Health Care Compliance and Operations
Matthew counsels hospitals, provider-sponsored plans, population health companies and other industry stakeholders on regulatory matters associated with Medicare Advantage plans, the Medicare Shared Savings Program (MSSP), the BPCI-Advanced Model, and other CMS and CMMI payment models and demonstrations. He advises clients on the intricacies of participating in multiple Alternate Payment Models (APMs) and MIPS under the Quality Payment Program. Matthew assists health systems in developing integrated delivery systems, payor contracting strategies and shared-risk arrangements with vendors.
- Represents a large community hospital in creating an integrated delivery system and implementing managed care contracting strategy
- Advised a multi-hospital health system in establishing a shared risk arrangement and co-branded insurance product with a large national payor
- Advised a regional health network in establishing a shared risk arrangement with a state funded employee benefit plan
- Assisted large integrated delivery system in creating regional ACO with community-based providers for participation in the Medicare Shared Savings Program
- Advised national population management company on multi-state regulatory requirements pertaining to population management activities, e.g., utilization management, telemedicine, TPAs, benefit carve-outs
Matthew is a competitive sailor.