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Contacts

Accountable Care Organizations & Physician Hospital Alignment Strategies

Related Practices

Rankings & Honors

  • U.S. News/Best Lawyers has named Nixon Peabody “Law Firm of the Year” in Health Care Law in 2016
  • “Deal of the Year” for Health Care Financing by The Bond Buyer for Presence Health Network 2016 bond offering
  • Ranked nationally in U.S. News/Best Lawyers “Best Law Firms” in Health Care Law and received metropolitan rankings in Health Care Law in Albany, Boston, Chicago, Los Angeles, New York City and Rhode Island
  • Ranked in Illinois, Massachusetts and New York for Healthcare in Chambers USA: America’s Leading Lawyers for Business
  • Ranked nationally by Modern Healthcare—Largest Healthcare Law Firm
  • Recognized lawyers by Best Lawyers in America in the field of Health Care law
  • Recognized lawyers by Super Lawyers in the area of Health Care law
  • Recognized by the American Bar Association’s Health Law Section in its Annual Regional Law Firm Recognition Program
  • Recommended in The Legal 500 United States 2016
 

ACCOUNTABLE CARE ORGANIZATIONS & PHYSICIAN HOSPITAL ALIGNMENT STRATEGIES

We partner with our clients to formulate innovative physician hospital alignment strategies.

Our Approach

The Patient Protection and Affordable Care Act is forcing health care providers to reexamine their existing operating models and explore alignment strategies for long-term viability in the market.

We’re at the forefront of Accountable Care Organization (ACO) implementation and have working knowledge of ACO formation and operation, including the Medicare Shared Savings Program and the Pioneer and Advance Payment models.

We enjoy strong relationships and open communication with regulators at the Centers for Medicare & Medicaid Services / Office of Inspector General, the CMS Innovation Center and the Federal Trade Commission. This helps to clarify ambiguities and validate our interpretations of the law, ensuring compliance with payment policies, physician self-referral and anti-kickback safe harbors, Stark exceptions, antitrust, privacy, security and Civil Monetary Penalty (CMP) laws.

We offer strategic counsel on forming and operating Independent Practice Associations, Physician/Hospital Organizations, Management Service Organizations, provider networks and ACOs, routinely advising on licensure, practice management, fraud and abuse, valuation methodologies and reports and nonprofit tax issues.

Working closely with the health network’s professional staff and consulting organizations, we also support the design and implementation of clinical integration initiatives, including drafting and negotiating ACO network agreements and agreements between ACOs and IT vendors.

We work with

  • Accountable Care Organizations
  • Hospitals and health systems
  • Independent practice associations
  • Managed care organizations
  • Physician/hospital organizations
  • Provider networks

Media Clips

  • Providers face uphill climb after 2016 election, experts say
    McKnight's Long-Term Care News | November 1, 2016
    This article focuses on the outcome of the U.S. election may affect long-term care providers. Chicago health care partner John Durso is quoted in this piece discussing how doctors and hospitals are focused on accountable care organizations to reduce per capita costs.
  • Ask the Legal Expert about...
    McKnight's Long Term Care News | July 1, 2016
    Chicago health care partner John Durso addresses what points should be considered when a facility starts contracting talks with an accountable care organization or other group arrangement.

Ideas

Renewed focus on managed care, program compliance in the OMIG's newly released 2016–17 work plan
Health Care Alert | May 12, 2016

Medicare Revalidations: Improvements and Cautions
Health Care Alert | February 26, 2016

. . . View all . . .

Press

Physician Hospital Alignment Strategies: IPA, PHO & Accountable Care Organizations