Accountable Care/Hospital-Physician Integration

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Hooper, Lundy & Bookman’s recognition for unparalleled Medicare reimbursement expertise combined with our decades of experience in advising health care providers regarding hospital/physician integration have led to our leadership role in advising clients regarding integrated delivery systems, clinically integrated networks, and Medicare and private payor ACOs.

We currently advise clients on a number of clinically integrated network and ACO–related issues, including:

  • Specific ACO models and qualifications
  • The viability of ACO implementation/participation
  • ACO formation, capitalization and governance
  • Structuring compensation and bonus incentive arrangements among physicians, hospitals and other ACO providers
  • Operational issues
  • Regulatory issues related to ACOs, including
        • Stark
        • Fraud & Abuse
        • Civil Monetary Penalties
        • Corporate Practice of Medicine
        • Antitrust
        • Tax exemption issues
  • Partial capitation
  • Implications for existing managed care contracting arrangements
  • Structuring multi-hospital clinically integrated networks
  • Structuring private direct-contract ACOs between large employers and health systems for employers' self-funded health plans

The firm has an ACO Task Force, consisting of ten attorneys and chaired by Charles Oppenheim, to focus on issues relating to ACOs. The Task Force regularly provides educational services to hospitals, physician groups and other health care attorneys about ACOs through presentations and comprehensive reports and articles.

For media assistance, please contact Maura Fisher at 202-580-7714.