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Affiliations, Joint Ventures, and Strategic Alliances

Affiliations, Joint Ventures, and Strategic Alliances


Market forces producing the demand for hospital-physician integration and other strategic alliances include programs of clinical integration, risk-oriented contracts with major payors, ACO-type programs (whether with Medicare or a commercial payor), and the development of provider-owned payment organizations.  They all share one thing in common: institutional providers and physicians must create relationships or organizations that enable cost reduction and quality improvement initiatives, and facilitate the sharing of limited dollars on an equitable basis.

Relationships between hospitals and physicians can take many forms:  physician employment, physician-hospital organizations, management services organizations, gainsharing, accountable care organizations, and risk contracting with payors.  Our team is well-versed in structuring strategic alliances and innovative integration and delivery strategies that enable our clients to comply with the ever-changing regulatory environment and adapt to new payment models.  We also assist our clients in assessing the impact of Stark, the Anti-Kickback Statute, the Civil Monetary Penalties Law, the tax-exemption provisions of the Internal Revenue Code, and applicable state regulation of insurers and TPAs on existing and proposed arrangements.

In an environment in which provider payment is increasingly being tied to results for quality, access, and efficiency, these strategic alliances are critical.  Smith Moore Leatherwood's team can help your organization achieve its relationship goals and assist in the development of more effectively integrated patient service structures.



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  • Structured and assisted with physician practice acquisitions and divestitures
  • Developed alternative compensation models for employed physicians, including compensation arrangements based on cost-reduction, quality improvement, or both
  • Developed service line management agreements for the operation of entire hospital departments
  • Prepared medical directorship and staff leadership arrangements
  • Established joint ventures by and among hospitals, physicians, and management companies to own and operate ancillary businesses
  • Structured clinical co-management arrangements between health systems and physicians
  • Formed independent practice associations (IPAs) and physician-hospital organizations (PHOs)
  • Established clinically integrated networks and accountable care organizations (ACOs)
  • Formed health maintenance organizations (HMOs) and third party administrators (TPAs) for health care providers
  • Assisted in developing intellectual property agreements and collaborations
  • Advised clients regarding HIPAA and information technology issues relating to practice acquisition and integration

* Past success does not indicate the likelihood of success in any future legal representation.


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