It’s the industry disruptors, the unusual partnerships, and the cross-border and cross-sector relationships that are driving Collaborative Transformation in the health care and life sciences organizations. But a Collaborative Transformation takes more than signing paperwork and shaking hands. A successful Collaborative Transformation takes cultural integration between non-traditional partners, incorporating new technologies into health care regulatory compliance structures, and so much more. At McDermott, we’ve recently had the opportunity to help our clients pursue their own Collaborative Transformations, and are proud to showcase their achievements.

Innate Pharma Expands its Collaboration with AstraZeneca

McDermott Will & Emery advised Innate Pharma, a French oncology-focused biotech company, in signing a multi-term agreement with AstraZeneca and MedImmune – AstraZeneca’s global biologics research and development arm. This agreement broadens the existing collaboration, aimed at accelerating the development of an oncology portfolio of each of the parties and to provide patients with more rapid access to new therapeutic options. This extended collaboration will permit Innate Pharma to develop and commercially strengthen its investment ability to develop its immuno-oncology portfolio (IO) and its R&D platform. For its part, AstraZeneca will enrich its IO portfolio with new clinical and preclinical programs. For more information on this collaboration, click here.

CVS + Aetna

McDermott is one of the firms that has advised CVS Health in connection with its $69 billion purchase of Aetna. The transaction, one of this year’s largest M&A deals, is expected to transform the US health care sector. For more information on this collaboration, click here.

Continue Reading Pursuing Progress: Collaborative Transformation in Action

For biotechs, success involves a several year hike through mazes of complex, cross-border, business, scientific, financial and regulatory issues. During this year’s BIO2018 conference in Boston, McDermott gathered a panel of industry leaders and McDermott practitioners and led a case study assessment of cross-border biotech M&A, linking life sciences hubs in Europe, Asia and North America. I had the opportunity to moderate our panel as we walked through the structuring and closing of an M&A transaction that involved the auction of a fictional US biotech company that has oncology platform IP/technology. While the company described in the case study was fictional as such, the company and its circumstances were a composite of McDermott’s actual deals.

Our panel’s examination of this case study yielded valuable insights into the context, cross-border dynamics, practicalities, opportunities and challenges underlying the growing volume of international life sciences M&A deals. For example, here are six takeaways.

