Garfunkel Wild has advised dozens of clients including accountable care organizations, organized delivery systems, and independent practice associations (IPAs), including many that have pursued clinical integration. Garfunkel Wild assists these clients in navigating the regulatory hurdles that face networks as they move along the path of clinical integration, including those presented by the federal and state antitrust laws.
In order to achieve clinical integration, networks need to develop an active and ongoing program to evaluate and modify practice patterns by the network’s participants so as to create a high degree of interdependence and cooperation among its members, to control costs and ensure quality. Measures of clinical integration include, among others: goals related to quality and service utilization, development and adoption of practice standards, regular evaluation of individual providers and aggregate performance against these measures, and investment of human resources and collective quality improvement.
With these goals in mind, Garfunkel Wild has advised its clients from inception, participating on steering committees, structuring governance, obtaining regulatory approvals, drafting and reviewing policies and procedures, providing ongoing guidance to the governing board and ultimately negotiating with managed care plans once the network becomes clinically integrated.
With these goals in mind, Garfunkel Wild has advised its clients from inception, participating on steering committees, structuring governance, obtaining regulatory approvals, drafting and reviewing policies and procedures, providing ongoing guidance to the governing board and ultimately negotiating with managed care plans once the network becomes clinically integrated.
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Debra A. Silverman
Partner/Director