Successful Managed Care arrangements require a thorough understanding of the practical and operational considerations unique to contracting in this industry —from traditional fee-for-service to risk-based, bundled payment.
Our attorneys understand the importance of policies and procedures. They are highly skilled at developing strategies and writing contract language that lead to successful implementation and enforcement of negotiated terms.
We represent health care providers in evolving Managed Care models, including risk-sharing, capitation arrangements and bundled payments.
We also routinely advise providers on pay-for-performance programs, quality bonuses, gain sharing programs, fee-for-service arrangements, value-based contracting models, clinical integration initiatives and litigation and arbitration over pay or contracts.
We have developed and structured numerous provider networks, including multi-specialty, single specialty and carve-out networks, often advising on clinical and economic integration issues and corporate structure, including the use of the messenger model.
We also represent physician networks in Federal Trade Commission (FTC) investigations.
Our attorneys represent the legal interests of a wide variety of managed care clients, including: