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Compliance Tips for Integrated Health Care Organizations: Coordinated Care and the Shift to Value-Based Reimbursement

This Briefing is brought to you by AHLA’s Fraud and Abuse Practice Group.
  • October 19, 2020
  • Daniel F. Murphy , Bradley Arant Boult Cummings LLP

From the early debates on the Affordable Care Act until today, the goal of transitioning from predominantly fee-for-service (FFS) health care reimbursement systems to value-based payment models has been a rare area of bipartisan consensus on health care policy.

In its 2019 proposed rules for reforming federal fraud and abuse regulations as part of the Regulatory Sprint to Coordinated Care, the Department of Health and Human Services (HHS) “identified transforming our healthcare system to one that pays for value as one of [its] top priorities”, observing that “[d]elivering better value from our healthcare system will require the transformation of established practices and enhanced collaboration among providers and other individuals and entities.”

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