Forming Provider-Payer Partnerships: Key Considerations for Providers

Evaluating Product, Membership, Network, Partnership Model, and Financial Model When Pursuing Partnerships

Recording of a 90-minute CLE video webinar with Q&A

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Conducted on Thursday, December 9, 2021

Recorded event now available

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Course Materials

This CLE webinar will guide healthcare counsel on provider-payer partnerships and the critical considerations for providers. The panel will evaluate product, membership, network, partnership, and financial models when pursuing a partnership, as well as outline navigating the process.

Description

Healthcare provider organizations and health plan collaborations create new opportunities but also present legal and business risks. These collaborations integrate care delivery and financing. Before proceeding with the partnership, healthcare providers need to carefully evaluate several considerations, including the partnership model and the products created.

For example, will the providers have some exclusivity or preferential status with the payer? What lines of business of the partnership make sense? Both providers and plans need to understand their target geographic market and their needs to differentiate their offerings and make them compelling to the potential members.

A partnership must be able to support its members' care needs. The membership model is essential and set up to achieve the delivery of the needed healthcare. Being able to reach the proper scale will allow both payers and providers to mitigate and manage risk.

Listen as our authoritative panel of healthcare attorneys examines provider-payer partnerships and the primary considerations for providers. The panel will evaluate product, membership, network, partnership, and financial models when pursuing a partnership and offer best practices for navigating the process.

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Outline

  1. Provider-payer partnerships
    1. Emerging trends
  2. Key considerations for providers
    1. Product
    2. Membership
    3. Network
    4. Partnership model and governance
    5. Financial integration
  3. Best practices for navigating the process

Benefits

The panel will review these and other vital issues:

  • What are the current and emerging trends with payer-provider partnerships?
  • What are the key considerations that healthcare providers should evaluate before entering into a partnership with health plans?
  • What are the potential hurdles facing providers who want to enter into a payer-provider partnership?

Faculty

Mitchell, Gregory
Gregory R. Mitchell

Partner
McDermott Will & Emery

Mr. Mitchell works with healthcare payors and providers to meet the full spectrum of their managed care and...  |  Read More

Ruiz, Michael
Michael Ruiz

Associate Director, Healthcare
Guidehouse

Mr. Ruiz provides strategic network leadership that delivers measurable network management strategies to organizations...  |  Read More

Waxman, J. Mark
J. Mark Waxman

Retired Partner
Foley & Lardner

Mr. Waxman is former Chair of the firm's Health Care Industry Team. He focused on healthcare issues and handled...  |  Read More

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