HomeWebcastPhysician Integration Strategies: What You Need To Know in 2015
Physician Integration Strategies CLE/CPE CLE

Physician Integration Strategies: What You Need To Know in 2015

Live Webcast Date: Tuesday, June 02, 2015 from 3:00 pm to 5:00 pm (ET)
CLE-LegalRecording

Physician Integration Strategies CLE/CPE

Join us for this Knowledge Group Physician Integration Strategies CLE/CPE Webinar. Health care continues to evolve rapidly in the United States as do the relationships of hospitals and physicians. Several factors have been encouraging partnerships between hospitals and independent groups of physicians. The primary aim of these Hospital–Physician Integration Transactions is to reduce costs. But secondarily, it is to improve efficiency and the quality of patient care in response to the new health care laws.

Direct employment of physicians allows for easy compliance with federal and state regulations and enables collaboration on pricing that physician-hospital organizations (PHOs) do not. The alternative is closer collaboration with physicians without paying them a salary. Under Management services organizations (MSOs), hospitals administer the business and the physicians practice.

The hospital, or its affiliate, can purchases all of the assets of the physician practice and employ the physician or lease the practice. Federal fraud and abuse laws, including the Anti-kickback Statute (AKS) and the Stark Law come into play in such affiliations. The AKS prohibits the offering, payment, receipt, or solicitation of any re-numeration in exchange for referrals of federal health-care services. The Stark law is a strict liability, civil law that prohibits a physician from referring a 'designated health services' to an entity with which there is a financial relationship.

The hospital or health system should carefully consider which model fits the goals and objectives of its organization, to what extent physicians should be involved in the governance and management, that sound payment contracts exist, and that all physicians salaries and any rentals are at 'fair market value'.

The Knowledge Group has assembled a panel of key thought leaders to provide the audience with an in-depth over-view and analysis of emerging Physician-Hospital Integration Strategies. Speakers will provide insight into sound strategies to ensure legally binding contracts and compliance with federal and state laws in 2015 and beyond.

Key topics include:

  • Physician-Hospital Integration Transaction (PHIT) Models
  • Entire Practice Acquisition
  • Employment and Practice Lease
  • Lease of Entire Practice
  • Purchase of Ancillaries
  • Legal Issues Associated with Physician Integration
  • Anti-Kickback Statute (AKS)
  • Stark Law
  • Factors to Considers in Pursuing Physician Integration
  • Choosing a Model that Fits Organizational Goals and Objectives
  • Physician Involvement in Governance
  • Auditing Physician’s Practice, etc.
  • Legal Issues in PHIT
  • Contractual Issues
  • Compliance and Litigation Risks

Who Should Attend

  • Healthcare Lawyers
  • Health Industry Advisors
  • Health Policy Directors
  • Health Services Professionals
  • Healthcare Consultants
  • Healthcare Finance Professionals
  • Directors and Officers of Healthcare Firms
  • Legal Risk Officers and Administrators
  • Hospital Executives (Finance, CFOs, General Counsel and Related)
  • Other Related/Interested Professionals

Faculty

Physician Integration Strategies CLE/CPE
Michael R. Glick
Director, Physician-Health Initiatives
Blue Consulting Services
Physician Integration Strategies CLE/CPE
Lawrence B. Garcia
Shareholder
Kronick Moskovitz Tiedemann & Girard

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Physician Integration Strategies CLE/CPE

SEGMENT 1:
Michael R. Glick , Director, Physician-Health Initiatives
Blue Consulting Services
  • The “why you do” before the “how to do”
  • Where the value comes from
  • Model around clinical integration/generic aspect

SEGMENT 2:
Lawrence B. Garcia, Shareholder
Kronick Moskovitz Tiedemann & Girard

As we have passed the 5th anniversary of the adoption of the Affordable Care Act (“Act”), it is appropriate that we focus on a particular goal of the Act which is less controversial than the individual mandate, the expansion of the Medicaid program or the implementation of the health insurance exchanges.  A specific goal of the Act is the implementation of the “triple aims” of health care reform which include: (i) improving the individual experience of care, (ii) lowering the total cost of care and (iii) improving clinical outcomes for coverage patient populations.  A key program in achieving the triple aims is a conversion of patient care payments from volume based fee-or-service payments to value-based contracting. 

Both governmental payment programs and health insurance companies are charting a path of value-based contracting.  This session will address many of the complex legal and regulatory issues that must be evaluated by a clinically integrated network of providers (“Network”) to participate in a value-based contract which may include incentive payments for clinical performance that helps to achieve the triple aims.  Key issues that will be addressed are as follows:

  • What are the key antitrust issues that a Network must address to enter into joint contracting negotiations for a value-based contract?
  • What is the legal structure “of choice” that is being used to form a Network?
  • What role should physicians and hospitals play in the design and operation of a Network?
  • What are the most common clinical performance standards used by a Network?
  • What are the key regulatory issues that must be addressed for a Network to contract with participating physicians and medical groups in its service area?

