Closer ties with physicians skirt safe harbors fears.
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The idea of physicians and hospitals banding together to contract with employers isn't new. These providers have formed direct contracting organizations, and a variety of complex models have been devised, many taking the form of business corporations and limited partnerships. Sometimes they're necessary, but a lower-cost, simple organization might be just the answer to a changing payer environment.
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Voluntary hospitals face new scrutiny over the old benefit of tax exemption. With the standards becoming murkier, not-for-profit institutions wonder where they stand.
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Increasingly, services traditionally provided to inpatients are moving to the outpatient setting, resulting in greater antitrust risk. Antitrust issues are most likely to arise when a hospital with a large share of the inpatient market attempts to increase outpatient volume by restricting their patients' choices of outpatient providers, or when providers who control scarce outpatient resources attempt to restrict competition by denying other providers access to a facility. This trend has affected physicians both as competitors of hospitals in the outpatient services market and as participants with hospitals in ventures for the provision of outpatient care.
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