  • Take a good look in the mirror. First, differentiate between your company’s wants vs. its needs, said Greg Benning, managing director and head of financial advisory at Back Bay Life Sciences Advisors. Review your company’s access to resources, particularly its near term funding, to make sure you can accomplish your development objectives regardless of whether your M&A aspirations are achieved. Next, conduct an in-depth analysis of the company’s platform and its asset portfolio, and assess how third parties will view it. This process should yield a realistic assessment of actionable alternatives. “Having defined the playing field, we can start to look at the position of different alternatives more objectively and clearly,” Greg said.
  • Map out your IP strategy early. Your IP strategy must be optimized from the very beginning, said McDermott partner Kristina Bieker-Brady. Do not wait to do this until you suddenly wish to market the company or to raise funding. And don’t be too enamored of broadly scoped patents–narrowly designed patents may generate more defensible and credible IP, and in the case of platform IP, can result in a discrete, valuable assets that you can sell and/or commercialize (and use to prosecute infringers) without jeopardizing your company’s core platform. You then optimize your ability to structure for optionality in your future–preserving the luxurious ability to postpone to the future the decision of whether it is best to sell your whole company all at once, or perhaps to sell/outlicense your IP on an asset by asset basis?McDermott partner Linda Ji also recommended that a US company’s early patent strategy should include China. This enables the US company to make the most of opportunities to sell or outlicense to Chinese life sciences investors and companies, which will not be as interested in an IP asset that lacks IP protection in China. Remember that China’s middle class market alone is roughly equal to the size of the entire USA.
  • Prepare to jump through extra hoops for overseas buyers.Investment and acquisition activity in the United States by EU and Chinese companies continues to increase year over year,” I noted. But before Chinese investors can execute international transactions in the US, they must secure exchange control approval from the Chinese government, which can take several months. Also, on the US side, EU, Chinese and other foreign buyers and investors transactions will often need approval from the Committee on Foreign Investment in the United States (CFIUS). Recently, the US government has taken a broader view of what types of transactions implicate “national security,” and there are reasons to expect dramatic expansion of the CFIUS rules. In particular, we believe that biotechnology itself will be regarded as one of the industries in which investment and acquisition will require approval. This could affect both M&A activity and also venture capital and private equity investments. In response to such examples of China and USA government regulation of deal-making, transaction parties might start to explore various risk mitigation measures, for example, a reverse break-up fee payable by the party that cannot obtain the government approval; or multi-staged closings of investment deals to permit some investors to close before other investors; or dual-level investor rights so that some investors have greater rights than certain other investors. And, it would be interesting to determine if the commercial appetite for representation and warranty insurance might also begin to extent to similar insurance be obtained to cover risks from exchange control or CFIUS non-approval.
  • Parallel processing–aka, keeping options on the table. Most companies will prepare themselves for parallel paths to maximize value, be it another private financing, an IPO or an M&A deal. Even if short-term gain via M&A is a goal, preparing an S-1 for a prospectus to go public can serve as leverage to maximize private M&A bids. “The more options you can keep on the table longer, the more likely you are to have an outcome that you like,” said Henry Skinner, senior vice president at Tekla Capital Management.
  • Early on, avoid the back-to-school blues. If at all possible, when a company is in its early stages of building its IP portfolio, it should avoid or amend in-licenses that grant a university or scientific institute the authority to approve all transactions (such as M&A deals). Such a license undesirably “shifts most of the leverage to the university,” said Michael Mano, lead counsel, business development, at Biogen, Inc. Also, he counsels against university licenses that contain poorly drafted exclusivity provisions that saddle a potential buyer with non-commercial restrictions that–though sensible for a really small, really young biotech–make no sense for a large pharmaceutical company bidder. For example, if a potential buyer has a competing program that runs afoul of that exclusivity, your M&A deal could face significant structuring and risk-allocation headaches before it can close.
  • Don’t let your know-how walk out the door. Patents don’t leave a company, but people do, and they take their valuable know-how with them. Retaining valuable people requires being sensitive to cultural differences among staff, and also requires appropriately structured incentives, said Jeff Lu, co-founder and CEO of Engine Biosciences. A biotech company’s management can play a key role in aligning the employees’ equity incentives with the selling investors’ interests.

In a new Governing Health vidcast, McDermott partner Michael Peregrine breaks down why you may need to revamp your conflicts of interest procedures, and how the general counsel and the compliance officer can work together to protect the health system from conflicts-related risks.

Many health systems’ conflict of interest policies and protocols haven’t been updated since the 1990s. While these approaches—based on duty of loyalty and simple concepts of financial interests—may have fit the bill in the past, today’s rapidly shifting environment poses new governance-related challenges that have direct implications for the process by which conflicts of interest are identified, disclosed and addressed. These challenges include:

  • Diversification of health system portfolios, featuring investments in a broadening scope of products, services and enterprises, particularly in the case of innovative technology and delivery of care platforms
  • Growing officer and director interest in investing alongside their health system
  • Swift consolidation of the inpatient health care provider market and increasing ambiguity in identifying competitors
  • Sharpening focus on material bias arising from personal relationships (intra-board or external)
  • Non-traditional market participants, including high-tech market disrupters and powerful new organizations formed by vertical or horizontal combination
  • State regulators’ attention and reaction to media reports regarding high-profile instances of conflicts of interest
  • The presence of constituent directors on corporate and joint venture boards
  • New case law focusing on how personal interests may affect leadership decisions

Continue Reading Addressing Conflicts of Interest: It’s a Whole New Ballgame

At a time when health care organizations are facing greater financial and reputational costs than ever before, more than 150 health care industry leaders, legal and compliance executives, and investors gathered for McDermott’s Health Care Litigation, Compliance & Investigations Forum at the Ritz-Carlton in Chicago to discuss strategies for proactively managing and effectively responding to compliance risks, investigations and litigation.

Sylvia Mathews Burwell, Secretary of Health and Human Services from 2014 to 2017, delivers the keynote presentation.

The event covered a wide range of issues, including fraud and abuse (such as False Claims Act and Stark Law matters), governance, cybersecurity, antitrust, white-collar, intellectual property, products liability and tax-exemption disputes. The event also featured a keynote address by Sylvia Mathews Burwell, Secretary of Health and Human Services from 2014 to 2017, on the foundations of the Affordable Care Act (ACA), the ramifications of the elimination of the individual mandate and the ACA’s prospects going forward.

