Value-Based Care

Our Value-Based Health Care team includes one of the country’s leading attorneys in value-based care who has been at the forefront of this payment model since 2012, guiding and transitioning physicians, hospitals and major government and commercial payers from across the nation. Combined, our lawyers have assisted in the formation of more than 60 Physician Organizations and Physician Hospital Organizations, and more than 20 accountable care organizations (ACO). Health care organizations have chosen Smith Anderson to assist with their value-based care strategies because of our team’s deep experience with the opportunities and challenges of value-based care with which providers are faced.

We have demonstrated our commitment to this evolving topic, having helped start Toward Accountable Care Consortium (TAC), a community of over 40 North Carolina medical societies and organizations. Our attorneys are regularly engaged in forming Medicare ACOs, advising clients on Medicaid value-based care initiatives, working with Medicare Advantage plans, assisting clients with navigating the regulatory landscape, and negotiating private payer value-based care contracts. We also advise clients on corporate restructuring matters, tax issues facing value-based care participants, governance issues and shared savings distribution issues.

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• Strategic general counsel services for ACOs and other value-based reimbursement initiatives
• Contract drafting and negotiation with payers, providers and partners
• Data privacy compliance and incident response
• Data analytics and population health strategies
• Clinically integrated network formation and regulatory advice
• Tax advice and planning
• Corporate counseling
• Stark/Anti-Kickback Statute Waiver compliance
• Medicare Shared Savings Plan (MSSP) application process
• Population health analytics technology development and licensing
• Antitrust compliance