Clinical Integration and Alignment
Bruce A. Johnson
Antitrust - Health Care
Benefits - Health Care
Certificate of Need
Compliance (Fraud and Abuse, Stark)
Health Care Litigation
Health Care Real Estate
Health Care Services
Health Care Technology & Innovation
HIPAA/Health Information Privacy and Security
Labor and Employment - Health Care
Payor Disputes and Reimbursement Audits
Public Policy - Health Care
Polsinelli’s lawyers understand that effective health care provider alignment and integration are essential to future business success. We excel at collaborating with clients to develop timely, pragmatic, workable solutions that promote business imperatives and compliance.
Our team includes professionals with diverse work experiences with hospitals, physicians and a host of other health care providers. We combine excellent legal skills and services, with experience in clinical care and quality, payor contracting, compensation, operations, and other critical success areas in all facets of the health care industry. Our clients include national, regional and local health care systems, hospitals, academic medical centers, physician groups, clinically integrated networks, accountable care organizations and a host of other provider organizations across the entire continuum of care.
We have deep experience in a host of complex alignment and integration arrangements being used today including:
Commercial and public sector ACO and related payment initiatives
Clinically integrated network development and operations
Statewide/Regional clinically integrated networks/accountable care organizations
Health care mergers and acquisitions
Service line management and co-management agreements
Population health management programs and related systems
Shared savings and similar payor contracting arrangements
Bundled payment initiatives with public and private payors
Pay for quality arrangements
Physician engagement and governance structures
Physician employment arrangements
Professional service arrangements
Physician and other provider compensation and incentive structures
Alignment involving clinical and information systems and technologies
Structured a clinically integrated network owned by an academic medical center and a community hospital and obtained approval to participate in the Medicare Shared Savings Program. (Pennsylvania).
Created a state wide clinically integrated network owned by eight large hospital systems including an academic medical center. (Wisconsin).
Assisted in the design and on-going implementation of clinical integration project involving an academic medical center and two county hospitals (with high levels of indigent care) involving alignment through clinical and information systems and technologies. (California).
Assisting physician practices and health systems in crafting a variety of Bundled service, shared savings, pay for quality, hospital efficiency and similar incentive systems to align physician performance with health care facility quality and efficiency goals. (Michigan).
Assisting a health system in the design and implementation of an “OrthoCIO” directed at orthopedic/musculoskeletal bundled service offers involving academic/FPP, hospital employed and community physicians, inpatient and outpatient hospital services and ambulatory surgical centers. Aligning the initiative with existing community resources including an existing clinically integrated network, payor strategies and other participants (on-going). (Nebraska).
Representing physicians/physician practices in the development and implementation of new relationships with hospitals and health systems, including addressing governance, compensation, funds flow, incentive structures and other variables. Designing models to promote physician leadership and direction as consistent with emerging initiatives directed at clinical quality, cost management and population health.
CMS “Goes Fishing” on Stark Law’s Impediments to Value-Based, Coordinated Care
The Strategic Implications of MACRA
Understanding MACRAs Strategic and Compliance Implications
May 25, 2017
Accountable Care Organization Update
April 1, 2015
Health Reform and Related Health Policy News
November 22, 2013
Not Just Another Fall Day - Don't Let the HIPAA Compliance Deadline Knock You Down
September 18, 2013
Webinar: MACRA Proposed Rule – Key Proposals, Implications and Comment Opportunities
July 19, 2017
Webinar: Understanding MACRA’s Strategic and Compliance Implications
May 25, 2017
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