If your organization needs support in current litigation or wants to ensure best practices to help avoid one, we’re here to help.

Below are key insights from the sessions:

Every Day’s Adventure: How Leading GCs Are Thinking about Compliance and Enforcement

  • Collaboration between the general counsel and the compliance officer provides a proactive and team-oriented approach to substantive legal and policy issues.
  • Keys to effective collaboration include communication, coordination and a culture of sharing, coupled with respect for the independence of the compliance/audit function.
  • Transparency is key; bad news is OK, but surprises are not. Stay closely engaged with the board and internal audit team. Of audience members surveyed, 40 percent brief their board on legal or compliance matters about once a quarter, and 47 percent do so every board meeting.
  • Preventative compliance measures involve a formal enterprise risk management plan and proactive two-way communication with line teams regarding trends and solutions.
Attendees share their thoughts on the biggest practical takeaway that has emerged from Escobar.

Trendspotting: Government Enforcement 2020

  • Cooperation and individual accountability will remain government priorities in enforcement efforts and settlements with companies.
  • Government investment will continue to center on the opioid crisis and Anti-Kickback Statute/False Claims Act enforcement. The Granston and Brand Memoranda are unlikely to curtail the latter.
  • For an in-depth discussion of these issues and other recent developments, see McDermott’s Health Care Enforcement Quarterly Roundup Q3.

Avoiding Dante’s Inferno: Dealing with Physician Disputes

  • During a physician practice management organization acquisition, transparency and education regarding the transaction and integration process help prevent physician disputes down the road. Be clear regarding the goals of, and rationale for, the transaction. Effective integration is the most important factor for success in a transaction with physicians, according to 56 percent of audience respondents.
  • Internal physician champions foster cooperation; seek buy-in by demonstrating how the integration will advance quality of care.
  • Align incentives and economics to keep physician and company goals consistent.

    Attendees share what they consider to be their biggest digital health compliance threat.

Managing Compliance and Data Privacy in 2018: From Human Error to Artificial Intelligence

  • Creating a culture of compliance is critical for managing risk, but doing so is increasingly challenging for organizations seeking to innovate within health care and apply expertise and ideas from other fields.
  • Compliance and legal, while serving separate purposes, are inextricably intertwined. Align these functions thoughtfully to ensure optimal performance and clarify the relationship between the compliance officer and the general counsel.
  • Artificial intelligence (AI) offers powerful tools not only for health care delivery but also for managing an organization’s compliance risks. Currently, 20 percent of audience respondents use AI to identify or investigate compliance issues. Like any tool, AI must be thoughtfully leveraged. Establish rigorous processes to prevent human error and ensure data security.

Expecting the Unexpected in a Government Investigation: From Ambush Interviews to Unbudgeted Legal Fees

  • In responding to investigations and promoting business concerns, care must be taken to avoid even the appearance of obstructing the investigation. Be accurate and observe ethical boundaries.
  • Early credibility and candor with the government can promote collaboration on narrowing the scope and burden of response, especially regarding digital data.
  • Discourage employee speculation about the identity of the whistleblower in order to reduce the risk of retaliation claims.
Attendees share their highest communication priorities during a crisis.

Crisis Management: Weathering the Storm and Protecting Your Reputation

  • When mapping out a crisis management strategy, think “when,” not “if.” Twelve percent of audience respondents reported that their organization has no crisis response plan in place and 33 percent were unsure.
  • Even if a crisis event does not reflect on an organization’s performance, the organization’s response to the crisis often shapes public perception of its standards and quality.
  • Tone is key, as is demonstrating core values such as integrity, competence, transparency and empathy. An effective crisis response shows care for victims, promises a thorough investigation and implements speedy corrective actions.

McDermott lawyers who presented at this event included David S. Rosenbloom, Laura McLane, Stephen W. Bernstein, Monica Wallace, Tony Maida, Amy Hooper Kearbey, Amandeep S. Sidhu, and Paul M. Thompson.

The latest episode of the Governing Health podcast gets back to basics: the board’s responsibility for monitoring the impact of key economic trends and indicators. McDermott partner Michael Peregrine welcomes special guest John Challenger, CEO of executive outplacement firm Challenger, Gray & Christmas, who recently appeared on the Today Show and is one of the foremost thought leaders on the US economy and workforce. Together, John and Michael delve into today’s top economic issues and their significance for health system board governance.