Physician Integration Strategies CLE/CPE

Physician Integration Strategies CLE/CPE

Michael R. Glick Director, Physician-Health Initiatives Blue Consulting Services

Mr. Glick is a Director in Blue & Co., LLC’s Healthcare Consulting Practice focused in the areas of Hospital and Physician Integration, Clinical Service Line Strategy and Market Development.

Mr. Glick has more than 20 years of experience in business consulting and healthcare. For the past 15 years he has worked exclusively with hospitals and physicians and their practices. Mr. Glick has consulted on all aspects of healthcare management including physician practice integration, joint
venture initiatives, revenue enhancement, service line strategic planning, and revenue cycle. Over the last 10 years, Mr. Glick has been actively involved in working with hospital and physician organizations on strategies focused Physician Integration, including Service Line Co-Management and ACO/ Clinical Integration development.

Physician Integration Strategies CLE/CPE

Lawrence B. GarciaShareholderKronick Moskovitz Tiedemann & Girard

Lawrence B. Garcia has nearly 40 years of experience as a practicing attorney. Mr. Garcia’s experience encompasses the counseling and representation of clients in highly regulated business environments with a heavy concentration in providing support for healthcare providers, senior living providers, and small businesses. Mr. Garcia’s practice activities include mergers, acquisitions, financings, commercial transactions, healthcare law, construction law, and facilitated conflict resolutions, as well as the representation of clients before regulators.

In his current practice as a shareholder at Kronick Moskovitz Tiedemann & Girard, Mr. Garcia works with hospitals, health systems, federally qualified health centers, medical group practices and senior living providers in the design and implementation of “value-added” business relationships that are designed to improve the quality of clinical care provided by his clients. He also serves as legal counsel to the California Primary Care Association, and the California Hispanic, Asian and Black Chambers of Commerce. In addition to his active legal practice, Mr. Garcia also serves as the President of Garcia Consulting Group Inc., which provides business consulting services in the areas of healthcare, long-term care, business development and education consulting.

Mr. Garcia has served as Corporate Counsel for Catholic Healthcare West (“CHW”), a major non-profit, multi-corporate healthcare system in the western United States. CHW now, Dignity Health is the largest non-profit healthcare organization in California and operates hospitals and clinics in California, Arizona, and Nevada.

Mr. Garcia is a founding member of the Institute for Senior Living, a think-tank of leaders that works as a catalyst for innovations to meet the needs of the aging population. The Institute for Senior Living is a leader in the development of creative solutions to the problems of the nation’s growing senior population.

Physician Integration Strategies CLE/CPE

Course Level:
   Intermediate

Advance Preparation:
   Print and review course materials

Method Of Presentation:
   On-demand Webcast

Prerequisite:
   NONE

Course Code:
   145249

NASBA Field of Study:
   Specialized Knowledge and Applications

NY Category of CLE Credit:
   Skills

Total Credits:
    2.0 CLE

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About the Knowledge Group

The Knowledge Group

The Knowledge Group has been a leading global provider of Continuing Education (CLE, CPE) for over 13 Years. We produce over 450 LIVE webcasts annually and have a catalog of over 4,000 on-demand courses.

About the Knowledge Group

The Knowledge Group

The Knowledge Group has been a leading global provider of Continuing Education (CLE, CPE) for over 13 Years. We produce over 450 LIVE webcasts annually and have a catalog of over 4,000 on-demand courses.

Blue is currently the 53rd largest accounting and consulting firm in the U.S. Blue specializes in providing services to healthcare organizations and closely-held businesses. They take pride in their reputation within the healthcare industry. Blue provides services to over 200 hospitals, nursing homes, home health agencies, and 800 physician groups throughout the country. They make it their business to understand their clients' needs by providing them with the highest quality professional services through specialization, teamwork, and a commitment to excellence.

Blue currently has offices located in Columbus, Ohio; Lexington, Kentucky; Louisville, Kentucky; Indianapolis, Indiana; Carmel, Indiana; Seymour, Indiana; Columbus, Indiana; Bloomington, Indiana; and Abilene, Texas. Their Louisville, Kentucky; Columbus, Ohio; and Indianapolis, Indiana offices are dedicated entirely to the healthcare industry. They employ over 300 people, including 34 directors and over 200 professional staff members.

Website: https://blueconsultingservices.com/

Kronick is a full-service AV-rated law firm headquartered in Sacramento with additional offices in Bakersfield, San Luis Obispo, and Roseville.  Established in 1959, we are one of the largest law firms in Sacramento and serve as general and special counsel to hundreds of private corporations, nonprofit businesses, landowners, and public agencies throughout the State of California.  Our areas of expertise range from healthcare, agribusiness, corporate law, and litigation to water and natural resources, real estate and land use, labor and employment, and education law.  We emphasize streamlined legal services, preventative counseling, client-side experience and results-based advocacy.  Our attorneys come from varied backgrounds and leverage their experience and expertise to consistently achieve, protect and further our clients' goals and objectives.  

Website: https://www.kmtg.com/

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