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Health Care Reform Home

Clinical Integration and Antitrust

One of the basic goals of health care reform is to lower costs while increasing quality. One way to achieve this goal is by shifting the dominant payment methodology from volume-based to value-based. In changing payment models from the volume, fee-for-service approach to value-based models, such as bundled payments, capitated payments, and shared savings arrangements, the Affordable Care Act encourages hospitals and physicians to form clinically integrated organizations that will better manage the continuum of care for patients. Approaches to clinical integration should be carefully considered to ensure not only their effectiveness but also compliance with applicable federal and state antitrust laws. Hall Render's broad experience with clinical integration and related antitrust matters will assist you in properly structuring your clinically integrated organization.

Articles

Antitrust Implications for ACOs: FTC/DOJ Determine ACOs are Consistent with Indicia of Clinical Integration - Is This a Fundamental Shift in Antitrust Policy?
[01/31/2012]
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Regulations

Federal Trade Commission/Department of Justice Proposed Statement of Antitrust Enforcement Policy Regarding Accountable Care Organizations Participating in the Medicare Shared Savings Program
[03/31/2011]
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The Federal Trade Commission and the Department of Justice's "Statement of Antitrust Enforcement Regarding Accountable Care Organizations Participating in the Medicare Shared Savings Program" (Antitrust Policy Statement)
[10/20/2011]
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August 19, 2010 edition of U.S. Department of Justice and Federal Trade Commission's Horizontal Merger Guidelines
[11/29/2010]
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Recording and transcript materials from the CMS, HHS, and FTC Workshop Regarding Accountable Care Organizations and Implications Regarding Antitrust, Physician Self-Referral, Anti-Kickback and Civil Monetary Penalty Laws
[11/29/2010]
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Medicare Payment Advisory Commission's (MedPac) response to CMS' request for comments regarding Accountable Care Organizations
[12/03/2010]
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FTC Testifies on Antitrust Enforcement in the Health Care Industry
[12/03/2010]
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American Hospital Association's Guidance for Clinical Integration updated September 2010
[12/03/2010]
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American Hospital Association's Chart of legal barriers to clinical integration and proposed solutions
[12/03/2010]
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