Navigating “Downstream Risk” Arrangements

    View Author November 2017

    The October 2017 edition of the American Health Lawyers Association's (AHLA) Connections magazine features a lead article by partner Peter A. Pavarini and associate John P. Bunch, which discusses why some clinically integrated networks (CINs) and accountable care organizations (ACOs) are doubling down on the transition to value-based purchasing by entering into "downstream risk" arrangements with payers and the requirements to comply with state insurance laws.

    Despite a segment of the industry that remains skeptical, the number of fully functioning CINs and ACOs in the US has continued to grow, even in the face of Affordable Care Act "repeal and replace" efforts. The article explores the various factors motivating this growth and the impact of risk in these scenarios, as well as what providers and their counsel need to know before engaging in risk contracting.

    Copyright 2017, American Health Lawyers Association, Washington DC. Reprint permission granted.