The United States Court of Appeals for the Fifth Circuit has ruled the Convention on the Recognition and Enforcement of Foreign Arbitral Awards (the “Convention”) preempts a state law that prohibits including an arbitration agreement in a property insurance contract despite that the insurance policy also contained a conformity to statute provision designed to amend out any contract provisions that fail to comply with state law. 

A bill designed to protect Texas patients from incurring surprise out-of-network medical bills has been sent to Governor Abbott for signature.

S.I. Strong, Manley O. Hudson Professor of Law at the University of Missouri School of Law, has written a book chapter titled “Collective Redress Arbitration in the European Union,” in International Arbitration and EU Law (Edward Elgar Publishing Ltd, anticipated 2020); University of Missouri School of Law Legal Studies Research Paper No. 2019-09.

The United Nations Commission on International Trade Law (“UNCITRAL”), has issued its “Report of Working Group II (Dispute Settlement) on the work of its sixty-ninth session (New York, 4–8 February 2019).” 

By Holly Hayes In our series about Accountable Care Organizations (ACOs), physician management emerges as an area worthy of better understanding. Marc Bard and Mike Nugent make five observations about the “management of physicians and the achievement of outcomes” in their book “Accountable Care Organizations”: While greater clinical integration can be achieved without economics/financial integration, achieving a meaningful clinical integration is difficult without some economic incentives to support it. Greater integration is a key driver of improved clinical outcomes, economic performance, and, perhaps most important, provider satisfaction. Migrating from a loosely coupled to a tightly coupled management system is extremely difficult and takes significat investment of time, energy, and financial and social capital. Transforming care enough to significantly improve outcomes and resource utilization is much more difficult than achieving “clinical integration” at least as defined by the Federal Trade Commission. The emerging generation of physicians is more comfortable with standardization and more capable of practicing medicine as a true team endeavor. In future posts, we will explore some strategies for successful physician management and moving from a loosely to a tightly coupled management system. For our other posts on ACOs, see here, here, here and here. We welcome your thoughts on this topic. Technorati Tags: Healthcare Holly Hayes is a mediator at Karl Bayer, Dispute Resolution Expert where she focuses on mediation of health care disputes. Holly holds a B.A. from Southern Methodist University and a Masters in Health Administration from Duke University. She can be reached at holly@karlbayer.com.

By Holly Hayes In the 19th century, hospitals were shelters for the sick or dying supported by churches or other religious institutions. By the 20th century, medical care was more advanced and more expensive. Hospital administrators began to search for ways to pay for ever advancing costly medical procedures. Marc Bard and Mike Nugent in their book Accountable Care Organizations, Your Guide to Strategy, Design, and Implementation, write about the birth of the US healthcare system. Rather than a well-thought out business, the US healthcare system was more a series of accidents. In the middle of World War II, most of the labor force was in the military, leaving businesses with few job applicants and no choice but to compete by raising salaries. The Roosevelt administration sought to control salary inflation by instituting a national wage control — with one loophole – fringe benefits were exempt from the wage controls. Health plans emerged as a way to recruit employees. In 1943, the IRS ruled that these health benefits were exempt from income taxes. South Africa is one of the few other countries that links healthcare coverage to employment. Healthcare insurance had its birth when “An official at Baylor University Hospital in Dallas noticed that Americans, on average, were spending more on cosmetics than on medical care. ‘We spend a dollar or so at a time for cosmetics and do not notice the high cost,’ he said. ‘The ribbon-counter clerk can pay 50 cents, 75 cents or $1 a month, yet it would take about 20 years to set aside [money for] a large hospital bill.” (Read more here) At its beginning, a monthly payment of 50 cents a month could be exchanged for 21 days of free care at the hospital. The plan was marketed to teachers who signed up in masses. A PBR timeline of historical events in heatlhcare can be seen here. In 1950, healthcare was 4.5% of GNP, in 2011, it was 17% of GNP. Lacking a healthcare system that imposes its own cost controls, accountable care organizations (ACOs) offer a new idea for controlling costs while improving patient care. In a series of posts, we will explore the components of the development of a successful ACO. For previous posts on the development of ACOs, see here, here and here. Technorati Tags: Healthcare Holly Hayes is a mediator at Karl Bayer, Dispute Resolution Expert where she focuses on mediation of health care disputes. Holly holds a B.A. from Southern Methodist University and a Masters in Health Administration from Duke University. She can be reached at holly@karlbayer.com.