The Future of Healthcare: Direct Contracting Between Healthcare Providers and Self-lnsured Employers

New Jersey Lawyer April 2016

Gary W. Herschman, Anjana D. Patel, and Adam C. Solander, Members of the Firm in the Health Care and Life Sciences and Litigation practices, in firm’s the Newark, New York, and Washington, DC, offices, authored an article in New Jersey Lawyer, titled “The Future of Healthcare: Direct Contracting Between Healthcare Providers and Self-lnsured Employers.”

Following is an excerpt:

There is no doubt that the Affordable Care Act (ACA) ushered in dramatic changes to the way employers provide health benefits to employees. Historically, the provision of benefits to employees was voluntary and employers enjoyed great flexibility in the benefits they chose to provide to their employees, while having no constraints on the cost of those benefits. The ACA, for the most part, ended the provision of voluntary benefits through the employer mandate and, at the same time, regulates both the coverages that must be provided through the market reform provisions and also the cost of employer-sponsored plans through the so-called 'Cadillac tax.' This paradigm shift has left employers looking for ways to provide a high-performing benefit package that meets the ACI's requirements without escalating costs to the point of penalization.