Value-Based Care in Digital Health

Rising health care costs have also moved the industry and regulators alike to push toward telemedicine and other technology-based health care services. Providers and payors continue to seek ways to implement value- and outcome-based reimbursement, and technology is often at the core of these innovative arrangements. Our team of health care regulatory and policy attorneys regularly provides assistance to providers and payors alike on the following critical issues:

  • Understanding the potential impact of proposed Stark Law and Anti-Kickback Statute (AKS) regulations involving value-based arrangements.
  • Identifying potential areas of “care redesign,” including how your business can either benefit from care redesign or provide elements of care redesign to provider organizations.
  • Learning about potential options for risk sharing in alternative payment arrangements.
  • Understanding the range of available demonstration and value-based reimbursement models, such as accountable care organizations (ACOs), bundled payments, chronic care management, and others.

Our attorneys can also provide the following services to mitigate compliance risks in value-based digital health care arrangements:

  • Consultation on the structuring of risk-based arrangements.
  • Research and analysis of state fraud and abuse laws to confirm compliance with a proposed model.
  • Conducting a presentation on the new Stark Law and AKS proposed rules for in-house teams.
  • Coordinating with care redesign technology vendors to understand available data and determine which value-based arrangement aligns with your business and patient population.

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