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 a collaboration of providers such as clinically integrated networks. Topics covered will include the 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 as well as how to mitigate risk.
Outline
- VBE framework
- Considerations when determining whether 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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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
Mr. Mitchell works with healthcare payors and providers to meet the full spectrum of their managed care and reimbursement arrangement needs. He works closely with managed care organizations, insurers, hospitals and health systems, academic medical centers, and other organizations both large and small to negotiate and draft managed care agreements, network participation agreements, and more. Mr. Mitchell is experienced across a variety of arrangements and models, including fee-for-service, value-based care, bundled payment, shared savings and shared loss models, gainsharing and capitation arrangements.
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Daniela Yusufbekova, MHA
Senior Consultant
Pinnacle Healthcare Consulting
As a Senior Consultant supporting both the Compensation Valuation and Strategy and Operations division, Ms.... | Read More
As a Senior Consultant supporting both the Compensation Valuation and Strategy and Operations division, Ms. Yusufbekova’s expertise and primary area of focus centers around value-based care. Providing comprehensive support for numerous types of provider arrangements, she conducts competitive market research, fair market value analyses, and detailed modeling. Ms. Yusufbekova serves a variety of clients including healthcare systems, hospitals, medical groups, and accountable care organizations (ACO).
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