Care Coordination, Clinical Integration, Group Practices and Research, Oh, My: Designing Healthcare Provider Incentives After COVID and New Stark Law and AKS Final Rules

Care Coordination, Clinical Integration, and Research

A live 90-minute CLE video webinar with interactive Q&A


Monday, September 27, 2021 (in 2 days)

1:00pm-2:30pm EDT, 10:00am-11:30am PDT

or call 1-800-926-7926

This CLE course will guide healthcare counsel and advisers on the emerging trends in financial incentives for physicians and other providers and the pitfalls in properly documenting, structuring, and implementing them. The panel will review the relevant changes to the Stark and Anti-Kickback Statute regulations, the implications for physician incentives, and the different regulatory structures under which healthcare organizations must operate.

Description

The healthcare industry continues its shift from measuring and paying for the volume of care provided to emphasizing and tying payment to the value of care provided. With this shift, healthcare provider contracts and transactions increasingly include financial incentives that are to encourage coordinated and targeted efforts toward improvement on specified measures of value in care delivery. Although such financial incentives are generally considered reasonable and even necessary to achieve the socially-desired changes in provider practices and behaviors, they remain fraught with potential regulatory pitfalls, even after the new compliance options introduced through the Regulatory Sprint to Coordinated Care.

In many ways, the COVID-19 public health emergency and related challenges dramatically shifted our understanding of value in healthcare delivery, and likewise the goals and targets for provider financial incentives. Work RVUs and work hours have been replaced or significantly supplemented by measures of panel size, quality, and cost effectiveness. Traditional measures of good provider citizenship, such as participation in continuing education or outreach, are being replaced or supplemented by targets for advancing or participating in clinical research or care management initiatives.

At the same time, both related and unrelated regulatory and market changes have dramatically altered the data and “rules of the road” that may be relied upon for structuring compensation and service arrangements with physicians and other providers. These converging forces have made 2021 a year of new questions and answers for designing provider incentive compensation.

Listen as our authoritative panel of healthcare attorneys examines the emerging trends and pitfalls in designing and implementing financial incentives for physicians and other providers, including in the context of care coordination, clinical integration, primary care, medical research, and newer and emerging strategies to promote principles of equity and inclusion for both patients and caregivers.

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Outline

  1. Emerging trends and focus areas for healthcare provider financial incentives, including new "care team" bonuses allowed for group practices and rules about group practice protection for value based enterprise profits
  2. Old and new pitfalls in documentation, structure, and implementation, as evidenced through case law and regulatory guidance
  3. Commercial reasonableness and FMV after new Stark Law and AKS Final Rules, including how these concepts and their importance have changed (and also how they haven't changed)
  4. Best practices for avoiding pitfalls in the design and structuring of incentive compensation arrangements in 2021 and forward

Benefits

The panel will review these and other key issues:

  • What are the recent trends in physician incentives?
  • What steps can healthcare advisers take to ensure regulatory compliance when structuring physician incentives?
  • What are the implications for compliance with the Stark Law, the AKS, and other laws and regulations?

Faculty

Ferrari, Andrea
Andrea M. Ferrari, JD, MPH

Partner
HealthCare Appraisers

Ms. Ferrari focuses on physician payments related to hospital-physician alignment and efficiency improvement...  |  Read More

Jacobs, Clevonne
Vonne M. Jacobs

Attorney
Hall Render Killian Heath & Lyman

Ms. Jacobs focuses her practice in the area of healthcare transactions. Calling upon her years of dedicated experience,...  |  Read More

Attend on September 27

Cannot Attend September 27?

You may pre-order a recording to listen at your convenience. Recordings are available 48 hours after the webinar. Strafford will process CLE credit for one person on each recording. All formats include course handouts.

To find out which recorded format will provide the best CLE option, select your state:

CLE On-Demand Video

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