Managing the Transition to Value-Based Alternative Payment Models for Healthcare Providers and Payors
Navigating State Regulations and Overcoming New Challenges
Recording of a 90-minute CLE webinar with Q&A
This CLE course will provide guidance to counsel for healthcare providers and payors on managing the shift from fee-for-service to value-based alternative payment models (APM). The panel will discuss evolving state regulatory schemes and how to overcome the challenges presented by state regulations when transitioning to an APM.
- A historical perspective: The evolution of insurance industry regulation
- Value-based APMs: An overview
- Current regulatory environment
- Characteristics of APMs that may impact the regulatory burden
- Representative state regulatory approaches (California, Tennessee, New Jersey and others)
- Recent state developments and proposals
- Best practices for managing regulatory challenges
- Providers in an insurance world: Dealing with comprehensive regulatory regimes
- Navigating uncertain regulatory landscapes and new regulations, including creative alternative structures
- Looking ahead
The panel will review these and other key issues:
- What are the common features of APMs that impact state regulatory framework?
- What are the trends in state regulatory approaches?
- What hurdles do healthcare providers and payors operating in multiple state face as a result of differing state regulations?
McDermott Will & Emery
Ms. McDonald focuses her practice on transactional and regulatory counseling for clients in the healthcare industry,... | Read More
Ms. McDonald focuses her practice on transactional and regulatory counseling for clients in the healthcare industry, with particular focus on federal and state healthcare government programs and the intersection between healthcare payors and providers. She regularly advises health insurers, HMOs, healthcare government contractors, healthcare providers and other clients on compliance with healthcare laws and regulations, particularly in connection with Medicare Advantage, Medicare Part D, Medicaid managed care, the Affordable Care Act, state insurance laws, and state licensure and professional practice regulations.Close
J. Peter Rich
McDermott Will & Emery
Mr. Rich practices almost exclusively in the healthcare field, advising hospitals, medication groups, and health plans,... | Read More
Mr. Rich practices almost exclusively in the healthcare field, advising hospitals, medication groups, and health plans, as well as health industry clients. He has formed and restructured many types of managed care organizations, including ACOs, other types of physician-hospital organizations and similar integrated healthcare delivery systems, as well as HMOs and other types of health plans.Close