Provider and Payer Collaborate in Response to Health Reform

Provider and Payer Collaborate in Response to Health Reform

As a precursor to current health reform legislation, many states undertook their own reform initiatives in the 1990s. In one instance, a regional medical group and an insurer jointly created and capitalized a new company to improve quality and patient satisfaction by developing provider network products and initiatives.

We were the chief legal architects of the enterprise, which included a transfer and leaseback of clinic real estate, new facility financing arrangements, formation of a new service network under state law, establishment of an affiliated tax-exempt foundation, and agreement to various business covenants affecting participant operations in their mutual service area.