Payment Reform

Payment Reform

Ropes & Gray has a long history of assisting health care providers in planning for and adjusting to evolving standards and trends associated with payment reform. On behalf of our clients, we have studied the Medicare ACO debate and analyzed the final formal regulations governing the Medicare Shared Savings Program in great detail. We have evaluated the compliance requirements of state-specific ACO, integrated delivery system and payor reform in comparison to parallel federal programs and have guided multiple clients through the Medicare Shared Shavings Program application process, including the completion and submission of applications. We have also worked with the Greeley Group to educate medical staff leadership on the implications of the ACO on  medical staff members and have advised clients concerning the ACO impact on specialty hospitals (including pediatric and cancer facilities).

Accountable care demands skill in core areas like leadership and governance as well as the management of risk, talent, clinical care and health information. There is no template or right answer in the context of this dynamic industry. Under the pressure of cost containment, capital demands and complex relationships, clients must make informed choices and take carefully considered action. Experienced legal advice is critical in meeting the challenges facing ACO development.