Managed Care and Insurance

Health care costs and reimbursement rates are inversely related.
We strictly stand behind healthcare providers though our industry’s evolution.

With costs of care rising and reimbursement rates falling, providers are challenged more than ever.

This strain can impact their relationship with all types of third-party payors, especially those in the commercial managed care area. Our attorneys provide key technical advice to health care providers and managed care organizations with operational and regulatory issues. We represent health care systems in their efforts to integrate both financially and clinically in their markets.

Managed care has undergone significant changes over the past three decades. Many of the changes in health law parallel the evolution of managed care. We provide complete legal support for providers in these intertwined and ever more complex areas.

Herrin Health Law, P.C. does not and will not represent commercial health insurance payors.


Services we offer our clients include:

  • Providing guidance in connection with strategic initiatives on creating more integrated delivery systems
  • Helping providers and provider networks investigate and implement population health management strategies, including those involving behavioral health and uncompensated care
  • Structuring and negotiating joint ventures and agreements with a variety of third parties, including other health care providers, administrative service providers, and other vendors, to create integrated delivery systems
  • Developing new and innovative payment structures with managed care payors
  • Representing managed care and other organizations in licensure applications
  • Developing and operationalizing accountable care organizations (ACOs) both inside and outside of the Medicare Shared Savings Program (MSSP)
  • Providing strategic advice and legal assistance in connection with the development of managed care organizations and contracts with managed care organizations
  • Representing clients in managed care contract negotiations
  • Drafting medical group services contracts, network agreements, and employment arrangements for managed care organizations

Herrin Health Law, P.C. provides the information on this website as a service to the public. Although the information on this site deals with legal issues, it does not constitute legal advice. If you have specific questions related to information available on this site, you are encouraged to consult an attorney who can investigate the particular circumstances of your situation.

Due to the rapidly changing nature of the law and our reliance on information provided by outside sources, Herrin Health Law, P.C. does not warranty or guarantee the accuracy or availability of the content on this site or on other sites to which we link.

Please note that Herrin Health Law, P.C. does not provide legal advice on real estate purchase and sale transactions, bankruptcy or collection matters, workers' compensation, personal injury, Social Security benefits, or similar areas of law. We are happy to refer you to other counsel for representation in these areas.