Mei-Lin Tsou

Buyers need infusion-specific RCM controls to validate acquisition financials.

Payer rules now dictate both where infusions happen and how practices get paid for them.

Profitability depends on drug margin, billing accuracy, and payer management—not just filling seats.

Hospital outpatient sites earn 340B spreads while independent centers absorb full drug costs.

State laws protecting 340B drug discounts face uneven legal enforceability across jurisdictions.

Medicare's reimbursement formula penalizes biosimilars priced below their reference drugs.

Buyers must audit billing infrastructure, not just revenue, to value infusion practices correctly.

Margin, not revenue, determines whether an infusion practice survives.

Fragmented infusion RCM creates hidden revenue leaks that standard due diligence misses.

How sequestration and manufacturer pricing cut infusion practice margins below statutory levels.

Structuring RCM functions by risk exposure, not centralization preference, prevents costly denials.