Physician-Hospital Clinical Integration: Navigating the Complexities

Structuring Integrated Healthcare Models to Meet Incentive Requirements Under Healthcare Reform

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

Conducted on Thursday, July 21, 2011
Recorded event now available

This CLE webinar will prepare attorneys for healthcare providers to structure clinical integrations, including complying with applicable antitrust law, anti-kickback/Stark/CMP law, and the requirements under healthcare reform.


Effective clinical integration of hospital-physician systems will be a core element of healthcare delivery. Providers must transform current systems into integrated healthcare models to meet the incentive requirements established in the Patient Protection and Affordable Care Act (PPACA).

Healthcare providers must also understand the requirements for clinical integration, which is essential for healthcare providers to participate in accountable care organizations (ACOs) and other new public and private healthcare delivery and payment arrangements in the wake of the new PPACA.

Listen as our authoritative panel of healthcare attorneys and advisors examines the key legal and practical implementation issues to ensure effective clinical integration, including compliance with applicable antitrust law, anti-kickback/Stark/CMP law, and exempt organizations requirements under the Internal Revenue Code.


  1. Compliance with antitrust law
    1. Limitations on provider network
    2. Core elements of clinically integrated provider network within the meaning of antitrust law
    3. Competitive activities provider participants in a clinically integrated provider network may engage in
    4. Significant of exclusive v. non-exclusive provider network under antitrust law
  2. Issues facing ACOs under
    1. Anti-kickback law
    2. Stark law
    3. Civil monetary penalty
  3. Tax exempt status
    1. Qualification for tax exempt status under section 501(c)(3) or (c)(4)
    2. Structure of service contract arrangements
  4. Practical do's and dont's
    1. Feasibility and gap analysis
    2. Payment and clinical episodes
    3. Infrastructure and data issues
    4. Physicians and hospital alignment


The panel will review these and other key questions:

  • What are the core elements of a clinically integrated provider network within the meaning of the antitrust laws?
  • What issues do ACOs face under anti-kickback and Stark laws?
  • How do service contract arrangements have to be structured to avoid jeopardizing the hospital's tax exempt status?


David L. Klatsky, Partner
McDermott Will & Emery, Los Angeles

He has 20 years of experience in health industry mergers and acquisitions, with a focus on the transactional and regulatory aspects of promoting collaboration among providers. He has recently been retained by a leading national healthcare improvement alliance to advise its members regarding the formation of accountable care organizations. He is a frequent speaker on provider integration strategies.

Ashley M. Fischer, Partner
McDermott Will & Emery, Chicago

Ms. Fischer's practice is transactional and counseling-based and includes representation of healthcare organizations. Her transactional practice includes mergers, acquisitions and affiliations; divestitures; hospital/physician joint ventures and corporate reorganization. Her regulatory practice focuses on antitrust; the Anti-Kickback and Stark laws; health information privacy; and other regulatory matters.

William J. DeMarco, President
Pendulum Healthcare Development, Rockford, Ill.

He has over 30 years of experience in health plan development and management consulting and provides in depth analysis and decision support tools to determine root cause of utilization and cost, support predictive modeling and moving providers to a platform of clinical integration including Accountable Care Organization development and performance based contracting.

Joan Polacheck, Partner
McDermott Will & Emery, Chicago

Ms. Polacheck advises on a variety of healthcare compliance issues, including fraud and abuse and related matters. She assists healthcare providers and drug and device companies to perform “legal audits” and to establish and implement compliance programs and related policies. She also has extensive experience in managed care contracting on behalf of healthcare providers.


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Customer Reviews

I thought the webinar was timely and relevant.  Great speakers and excellent information.

Nancy Sever

Crystal Run Healthcare

The content covered was relevant and timely.

Francis LaMorte, MD

Alvarez and Marsal

Very informative — one of the best run programs in a plethora of on-line offerings.

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Stinson Morrison Hecker

The scope of the program provided in-depth information, as opposed to a general survey of issues/topics.

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Wolff & Samson

The speakers prepared good outlines and followed them during their presentations.

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Ringer Law Office

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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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