Via Email
We received a question about orthopedics specialty capitation from a reader.
Our thoughts on merging with another practice for contracting advantage… We received this email about orthopedics specialty capitation from a reader. An HMO approached our group about providing specialty services on a capitated basis. We then learned that another orthopedic group, affiliated with a different hospital, has been approached by another HMO for the same purpose. We are considering a merger for the purpose of managed care contracting. Is there a down side? Where can we get good advice?
Dear Reader:
Any merger of physician groups has potential legal and business pitfalls. An attorney skilled in healthcare antitrust can advise you about the potential antitrust and compliance problems and can help you to determine which models may best be suited to your group. An experienced healthcare business consultant can analyze the market feasibility and financial implications of the merger and advise you on whether the merger will provide the leverage necessary within the constraints set by the attorney, to make it profitable. In most cases, a generalist attorney should not be doing the market analysis, and the consultant should not be doing the legal analysis. The exception is when the attorney has additional training, education and experience in healthcare business administration.
