Beautyman Associates, P.C.

PHOs and Other Integrated Delivery Systems

 

 

 

Attorneys and consultants at Beautyman Alvstad, LLP have participated in developing some of the first PHOs in the country, as far back as the 1970's.

We currently serve as the administrative headquarters for a number of hospital-physician networks and market their services to managed care plans and employers.

 

Antitrust

Beautyman Alvstad, LLP has been working with the Federal Trade Commission (FTC) to loosen the restrictions on provider networks and integrated delivery systems.

The FTC has asked for our guidance in articulating the antitrust relief needed for providers. Please let us know if you have any antitrust situations which, on a no-name basis, merit communicating to the FTC. We can, if you would like, use the provided situations to press for relief.

The current federal regulatory environment seems slightly more inclined to counteract the bargaining power of HMOs.

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State Regulation

States are beginning to regulate intermediary entities, like PHOs, that sign risk contracts with HMOs. We have compiled an assessment of both the promulgated and proposed regulations in each state. In Pennsylvania, for example, Statements of Policy published by the Departments of Health and Insurance are regulating PHOs and other IDSs through HMOs. These regulations would, in effect, make HMOs an enforcement arm of the state, adversely impact the independence and bargaining power of PHOs and IDSs, and potentially compromise the confidentiality of information that PHOs and IDSs should keep secret for business and antitrust reasons.

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