Today’s “million dollar question:” How long is the economy expected to grow, and when should the finance committee look for signs of a recession?

Like canaries in a coal mine, the early warning signs of a slow-down are already present—if you know where to look. The current job creation statistics and record low unemployment numbers signal a tight job market for skilled workers. Companies may start to put expansion plans on hold for fear of being unable to recruit enough skilled workers to staff new plants or operations. “You can’t get to this full of an employment situation without the risks of a recession starting to grow,” John said. “Two years from now, it seems inevitable we’re going to be in some kind of recession.”

What are the governance ramifications of the most recent unemployment and job creation statistics?

Despite low unemployment and competition for skilled workers, wages are not going up. The board should engage with HR executives and recruiters to analyze how best to allocate capital toward growth-oriented plans. Retention of high-performing and high-skilled employees should be at the top of the board’s agenda. “Look at your talent inside your organization and understand who your key leaders are—the people you need most to stay at the organization and not be recruited away,” John said. “Fighting to keep them and making sure there are plans in place to hold them is really critical, because replacing them means you have to find new people with those same skills.” Even if you can find the right skillset in this tight job market, the new hires will not have the corporate memory or know-how that makes your current employees so valuable, he said.

Recent employment statistics also indicate that ambulatory jobs are at the forefront of job creation in the health sector. “This suggests that we’re beginning to see direct manifestations of health systems moving their focus to ambulatory care and away from the inpatient facility,” Michael said.

Does John Flannery’s departure from GE after just over a year as CEO indicate a new phase of “short termism” in board oversight of the CEO?

More than 150 CEOs were discharged in September 2018, a sharp uptick from the previous month. “That may be an anomalous situation, but it’s interesting that it happened at the same time that John Flannery left GE,” John said. “Usually when you see CEOs leave within less than a year, or just over a year in this case, there are communication problems inside the board and the C-suite. There was a sense from the news reports that the board expected much quicker decisive action on the new CEO’s part that wasn’t being taken.”

Today’s boards are quick to act in response to perceived CEO performance issues. If an organization’s share price is dropping, it often means that the CEO’s days are numbered, John said. To combat potential communication problems, a close relationship between the board and the CEO in his or her first year—and particularly the first 100 days—is helpful. “Alignment in terms of what’s expected and what the objectives are is crucial,” John said. “It shouldn’t be the kind of situation where the CEO is acting on his or her own with a board that’s not engaged in the strategic decisions being made.”

How much longer will the current trend of “older CEOs keeping their jobs longer” continue?

Recent statistics suggest that boards are more willing to retain senior CEOs longer than they did previously. This is likely due to the economy, John said. Because so many companies are posting excellent results, there is no immediate impetus to move a long-tenured CEO out.

What are the broader implications of recent “organizational justice” developments, such as Amazon’s decision to raise wages?

“It’s always the most successful companies that can make these kinds of decisions,” John said. “Sometimes they lead the way and others follow.” Because Amazon is a market leader, the real question is whether less successful competitors will be able to follow suit. That will determine whether Amazon’s minimum wage increase is the beginning of a broader trend.

In a similar development, Harvard University (John’s alma mater) recently increased its employee wages as a means of corporate social responsibility. In John’s view, the move was an ethical rather than a business decision. At the same time, the economic implications of large-scale wage increases is a significant matter that boards should monitor. “We’ve seen minimum wage laws in places like Seattle and other cities get enacted that would move wages up for people in the low-skilled or semi-skilled area of the workforce,” he said. “There’s always the question, if that were instituted on a wider basis, whether that would depress job creation, as companies could afford fewer workers. It’s an open issue and it’s going to become even more important.”

Click here to listen to the full episode.

As the health care and life sciences fields experience ever-increasing levels of disruption, diverse entities across the industry are teaming up to embrace and foster innovation. These new pairings are shaping the future of health care, as organizations come together to tackle the industry’s most pressing issues with redoubled agility and pooled resources.

In an environment of change and uncertainty, this trend of Collaborative Transformation is yielding improved financial outcomes, increased operational efficiencies, and a fresh infusion of diverse talent and perspectives—all of which result in enhanced quality of care.

