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Contacts

Managed Care Contracting & Network Development

Related Practices

Rankings & Honors

  • U.S. News/Best Lawyers has named Nixon Peabody “Law Firm of the Year” in Health Care Law in 2016
  • 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
 

MANAGED CARE CONTRACTING & NETWORK DEVELOPMENT

We maximize your expertise and bring our breadth of real time contracting knowledge to your managed care negotiations.

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Our Approach

Successful Managed Care arrangements require a thorough understanding of the practical and operational considerations unique to contracting in this industry —from traditional fee-for-service to risk-based, bundled payment.

Our attorneys understand the importance of policies and procedures. They are highly skilled at developing strategies and writing contract language that lead to successful implementation and enforcement of negotiated terms.

We represent health care providers in evolving Managed Care models, including risk-sharing, capitation arrangements and bundled payments.

We also routinely advise providers on pay-for-performance programs, quality bonuses, gain sharing programs, fee-for-service arrangements, value-based contracting models, clinical integration initiatives and litigation and arbitration over pay or contracts.

We have developed and structured numerous provider networks, including multi-specialty, single specialty and carve-out networks, often advising on clinical and economic integration issues and corporate structure, including the use of the messenger model.

We also represent physician networks in Federal Trade Commission (FTC) investigations.

We work with

Our attorneys represent the legal interests of a wide variety of managed care clients, including:

  • Long-term managed care providers
  • Health care provider networks
  • Medical homes
  • Hospitals and health care systems
  • Mental health and developmental disabilities providers
  • Nursing homes
  • Physicians and group practices
  • Statewide provider associations and coalitions

Ideas

Events

Managed Care Contracting & Network Development,Value-based Contracting Models