Integrated Delivery Structures

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Kutak Rock’s national team of health care attorneys has been actively involved in the development of a variety of integrated delivery structures designed to coordinate the provision of health care services, including hospital and physician services. Integrated delivery structures we have developed or worked on include accountable care organizations, managed care arrangements, joint operating agreements, tax‑exempt foundations, clinical co-management arrangements, gainsharing arrangements, personal services agreement and employment structures (including structures utilizing a separate physician entity with physician participation in governance), physician-hospital organizations, management services organizations and joint venture arrangements. Our attorneys utilize an interdisciplinary model to ensure all relevant legal areas are considered, including anti-kickback statute, antitrust, reimbursement, restrictions on inducements to reduce care, securities law, state law, Stark Law and tax (including tax-exempt bond financing) considerations.

While representing our health care clients, we focus on business considerations in addition to legal issues. We assist our clients in developing and implementing a process for moving transactions forward, and we have developed excellent relationships with consultants and valuators who help us ensure these arrangements proceed in a smooth, timely and compliant manner.