Remember when Hollywood wouldn’t show an unmarried couple in bed together? Blue Cross-Blue Shield of Illinois is taking that approach to contract negotiations. If hospitals want to negotiate jointly with the insurer, they...more
Medicaid plays a central role in financing mental health and substance use disorder (SUD) services, accounting for 26 percent of all spending on behavioral health services in this country. Medicaid beneficiaries with...more
Clinical integration is a somewhat imprecisely defined concept in the health care industry. Lawyers and health care executives have identified components and elements of clinical integration and frequently ask how many of...more
The Federal Trade Commission (FTC) has provided additional guidance, and comfort, to physicians seeking to clinically integrate for the purpose of, among other things, jointly negotiating payor contracts. This additional...more
In This Issue:
- Norman PHO
- Key Conclusions
- Implications for Established and Newly Forming Networks
- Excerpt from Norman PHO:
The Norman PHO is comprised of a single hospital system and...more
The Federal Trade Commission (FTC) recently issued its first advisory opinion addressing clinical integration programs since the enactment of the Affordable Care Act (ACA). Without a doubt the advisory opinion is useful for...more
The Federal Trade Commission (FTC) provided its first guidance for clinically integrated networks since passage of the Affordable Care Act (ACA) and the joint FTC/DOJ Accountable Care Organization (ACO) Antitrust Policy...more
On February 13, 2013, the FTC issued an advisory opinion letter that it did not plan to challenge the proposed creation of the Norman Physician Hospital Organization (“Norman PHO”)—which includes approximately 280...more
In a February 13, 2013, advisory opinion, the Federal Trade Commission (FTC) Bureau of Competition stated that it has no present intention to recommend that the FTC challenge a clinical integration program (CIP) proposed by...more
FTC staff advisory opinions are not issued all that frequently and advisory opinions regarding clinical integration are issued even less frequently. The latest advisory opinion, issued last week, is therefore noteworthy, not...more
Since the passage of the Affordable Care Act (ACA), much attention has been paid to the antitrust treatment of Accountable Care Organizations, provider ventures contemplated by the ACA that the Federal Trade Commission and...more
In This Presentation:
- Why Clinically Integrated Networks (CINs) Are Needed?
- How Are CINs Similar to PHOs/How They Differ?
- What’s In It for Physicians/for Hospitals/Others?
- How Are CINs Organized and...more
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