Leveraging the Value-Based Exceptions to Retain Physicians and Advance Hospital Goals

• December 15, 2025

• April Kirkley , Thompson Coburn LLP

Health systems are under increasing pressure to improve quality, reduce costs, and enhance patient outcomes—all while navigating complex regulatory frameworks. Physician retention is critical to achieving these goals as physicians are instrumental in maintaining continuity in care delivery, preserving institutional knowledge, and ensuring alignment with hospital quality and cost goals. Failure to retain physicians can disrupt care coordination and undermine performance on value-based metrics, which can directly impact a hospital’s reimbursement under alternative payment models. By leveraging the Stark law value-based exceptions at 42 C.F.R. § 411.357(aa), in-house counsel can assist their clients in the hospital setting with compliantly structuring physician compensation arrangements that reward physicians for achieving the hospital’s quality and cost objectives.

ARTICLE TAGS

• In-House Counsel Practice Group
• Fraud and Compliance