Structuring Value-Based Contracts: Key Considerations, Risk Mitigation, and Implementation
Recording of a 90-minute CLE video webinar with Q&A
This CLE course will guide counsel on structuring value-based contracts and the key considerations related to various value-based care reimbursement models for both single provider groups or collaboration of providers such as clinically integrated networks. Topics covered will include the new value-based enterprise (VBE) framework under the federal Stark Law and Anti-Kickback Statute. The panel will also discuss the key considerations to assure your organization is ready to enter value-based care models and shared financial risk contracts and how to mitigate risk under the new VBE rules.
Outline
- The new value-based enterprise framework
- Considerations when determining to enter into a value-based contract
- Risks and mitigation
- Key provisions
- Best practices
Benefits
The panel will review these and other important issues:
- Are you ready to enter into value-based care contracts?
- What are the critical provisions that should be included in value-based contracts?
- What steps should counsel take to mitigate potential risks associated with value-based contracts?
- What are best practices for structuring value-based contracts?
- What structures and incentives can be utilized under the VBE construct?
Faculty
Kevin J. Malone
Member
Epstein Becker & Green
Managed care organizations trust Mr. Malone to help them understand and navigate their most difficult legal,... | Read More
Managed care organizations trust Mr. Malone to help them understand and navigate their most difficult legal, compliance, and strategic risks and opportunities. He draws on more than a decade of experience working at the highest levels of healthcarehealthcare financing policy and law to help managed care organizations navigate the web of federal and state regulations and program policies governing the health care financing system. Mr. Malone is a go-to lawyer on issues concerning the Mental Health Parity and Addiction Equity Act (the federal parity law), delivery systems for Medicare-Medicaid dually eligible beneficiaries (such as special needs plans and the Programs of All-Inclusive Care for the Elderly (PACE)), and demonstration models for Medicare and Medicaid. He also advises providers ranging in size from large hospital systems to start-up health and telehealth companies on legal and strategic matters involving corporate formation, licensing, and third-party payment and coverage with a particular focus on value-based payment strategies. Provider organizations rely on his experience with managed care organizations and government regulators to develop successful strategies for market entry and growth.
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Lori A. Oliver
Shareholder
Polsinelli
Ms. Oliver’s practice focuses on a wide array of healthcare transactional, regulatory, and operational matters.... | Read More
Ms. Oliver’s practice focuses on a wide array of healthcare transactional, regulatory, and operational matters. Her deep bench of experience and in-depth understanding of the healthcare industry as both a lawyer and a former healthcare executive enables Ms. Oliver to offer practical solutions and strategic advice to clients. She has significant experience in healthcare alignments, affiliations, and relationship strategies; clinically integrated networks; academic medicine; healthcare operations; and complex compliance matters. Ms. Oliver has represented healthcare organizations in management services and other contractual arrangements requiring a thorough understanding of strategic objectives, business imperatives and applicable regulatory, compliance, or legal risk to ensure organizational success as well as represented clients in direct-to-employer value-based care arrangements with large self-insured employers, among other matters.
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