Breaking Barriers: Legal Perspectives on Integrating Primary and Specialty Care in Value-Based Arrangements

Fort Lauderdale, FL — November 2, 2023 — Nelson Mullins, a leading law firm, recently concluded its 2023 Value-Based Care Conference: Implementing Value-Based Strategies, focusing on practical implementation of Value-Based Care (VBC) strategies and arrangements. Among other things, the event brought together legal and policy professionals to delve into the intricacies of integrating primary and specialty care in VBC arrangements. Enlace Health proudly sponsored the Nelson Mullins Conference, and its Chief Legal Counsel, Robert Ball, participated as a panelist, contributing insights on Integrating Specialty Care and Primary Care in Value-Based Arrangements.

Key Insights:

  1. Data is Key: The importance of analyzing and understanding data in the VBC ecosystem was stressed, emphasizing its role in structuring VBC arrangements and achieving successful outcomes.
  2. PCP and Specialty Provider Integration: Recognizing the need for integration, speakers underscored the urgency for primary care and specialists to work collaboratively across the VBC spectrum.
  3. Focus on Specialty Care: With a growing awareness that the majority of spending is in specialty care, the conference emphasized the need for primary and specialty care coordination.
  4. Legal and Compliance Framework: The conference addressed the legal challenges involved in contractual arrangements between primary and specialty care, particularly in government-sponsored plans (Medicare/Medicaid/MSSP/ACO Reach).

The conference tackled the regulatory and compliance challenges associated with value-based arrangements, focusing on the importance of Stark Law exceptions and Anti-Kickback Law safe harbors. Legal experts highlighted the benefits of using a value-based enterprise as a strategy to navigate these challenges, particularly in government-sponsored plans.

The 2023 Value-Based Care Conference by Nelson Mullins provided valuable insights into the practical implementation and operationalization of VBC strategies. As the healthcare landscape evolves, the legal and policy community plays a pivotal role in ensuring compliance and fostering collaboration for successful value-based outcomes.

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