This is where the McDermott Health and Life Sciences team comes in. As a top-ranked US health law practice and a leader in life sciences with decades of experience advising the leading players in US and cross-border health and life sciences, we have the skill, market insight and ingenuity to partner with you wherever your innovation takes you. Whether you are forming innovative alliances across borders and industries, creating or implementing groundbreaking technologies and services, or restructuring investments to position your organization at the cutting edge of the market, our team can work alongside yours to achieve excellence.

Click here to learn more about McDermott Health, our recent work executing collaborative transformations on behalf of our clients and how we can help your organization form innovative business relationships.

On October 10, 2018 President Trump signed two bills that ban “gag clauses” in pharmacy contracts. Congress passed the two bills—one for Medicare prescription drug plans (“Know the Lowest Price Act”) that will go into effect in January 2020, and another for commercial employer-based and individual policies (“Patient Right to Know Drug Prices Act”) effective immediately—by almost unanimous vote in September 2018.

While many states have already prohibited the use of these clauses, this is the first such action on a federal level.

Gag clauses are sometimes found in contracts between pharmacies and insurance companies, pharmacy benefit managers or group health plans and bar pharmacists from telling customers that they could save money by paying cash for their prescriptions rather than using their health insurance. If pharmacists violate the gag rule, they risk penalties and/or contract termination. Under the new legislation, pharmacists are not required to tell patients about the lower cost option, but they also cannot be contractually prohibited from engaging in the cost conversation.

The legislation is consistent with the position of the Centers for Medicare & Medicaid Services (CMS), which, in May of this year, issued guidance stating that “gag clauses” are unacceptable in the Medicare Part D program.

It has now been one month since the US Department of Health and Human Services (HHS) Office of the National Coordinator for Health Information Technology (ONC) sent its proposed information blocking rule to the Office of Management and Budget (OMB) for required review.

We expect OMB to approve the much-anticipated proposed rule and ONC to release it soon with the usual opportunity for public comment. While we wait, there are some things that health information technology developers, health information exchanges, health information networks and health care providers who may be subject to the information blocking prohibition and enforcement actions can do to prepare for the upcoming comment period. But before we get to comments, let’s remind ourselves about how we got to this point.

By way of background, Congress asked ONC to produce a report describing the extent of information blocking and a strategy to address it. ONC submitted that report to Congress in 2015 (the 2015 Report) noting, among other things, enforcement authority gaps and indicating that successful information blocking prevention strategies would likely require congressional intervention. In the 21st Century Cures Act, which became law in 2016, Congress granted the HHS Office of Inspector General investigative and enforcement authorities for prohibited information blocking conduct. The Cures Act defined information blocking as a practice that “except as required by law or specified by the Secretary…, is likely to interfere with, prevent, or materially discourage access, exchange, or use of electronic health information [(EHI)].” As part of the law, Congress tasked the Secretary of HHS with issuing rules that identify “reasonable and necessary activities” that will not be considered prohibited information blocking. This is one purpose of ONC’s proposed rule.

At this point, we do not know precisely what kinds of activities ONC will propose to permit by carving them out of the broad information blocking prohibition. However, from the Cures Act we do know the types of practices Congress believed “may” be information blocking, namely:

  • restricting authorized access, exchange and use of EHI for treatment and other permitted purposes, and
  • implementing technology in ways that are:
    • nonstandard and likely to substantially increase the burden or complexity of access, exchange and use of EHI;
    • likely to impede EHI with respect to exporting complete information sets and in transitioning between health IT systems; or
    • likely to lead to fraud, waste and abuse, or impede innovation and advancements in health information access, exchange or use.

These track closely to the types of practices ONC identified as raising information blocking concerns in the 2015 Report, which also provided a few illustrative examples, including: Continue Reading ONC Expected to Release Proposed Information Blocking Rule Soon

For physician practice management (PPM) organizations going through an acquisition processes – whether by a physician group or a private equity firm – one idea should remain top-of-mind: integration must start before the closing.

The Harvard Business Review states that 70 to 90 percent of acquisitions fail because of integration issues, noting that “companies that focus on what they are going to get from an acquisition are less likely to succeed than those that focus on what they have to give it.”

