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Debtor estates and other distressed stakeholders can monetize formerly contaminated parcels which have no higher or better use than solar by leasing or selling those assets to specialized brownfields-to-solar developers. These niche developers can buy suitable parcels outright or offer twenty-year leases which can be transferred with the property. The Inflation Reduction Act and renewable energy-friendly states provide significant financial incentives which allow for generous lease rates. Bankruptcy trustees, debtor estates, creditors and other stakeholders have begun exploring this monetization strategy, which can be accomplished out of court, as long as the assets are at least partially remediated.

Many bankruptcy professionals are being called upon to help healthcare provider organizations as this industry faces unprecedented business distress. Whatever the professional's role, some basic understanding of healthcare finance can strengthen decision-making and performance.

This session will provide a high-level view of the unique fiscal considerations in the healthcare provider organization, specifically: 1) accounting and financial statements; 2) cashflow including the massive revenue cycle and accounts payable functions; 3) a murkier part of cashflow buried in the various governmental and private payer reimbursement models, and 4) fraud.

Beginning with accounting and financial statements, the mystery of gross revenue, net revenue, and accounts receivable on the income statement will be examined. Even experienced healthcare CFOs can trip up on accounts receivable calculations given the complexities of payer reimbursement models and payment practices, as well as the payer market changes occurring at an ever-faster pace.

Healthcare provider cashflow management consists of voluminous variations and constant change, more so in revenue cycle but also in accounts payable. Years ago, revenue cycle was simply called “billing.” The term revenue cycle more accurately describes the revenue generation process which can involve every function in the healthcare provider organization, from physician and nursing care to lab work and housekeeping.

Third, fundamentals of the most common healthcare reimbursement models will be discussed starting with basic fee-for-service reimbursement and moving through other models to the present attempts at value-based reimbursement. It may be surprising that while the industry grapples with the new value-based models, a sizable part of reimbursement is still fee-for-service.

Finally, there will be brief mention of fraud and embezzlement which can develop in the troubled healthcare provider organization and may be a significant contributor to poor financial performance.

Bankruptcies are on the rise, sub-chapter v has been wildly successful and non-bankruptcy alternatives continue to see acceptance around the country, especially for start-up, venture backed companies. What leads to the decisions on how to end a company's life. The discussion will (should) feature Prof. Elizabeth Pollman from the University of Pennsylvania Carey Law School, who is researching this subject.