Managing The Transition To Transformation: Antitrust Considerations When Forming Provider Contracting Networks

Summary

McDermott's Managing the Transition to Transformation series is designed to help health systems and other health care industry leaders address the many challenges presented by the transformation in payment and care delivery models. The goal of this series is to help organizations prepare so that they are not only competitive, but can also thrive under alternative payment models (APMs) and quality-based reimbursement models (QBRs). This article summarizes key antitrust considerations when structuring networks of independent competing providers to participate in value-based payments, and offers practical considerations for network formation.

In Depth

As providers become more accountable for the quality and cost of care, they seek ways to collaborate with each other to achieve their goals. Often, effective management of cost and quality requires coordination among numerous providers. The antitrust laws, however, govern the types of activities that