1. ACOs, IPAs, CINs, PHOs: Legal Issues Behind the Acronyms

Editor’s Note: There is considerable overlap in the nature and goals of the “alphabet soup” of network structures—Accountable Care Organizations (ACOs), Independent Practice Associations (IPAs), Clinically Integrated Networks (CINs) and Physician Hospital Organizations (PHOs). Often, there is little difference among the network types, regardless of the latest popular acronym chosen as the label. They all present similar legal challenges to establishing, structuring and operating a successful provider network. In a recent webinar, Manatt decoded the acronyms—and explained, for both lawyers and nonlawyers, how to navigate the legal issues involved in launching and maintaining a provider network.

In part 1 of our article summarizing the webinar, below, we explain key terminology and entity formation issues. Watch for part 2 of our summary in the March “Health Update,” which will focus on antitrust issues and risk management. Click here to view the webinar free, on demand, and earn CLE. Click here to download a free copy of the webinar presentation.

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Understanding the Terminology

Much of the terminology around provider networks is confusing and overlapping. Read more

2. Top Five Healthcare Antitrust Trends to Watch in 2019

1. More Vertical Deals

Given the track record of merger antitrust enforcement since 2007, parties seeking to combine entities at the same level of the healthcare supply chain have faced an increasingly difficult environment. Read more

3. Ending the Opioid Epidemic: Best Practices and Next Steps

Editor’s Note: The American Medical Association (AMA) and Manatt Health are undertaking in-depth analyses of four states’ responses to the opioid epidemic to identify best practices and next steps to address the crisis. In the January “Health Update,” we summarized the first spotlight analysis, examining the actions Pennsylvania is taking to fight the opioid epidemic. Below we summarize the second analysis, focusing on Colorado’s efforts to battle the crisis in three areas: substance use disorder (SUD) treatment, pain management and harm reduction. To download the full analysis free, click here. To register for our upcoming webinar, sharing the findings from all four analyses, click here. (See our next story for more details on the webinar.)

4. You’re Invited: What Are Best Practices for Ending the Opioid Epidemic?

Learn the Answer in a New Webinar from Manatt and the AMA, “Ending the Opioid Epidemic: Leading-Edge Responses and Next Steps.” Click Here to Register Free—and Join Us on March 27 from 1:00 – 2:00 p.m. ET.

Between 1999 and 2017, more than 700,000 people died from a drug overdose—with almost 400,000 of those deaths involving an opioid. Read more

5. New 1332 Guidance Gives States Lots to Think About

Editor’s Note: While Democratic victories in the U.S. House have fueled national conversations about some variant of Medicare for all, most of the policy change in the near term is likely to continue to be at the state level. In a new Health Affairs Blog post, summarized below, the Robert Wood Johnson Foundation and Manatt Health examine the consequences of the midterm election results for states, explore recent waiver guidance to encourage state action and look ahead at the states that might submit new waivers.

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Perhaps the most interesting 2018 result is that there are now 36 “trifecta” states, where one party controls the governorship and both branches of the legislature. Read more

6. The Risks of Capped Medicaid Funding

Editor’s Note: Although efforts to cap federal funding for the Medicaid program have faded from the limelight since congressional attempts in 2017 failed to repeal the Affordable Care Act (ACA), such proposals are still being advanced. Most recently, the president’s FY 2019 budget called for a block grant to replace uncapped funding for Medicaid expansion, with most other federal Medicaid spending subject to a per-person cap. Although the 2018 midterm elections changed the political landscape, the recurrence of proposals to cap federal Medicaid funding and the $779 billion federal deficit for the fiscal year 2018 suggest that federal Medicaid caps will continue to interest lawmakers. In a new article in Health Progress, the journal of the Catholic Health Association, Manatt Health explains the serious risks of capped Medicaid funding. Key points are summarized below. Click here to download a free copy of the complete article.

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Currently, the federal government and states share in all costs associated with running the Medicaid program. Read more