Across the nation, aging and disability community-based organizations (CBOs) are strengthening their position as viable health care contracting partners by forming community-based integrated care networks. At the center of a network is a contracting “hub.” These hubs allow CBOs across a region, state—or even across multiple states—to respond to the preference of health care providers and payers to contract with a single source.
To help ensure aging and disability CBOs have the tools they need to successfully contract with health care entities, the Aging and Disability Business Institute has produced the Resource Guide: Model Contracts for Community-Based Integrated Care Networks containing a set of three model contracts that provide examples of ways networks can frame contractual relationships with their participating CBOs (i.e., their network), with potential managed care payers and health care providers. Also included in the Resource Guide is an annotations narrative that explains certain contract provisions and how they impact the parties’ working relationships.
Resource Guide Components
- Network-CBO Model Contract
- Network-Payer Model Contract
- Network-Provider Model Contract
- Model Contract Annotations
As you work with these documents, note that nothing contained in these documents should be construed as legal advice. Networks and CBOs are strongly encouraged to seek competent legal advice from an experienced attorney who is familiar with health care contracting and applicable laws in your jurisdiction and to use these model contracts only to facilitate deliberations as networks and CBOs evaluate their unique circumstances and structural needs.
Acknowledgments:
The Aging and Disability Business Institute acknowledges the authorship and contributions of the following consultants and their assistance with these tools.
Martie Ross, principal author, Ross is office managing principal at PYA and serves as a trusted advisor to providers navigating the ever-expanding maze of healthcare regulations. Her understanding of new payment and delivery systems and public payer initiatives is an invaluable resource for providers seeking to strategically position their organizations for the future.
Paul Cantrell, editor, Cantrell is president at Clear View Strategies, LLC and has been working with and committed to the success of Area Agencies on Aging and other community-based organizations for more than a decade. Cantrell has served as a business acumen consultant to the National Associations of Area Agencies on Aging (n4a) for more than eight years. Previously, Cantrell served as health insurance policy director for the Georgia Insurance Department, vice president of Product Development for a coalition of Georgia’s largest corporations and corporate director for a leading managed care company.