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Successful Clinical Integration Initiatives in Physician Organizations: How to Build a FTC Compliant Program Audio Conference


Description: The FTC and Department of Justice have described a clinically integrated network as one that implements “an active and ongoing program to evaluate and modify practice patterns by the network’s physician participants and creates a high degree of interdependence and cooperation among the physicians to control costs and ensure quality.”

During the past five years there has been a significant increase in enforcement activity by the FTC in response to complaints alleging that physician networks are engaging in the suppression of price competition and utilizing structures that fail to meet FTC guidelines.

But the recent GRIPA opinion confirms that physicians that work together in an integrated, interdependent, quality improvement program is an achievable goal. Through clinical integration, organizations are able to improve the quality of care and achieve new efficiencies by evaluating and modifying the practice of medicine.

Clinical integration programs coordinate the sharing of clinical information between the community of physicians and hospitals, labs and imaging facilities through the use of new technology such as EMRs. There is great potential for improving care outcomes and reducing redundancy through the sharing of information. When physicians work together, they not only benefit their patients but also other physicians, health plans and the community as a whole.

What requirements and components are necessary for a successful FTC compliant clinical integration program? Can it lead to better reimbursement levels? And what other benefits can result from successful clinical integration initiatives?

Who Should Attend This Session

Providers, hospitals and health systems, PHO and IPA's, health plans, consultants, law firms, pharmaceutical companies, medical device manufacturers, healthcare technology companies, TPAs, PBMs, and associations with titles:

Administrator, Associate Director, CEO, President, COO, Director, Division Director, Executive Director, Manager, Medical Director, President, Senior Director Operations, Director Medical Affairs, Consultant, Vice President, Director Managed Care, Finance Director, VP Business Dev & Contracting, Marketing Research Manager,Physician Practice Management, Network Development and Provider Services Directors, Network Managers, Strategic and Implementation Consultants


Contents: Why Clinical Integration?

The Benefits of Clinical Integration

How Independent Practices Can Work Together

Key Elements a Clinical Integration Program to Be FTC Compliant

Potential Antitrust Issues and Solutions

Clinical Integration vs. Financial Integration

Best Practices for Compliant Integration

The Necessary Steps to Become Clinically Integrated

How to Secure the Necessary Physician Participation and Commitment

Other Considerations in Clinical Integration

Case Study: How Adventist Health Network recruited 600 physicians in hundreds of practices to join their PHO

Case Study: GRIPA Connect™ Clinical Integration, the second such program in the country to receive a favorable advisory opinion from the FTC

Question and Answer Session


Speakers Pam Williams, CMPE Executive Director, Adventist Health Network Gregg Coughlin, MBA, CPA President, Greater Rochester Independent Practice Association (GRIPA) Steven F Banghart Partner, Katten Muchin Rosenman LLP Phil Kamp President & CEO, Valence Health About Valence Health


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