Working toward a smooth transition for employees from day one will not only help boost morale, but also contribute to the value-add of your PPM. With that in mind, below are four key considerations to help implement an efficient and effective integration strategy, ensuring a seamless transition before, during and after the deal is done:

  1. Put Your People First – As we explored during our annual PPM/ASC Symposium back in March, the first step and greatest challenge in practice integration is ensuring cultural compatibility. For practices with workers that have different working styles and expectations, merging could cause friction points and potential turnover for those dissatisfied with the new conditions. Ensuring systems are in place for immediate employee inclusion is critical. This can begin with something as simple as including them in all-staff communications and keeping them up to date of what’s happening at the company. Feedback systems where merging workforces can share their insights and recommendations can also help employees feel heard and appreciated.
  2. Ensure Revenue Systems Are in Place – Financial processing is a complex but necessary step that absolutely needs to be in place before merging. For provider compensation, those involved in these transitions should work to achieve consistency of models, parity, visibility and accuracy from day one. There should also be a clear and consistent model for revenue recognition, with the revenue cycle maintaining performance during the transition process. Consistent pre- and post-close reporting, as well as management of financial performance and KPIs, are also necessary boxes to check in advance of the merger.
  3. Infrastructure is Critical – Protocols need to be in place on a systemic level for structural/contractual integration. That includes addressing IT connectivity and network interface requirements, vendor contracts and procurement, and real estate leases and facilities. These make up the workplace framework, and while they can be easy to overlook, ensuring infrastructure is sound and ready to go will allow employees to begin work as soon as possible.
  4. Don’t Overlook HR Systems – Another crucial aspect is to ensure that Human Resources capabilities are also integrated. Payroll and benefits systems should be up and running by the time an employee merger takes place. In order to ensure things go as smoothly as possible, it’s important to keep in mind potential speedbumps and address them well in advance. For example, section 409A of the Internal Revenue Code can impact equity structuring in certain situations, so it’s important to reference it when making key equity decisions for executives.

To stay up to speed on all of the regulatory challenges and growth opportunities in the PPM space, as well as the health and life sciences industries overall, bookmark our “Health & Life Sciences News” blog and connect with us on LinkedIn.

McDermott recently launched the second episode of its special edition podcast providing an in-depth discussion of the interplay between State Attorneys General enforcement authority and nonprofit Board of Directors responsibility in the governance and operation of health systems. This special edition of the Governing Health podcast series welcomed four prominent State Attorneys General (AGs) to discuss the transformation of the nonprofit health care sector.

In episode two, our panelists discussed how the evolution of nonprofit health care affects business activities, including M&A, Board of Directors obligations, and state nonprofit law across the health care landscape. Here are four key takeaways:

  • Beware the dangers of “mission drift.” Mission drift occurs when a change in corporate purpose conflicts with donor intent. As large health care organizations increasingly take on all aspects of health care, they often acquire nonprofit facilities endowed with gift assets. Health systems must consider how the original donor intended for those assets to be used in the community, said Karen Gano, President of the National Association of State Charity Officials and Assistant Attorney General of Connecticut, Special Litigation Unit.
  • Keep beneficiary interests front-and-center when considering a sale or a conversion to a for-profit business model. In New York, there is a statutory requirement that any sale of charitable assets must be for fair consideration and in the best interests of charitable beneficiaries, said Jim Sheehan, Chief of the New York Attorney General’s Charities Bureau. Even if a transaction makes good business sense for the organization, Boards must ask themselves, what provisions are we making for the community served, and how does this transaction serve the nonprofit’s underlying mission? “We don’t have the authority to substitute our judgment for that of the Board, but we are obliged to ensure that the board has exercised its fiduciary duties of both loyalty and care in arriving at the decision to sell or convert,” said Mark Pacella, Chief Deputy Attorney General of Pennsylvania, Charitable Trusts and Organizations Section.
  • Retain control when engaging in a joint venture with a for-profit entity. The state AG office will examine joint ventures—whether they involve new programs or services, or the construction of a new facility—to ensure there is actual control with an emphasis on care and no excess benefits to any individual or to the for-profit partner, said Bob Carlson, Assistant Attorney General of Missouri.
  • Ensure that investment in innovative activities is objective. If the investor is the entity itself or its executives, the investment process can become politicized. “One the expectations we have is that there be a very rigorous process for assessing both initial investments and whether additional money is put in the same way [as it would be in] any other investment,” Jim said.

Click here to listen to the full podcast.

Coming Soon: Episode Three

In the final episode of this special three-part podcast series, our guests will discuss how operating activities, fiduciary duties and the class of beneficiaries are affected by the transformation of nonprofit health care.