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Five Questions with a Health Lawyer: Nicholas Alarif
Nicholas Alarif
Office: Washington, DC
Years at Firm: 3
What is your favorite part about practicing healthcare law at McDermott?
I hate to sound like a broken record, but the best part about practicing at McDermott is the innovative and collaborative culture. I have found that McDermott fosters a team-based approach to solving client issues. The opportunity to interact with experts in so many disciplines and sub-disciplines to achieve common goals for our clients has been fantastic. Further, I have found that my colleagues are open to new approaches to tackle client issues and are always happy to streamline internal processes. Innovation is not what you typically think of in a law firm environment, and McDermott’s embrace of change makes for an exciting and fun place to practice.
What is the biggest opportunity and greatest challenge facing clients in your area of focus today?
The biggest opportunity and greatest challenge may actually be the same—a shifting regulatory landscape. For instance, the Centers for Medicare and Medicaid Services and the Office of Inspector General recently published proposed revisions to the physician self-referral law (Stark Law) and the Anti-Kickback Statute (AKS) regulations, which, among other things, are attempting to foster transitions from fee-for-service medicine to value-based care. These proposed changes will potentially allow providers broader flexibility when engaging in financial relationships with a value-based goal. The proposed changes present the industry with many new opportunities to participate in novel compensation arrangements with providers. However, these proposed changes come with a degree of uncertainty regarding what is in and out of bounds. That is to say, what type of value-based arrangements will squarely satisfy a Stark Law exception or AKS safe-harbor and which arrangements may subject a provider to material compliance risks? These types of questions often emerge with a shifting regulatory paradigm, and dually offer stakeholders with both risk and reward.
What kind of client work gets you most excited when it comes across your desk?
Five Questions with a Health Lawyer: Matt Perreault
Matt Perreault
Office: Boston
Years at Firm: 2
What is your favorite part about practicing health care law at McDermott?
As so many of my colleagues have expressed throughout this series, my favorite part of practicing healthcare law at McDermott is being a member of a collaborative and collegial team that is advising our diverse clients on their most critical and pressing issues. Having spent much of my career in-house, I have experienced firsthand how McDermott’s approach to client service, anchored in humility, empathy and practicality, consistently delivers differentiated value and results for our clients.
What is the biggest opportunity and greatest challenge facing clients in your area of focus today?
I believe that the transition to value-based arrangements will continue to accelerate. Collaborative Transformations will proliferate and present both tremendous opportunities for, and challenges to, traditional healthcare providers. Hospitals, health systems and other providers who embrace the challenges and opportunities presented by this paradigm shift will reap the benefits of their investments. Those who resist this cultural change risk losing ground and market share to their competitors.
What kind of client work gets you most excited when it comes across your desk?
2019 Hospital and Health Systems Year in Review
Hospitals and health systems are facing consumer demand for innovation, the need to expand and enhance streams of revenue and the push for improved quality, all while navigating changing regulations, federal enforcement, antitrust litigation and business pressures. 2019 saw hospitals and health systems navigate these challenges and more, with valuable lessons for 2020.
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Five Questions with a Health Lawyer: Joe Parise
Joe Parise
Partner
Office: Boston
Years at Firm: 6
What is your favorite part about practicing healthcare law at McDermott?
In short: the people. I have always had a cross-office practice, and as a result have been lucky enough to work with many different attorneys within the Health practice group. I am constantly impressed by the depth and breadth of experience that the group offers, as well as the creativity and thoughtful approach that our attorneys bring to tricky client issues. Being surrounded by talented attorneys (from the senior partner to the junior associate ranks) makes me want to “raise my game” and, I think, brings out the best in each of us.
In addition to the professional qualities, I am grateful for the fact that our attorneys bring a positive attitude each and every day, and create an enjoyable working environment. I have made some great personal connections over the years, and consider many of my colleagues to be good friends.
What is the biggest opportunity and greatest challenge facing clients in your area of focus today?
For the most part, I work with healthcare services providers and those that invest in such providers. I think the biggest opportunity for my clients relates to innovation in healthcare services delivery. Embracing new technologies (including those related to telehealth), optimizing the collection and use of data – these are the tools that will allow providers to improve outcomes and reduce costs of care.
From my perspective, the biggest challenge for healthcare provider clients (and those clients that invest in the healthcare services industry) will be continuing to manage the transition to value-based care. The cost of healthcare in the US has been, and will continue to be, a hot topic for political and economic discussion. The movement away from traditional fee-for-service reimbursement, and towards a model that is based on value and outcomes, is one about which all providers must be thinking carefully.
