Payor-Provider Integration and Collaboration: Future Opportunities and Key Legal Risks for MAOs to Consider

November 3, 2023 9:45am

Jennifer Kildea Dewane
Vice President & Counsel, Government Business Division
Elevance Health

Steven Hamilton
Partner
Reed Smith LLP

  • Analyzing the different types of partnerships that are being formed between plans, providers and other entities
  • Pinpointing legal risks and diligence considerations for MAOs
  • Addressing legal risks with provider marketing and patient recruitment
  • Fine-tuning MAO-provider contracts
    • Addressing physician incentive plan requirements and limitations
    • Assessing the impact on shared savings and other compensation arrangements on bids etc…
    • Navigating AKS and relevant safe harbors
  • Key considerations for the future integration and exclusive arrangements