Value-Based Care.
Providing trusted and experienced counsel through the transition to value-based care.
At AHL, we understand that as payors and providers transition to value-based care models, risk sharing arrangements, and other alternative payment strategies, trusted and experienced healthcare counsel is critical in navigating the regulatory complexities. Our team has deep expertise in providing strategic guidance to providers and payors related to Accountable Care Organizations (ACOs), Clinical Integrated Networks (CINs), Independent Practice Associates (IPAs), and other clinically integrated provider networks. We assist providers and payors with a full range of legal services, including:
Formation of Clinically Integrated Provider Networks: Guiding providers through the formation process, structuring the network, developing a participating provider strategy, and establishing appropriate quality and governance practices.
CMS Center for Medicare and Medicaid Innovation Programs (CMMI): Guiding providers in the organization and contracting for various CMMI programs, including MSSP ACOs, ACO REACH, and the GUIDE Model.
Regulatory Compliance: Navigating the intricate regulatory environment of the healthcare industry, including federal and state fraud and abuse laws, HIPAA compliance and state privacy laws, reimbursement and compensation issues, and antitrust considerations.
Contract Strategy and Negotiation: Offering strategic advice and legal support for arrangements between providers and payors, developing provider network agreements and compensation methodologies under which providers have the opportunity to receive shared savings and other incentive payments.