What kind of client work gets you most excited when it comes across your desk?
Five Questions with a Health Lawyer: Larry Guess
Larry Guess
Partner
Office: Chicago
Years at the Firm: 6 years
What is your favorite part about practicing healthcare law at McDermott?
My favorite part of practicing healthcare law at McDermott is the complexity of our client matters and working with my colleagues to get great results for our clients. The healthcare industry is constantly changing and innovating, and our clients engage us to help them adapt to these changes and maximize innovation in the space.
What is the biggest opportunity and greatest challenge facing clients in your area of focus today?
The biggest opportunity facing our clients is the bullish investment perspective in the healthcare industry. Currently, there are buyers with a tremendous amount of capital to deploy and sellers looking to maximize current market conditions. The healthcare transactional climate is very dynamic and certain clients are willing to invest in more risky assets. While the payoff can be substantial, the speed and complexity of these transactions can be very challenging for clients. McDermott’s healthcare group excels in delivering value to our clients by managing the speed of transactions while navigating complex regulatory regimes, enabling our clients to understand the risk associated with a particular investment and opportunities to maximize returns.
What kind of client work gets you most excited when it comes across your desk?
Five Questions with a Health Lawyer: Jeremy Earl
Jeremy Earl
Partner
Office: Washington, DC
Years at the Firm: 10
What is your favorite part about practicing healthcare law at McDermott?
My favorite part about practicing at McDermott is the challenging and constantly evolving nature of the work. Our clients put trust in us to advise them on their toughest legal questions and business challenges. I don’t take that trust lightly and it is exciting to come to work every day to meet and exceed the high expectations clients rightly have for us.
What is the biggest opportunity and greatest challenge facing clients in your area of focus today?
I represent managed care companies, which has traditionally meant health insurers and health maintenance organizations (HMOs). Due to legislative and competitive factors, healthcare financing and delivery is rapidly evolving and new models are being introduced to compete with traditional health insurers and HMOs. In 2012, Ezekiel Emanuel and Jeffrey Liebman boldly predicted in the New York Times that “[b]y 2020, the American health insurance industry will be extinct” and replaced by ACOs. That this has not happened is, at least in part, due to innovation by health insurers through such efforts as expanding value-based payment models.
At the same time, the traditional roles of providers and health insurers are blurring and providers and risk-bearing intermediaries are introducing innovative ways to finance healthcare delivery that compete with health insurers. While this has increased competitive pressures on managed care companies, I am excited to support companies who are driving this innovation.
What kind of client work gets you most excited when it comes across your desk?
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How to Engage in Constructive Disruption
The healthcare industry is facing significant disruption from new market entrants and technology innovations that have the potential to improve how healthcare is delivered. But how do you tell which innovative technologies and ventures will have a sustained and positive impact, and which are just noise? In this episode of the Collaborative Transformation podcast series,
Five Questions with a Health Lawyer: Marshall E. Jackson, Jr.
Marshall E. Jackson, Jr.
Associate
Office: Washington, DC
Year at Firm: 4
What is your favorite part about practicing healthcare law at McDermott?
My favorite part of practicing healthcare law at McDermott is working with clients that are out in front tackling very interesting and unique issues. The healthcare industry continues to evolve, and our clients are at the forefront. The changes in the industry have required clients to navigate areas of uncertainty, and our clients look to us to help them navigate that uncertainty. I have been blessed to sit shoulder to shoulder with a dynamic McDermott team helping our clients tackle new and unprecedented issues. No day is a dull day.
What is the biggest opportunity and greatest challenge facing clients in your area of focus today?
Many of our clients face the challenge of balancing the need to deliver affordable, quality healthcare to people when and where they need it, while maximizing return on investment for their business within a hot healthcare market. While one side seems provider-centered and the other investor-centered, providers and investors alike grapple with this balancing act. In addressing this balance in the context of an ever-changing industry, our clients are seizing opportunities to embrace new ways to deliver healthcare, and forming strategic partnerships and collaborations to strike the balance. We are increasingly seeing the industry embrace the use of digital heath technologies to allow providers to reach patients and address growing healthcare concerns. We are also seeing providers, payors, retailers, tech companies, and investors collaborating in new ways to spearhead innovation within the industry. It has been great to work with clients to address this challenge through innovative approaches.
Podcast: Collaboration Through Innovation Centers
Healthcare is facing a time of transformation as regulators, providers and other stakeholders take action to improve care coordination and increase the use of technology to deliver care. Hospital and health system innovation centers are increasingly acting as the catalyst to fuel growth and expansion through technology and data. In this episode of the Collaborative