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Risk Contracting for
Telehealth Providers
VSee 2018
Morgan Tilleman
THERE IS RISK IN RISK CONTRACTING
1
WHERE IS THE RISK
Customers
• Individuals
• Associations or Groups
• Self-funded Benefit Plans
• NOT an insurer or HMO
Payment Structures
• Capitation
• Extreme Discounts
• Unlimited Consultations
• Downside risk in any form
MITIGATE YOUR RISK
Contract with insurers, HMOs and government
-OR-
Structure contracts correctly
TIPS FOR CONTRACT STRUCTURING
• Limits on utilization by every individual
• Reasonable volume discounts
• Shared savings
• Cover your costs in worst-case scenarios
ATTORNEY ADVERTISEMENT. The contents of this document, current at the date of publication,
are for reference purposes only and do not constitute legal advice. Where previous cases are
included, prior results do not guarantee a similar outcome. Images of people may not be Foley
personnel.
© 2018 Foley & Lardner LLP
thank you
Morgan J. Tilleman
Senior Counsel
mtilleman@foley.com
414.297.5871
6

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Risk Contracting for Telehealth Providers

  • 1. Risk Contracting for Telehealth Providers VSee 2018 Morgan Tilleman
  • 2. THERE IS RISK IN RISK CONTRACTING 1
  • 3.
  • 4. WHERE IS THE RISK Customers • Individuals • Associations or Groups • Self-funded Benefit Plans • NOT an insurer or HMO Payment Structures • Capitation • Extreme Discounts • Unlimited Consultations • Downside risk in any form
  • 5. MITIGATE YOUR RISK Contract with insurers, HMOs and government -OR- Structure contracts correctly
  • 6. TIPS FOR CONTRACT STRUCTURING • Limits on utilization by every individual • Reasonable volume discounts • Shared savings • Cover your costs in worst-case scenarios
  • 7. ATTORNEY ADVERTISEMENT. The contents of this document, current at the date of publication, are for reference purposes only and do not constitute legal advice. Where previous cases are included, prior results do not guarantee a similar outcome. Images of people may not be Foley personnel. © 2018 Foley & Lardner LLP thank you Morgan J. Tilleman Senior Counsel mtilleman@foley.com 414.297.5871 6