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

Conducted on Wednesday, April 12, 2017
Recorded event now available

This CLE webinar 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.


Healthcare payors and providers are working to align financial incentives and allocate financial risk so that providers are absorbing more of the financial burden in exchange for increased patient volume and greater potential financial gains. State approaches to regulating these value-based APMs vary and are continuing to evolve, creating new legal and operational challenges for health plans and providers as the shift to APMs accelerates.

Both health plans and providers need to understand the legal landscape, how different states are approaching the task of protecting providers and patients, and how to deal most effectively with the regulatory challenges—including creative structures to minimize regulatory burdens.

Listen as our authoritative panel of healthcare attorneys examines the current regulatory environment and provides insight into different state regulatory approaches. The panel will also provide guidance to navigating the new regulations and overcoming the challenges while making the transition to APMs.


  1. A historical perspective: The evolution of insurance industry regulation
  2. Value-based APMs: An overview
  3. Current regulatory environment
    1. Characteristics of APMs that may impact the regulatory burden
    2. Representative state regulatory approaches (California, Tennessee, New Jersey and others)
    3. Recent state developments and proposals
  4. Best practices for managing regulatory challenges
    1. Providers in an insurance world: Dealing with comprehensive regulatory regimes
    2. Navigating uncertain regulatory landscapes and new regulations, including creative alternative structures
  5. 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?


Kate McDonald, Partner
McDermott Will & Emery, Washington, D.C.

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, healthcare government contractors, healthcare providers and other clients on compliance with healthcare laws and regulations.

J. Peter Rich, Partner
McDermott Will & Emery, Los Angeles

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.


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*Only available for attorneys admitted for more than two years. For OH CLE credits, only programs recorded within the current calendar year are eligible - contact the CLE department for verification.

**NH attendees must self-determine if a program is eligible for credit and self-report their attendance.

CLE On-Demand Video $297.00

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Customer Reviews

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Health Law Advisory Board

Lowell C. Brown


Arent Fox

Jennifer L. Evans



Ryan S. Johnson


Fredrikson & Byron

Gina M. Kastel


Faegre Baker Daniels

Karen S. Lovitch


Mintz, Levin, Cohn, Ferris, Glovsky and Popeo

David A. Manko


Proskauer Rose

John J. Miles

Senior Counsel

Baker Donelson

C. Elizabeth O'Keeffe


Wyatt, Tarrant & Combs

J. Peter Rich


McDermott Will & Emery

Donald H. Romano

Of Counsel

Foley & Lardner

Judith A. Waltz


Foley & Lardner

John R. Washlick


Buchanan Ingersoll & Rooney

Jesse A. Witten


Drinker Biddle & Reath

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