Blog: clinical integration

 

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Can an ACO Violate the Antitrust Laws?

Posted on June 21, 2018 by
Blog

This may not be obvious to people who do not keep track of the Federal Trade Commission (FTC)/Department of Justice antitrust enforcement policy, but an enforcement action has never been published involving an Accountable Care Organization (ACO) that participates in Managed Security Service Provider (MSSP) or another federal health care program.  The reason for the […]

Jointly Providing Health Care Fee Information to Payors

Posted on May 22, 2014 by
Blog

As health care provider networks move down the path toward clinical integration, we are often asked to provide guidance on how information can be jointly provided to payors. The antitrust laws recognize that collective sharing of some pricing information, even by otherwise competing providers, can be beneficial and does not necessarily violate antitrust laws. However, […]

Messenger Model Contracting – A Structure of the Past

Posted on May 19, 2014 by
Blog

There are many organizations around the country that use a messenger model as a managed care contracting mechanism. Under the messenger model, an intermediary is used to shuttle offers from managed care organizations to individual providers who sign on to the network. Messenger model networks should not be confused with clinically integrated systems. Clinical integration […]