Healthcare Industry Transformation Drives Need for a Place at the Regulatory Table

June 29, 2018

The past decade has seen a radical reimagining of the health care industry in New York and around the nation—a transformation that has already reinvented the way hospitals, physicians, and nursing homes serve their patients and are paid for their services.

Twelve years after the final report of the New York State Commission on Health Care Facilities in the 21st Century (commonly known as the Berger Commission), and eight years after passage of the Affordable Care Act (commonly known as Obamacare), that revolution has yet to subside. Rather, it has taken on new energy and focus that will change the way services are provided and is fundamentally changing the way smart law firms tackle transactional and regulatory health care matters. “While the Berger Commission closed and downsized hospitals, and Obamacare shrank the rolls of the uninsured, the most lasting impacts may be felt by federal and state reforms, including Governor Cuomo’s Medicaid Redesign Team (MRT), which continue to move New York’s Medicaid program—the largest in the nation—away from a fee for service model,” explained Mark Ustin, former General Counsel to the Berger Commission and now a partner in Farrell Fritz’ Albany office. “In its wake, a healthier patient focused, value-based payment infrastructure is being put in place. Affordable Care Organizations, Health Homes, and the Delivery System Reform Incentive Payment (DSRIP) Program are all elements of a fundamental restructuring of how services are provided, particularly to vulnerable populations, including the poor, senior citizens, people with developmental disabilities, the mentally ill, people with substance use disorders, the physically disabled, etc.”

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Reprinted with permission from Long Island Business News, May 25-31, 2018 issue.

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