Value-Based Payments in Public and NotforProfit Hospitals in the Age of COVID-19

June 17, 2020

Regulatory changes such as the Pathways to Success initiative and those related to HHS’ “Regulatory Sprint to Coordinated Care” are bringing changes to the nature and types of arrangements and transactions between providers. The changes include increases in risk-based contracting and in alignment strategies that rely on payment principles that were previously less common, such as gainsharing, capitation, and subsidization. Like other hospitals and health systems, those that are tax-supported, not-for-profit, religiously-based, and/or part of the public safety net may identify the need to participate in these new strategies in order to survive in the current market. However, given the specific laws and regulations that may govern them- including, as examples, public financing restrictions and/or prohibitions on private inurement- these classes of hospitals and health systems have special considerations when structuring and entering into new types of risk and payment arrangements. These special considerations are layered on a complex patchwork of more general laws that affect all hospitals and health systems. Our panel of experts will identify and discuss the complex new scope of considerations in the wake of Pathways to Success and the Regulatory Sprint.


David Muhlestein, Leavitt Partners

Kelly  Anderson, Baptist Health  

Lisa Han, Jones Day

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