are in industries we know well, so the potential for growth is compelling. In addition, this timely acquisition will expand our reach, and expand the value we can offer customers." "This transaction reflects Merrill Lynch's continued strategic focus on divesting non-core assets and optimizing capital allocation, while also enabling the redeployment of approximately $1.3 billion of capital into other parts of our business," added John Thain, chairman and CEO of Merrill Lynch.

Formed in early 2002, Merrill Lynch Capital is a broad-based commercial finance business covering corporate finance, equipment finance, real estate finance and healthcare finance. The equipment finance unit was ranked No.40 in this year's Monitor 100 survey with year-end 2006 assets of $1.6 billion. In the ABF Journal's 2007 spring survey, Merrill Lynch's asset-based lending unit reported total 2006 fundings of $1.9 billion from $3.0 billion in managed commitments.

Credit Quality in a Freefall

Credit quality deteriorated steeply from mid-October to mid-November despite the recent actions by the Federal Reserve to stimulate credit markets, CFO reports.

As of Nov. 15, $36.2 billion worth of debt was in distressed issues, more than four times the $8.6 billion reported a month earlier, according to Standard & Poor's. Distressed debt as a percentage of total debt recorded its largest monthly increase in five years, more than doubling to 4.9% from 2.3 percent. The ratio was as low as 2.1% 12 months ago.

Read this story in its entirety at CFO.com.

Health Care VC Funding In 2007 Set To Surpass 2006

Venture Capital Keeps Flowing Into Health Care, Shows No Signs Of Slowing

Venture capital firms invested $686.5 million in 34 privately held health care companies during October 2007, including 16 investments in biotechnology, eight in medical devices, five in biopharmaceuticals, three in pharmaceuticals and two in health care services. According to some sources, at least another $70 million was invested in other health care companies, and undisclosed amounts were invested in some others, but no confirmation of those deals had been received by press time.


Link:
http://www.levinassociates.com/dealmakersforum/dealmakers%20hcfn.htm

CMS PUBLISHES NATIONAL LIST OF POOR-PERFORMING NURSING HOMES

The Centers for Medicare & Medicaid Services (CMS) today released the first ranking of the nation's poor-performing nursing homes.

Release of the national list of facilities, identified as special focus facilities (SFFs), is expected to offer powerful new information on nursing homes.

See link:

http://www.cms.hhs.gov/apps/media/press/release.asp?Counter=2672&intNumPerPage=10&checkDate=&checkKey=&srchType=1&numDays=3500&srchOpt=0&srchData=&srchOpt=0&srchData=&keywordType=All&chkNewsType=1%2C+2%2C+3%2C+4%2C+5&intPage=&showAll=&pYear=&year=&desc=&cboOrder=date