Physician Compensation: New Paradigms in the Post-ACA World, Part II- The 2015 Perspective

Structuring Payment Models for Cost Reduction, Quality Improvement and Clinical Integration

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


Conducted on Thursday, January 15, 2015

Recorded event now available

or call 1-800-926-7926
Program Materials

This CLE webinar will provide guidance to healthcare counsel on structuring physician compensation and financial incentive payments to participating physicians to reduce costs and improve quality of care. The panel will discuss the implications for Stark law and anti-kickback compliance, and offer best practices for clinical integration.

Description

The Affordable Care Act sparked significant changes in healthcare payment models, including expansion of value-based payments by Medicare and other payors, increased demand for primary care, and changes in reimbursement rules. These changes, in combination with other factors, have contributed to a new wave of integration in the healthcare industry.

Some providers are choosing to clinically integrate to provide for better coordination, quality and cost effectiveness of care. Often, these clinically integrated networks provide financial incentives to participating physicians to drive improvements in quality and efficiency of care. Such financial incentives can raise challenging questions for healthcare counsel and compliance officers. 

Listen as our authoritative panel examines the emerging compensation questions of the post ACA world. The panel will discuss how current and emerging practices challenge what constitutes a fair market value and commercially reasonable payment to a physician or other healthcare provider, address implications for Stark and anti-kickback compliance, and offer best practices for clinical integration.

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Outline

  1. Regulatory compliance issues related to structuring and implementing plans for aligning providers and achieving clinical integration
  2. Emerging strategies for aligning providers and achieving clinical integration
  3. The roles of physicians and other providers in emerging structures, and the use of payments and other financial incentives to encourage optimum performance of those roles
  4. How new payment models and incentive structures challenge long-standing thinking about what constitutes a fair market value and commercially reasonable payment to a physician or other healthcare provider
  5. Successful provider alignment and clinical integration
    1. Options for achieving alignment and integration
    2. Compliance
      1. Stark law
      2. Anti-Kickback Statute
      3. Antitrust laws
      4. Other laws and regulations for which compliance hinges on FMV and/or commercially reasonable financial relationships

Benefits

The panel will review these and other key issues:

  • How are current and emerging practices challenging long-standing notions of what constitutes a fair market value, commercially reasonable payment to a physician or other healthcare provider?
  • What are the implications for compliance with the Stark law, the Anti-Kickback Statute, and other laws and regulations?
  • Are there any lessons or best practices for counsel and compliance officers from the experiences since 2010?

Faculty

Ferrari, Andrea M.
Andrea M. Ferrari, JD, MPH

Manager
HealthCare Appraisers

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

Kevin Locke
Kevin Locke
Principal
DHG Healthcare

Mr. Locke has served as an executive in healthcare operations, strategic planning, new business development and...  |  Read More

Chris E. Rossman
Chris E. Rossman

Partner
Foley & Lardner

Mr. Rossman has significant experience in major corporate transactions for healthcare clients, primarily hospitals...  |  Read More

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