As the health care landscape grows more complex, physician groups are seeking strategic solutions to remain competitive and financially sustainable. Baker Donelson offers comprehensive legal guidance for physician transactions, helping practices navigate strategic opportunities such as affiliations, acquisitions, mergers, restructurings, or innovative partnerships. Our team delivers tailored guidance that aligns with each group's goals, specialty, and market dynamics.
Physician Transactions Are Accelerating
Independent physician practices are under significant pressure from multiple market forces, including:
- Rising Costs and Inflation: Operational and administrative expenses continue to climb, making it increasingly difficult for small and mid-sized physician practices to maintain financial stability.
- Reimbursement Challenges: Medicare and commercial payor reimbursement rates have not kept pace with inflation, eroding margins for independent physician groups.
- Heightened Competition: Large and well-capitalized organizations, including health systems, national practice management companies, and publicly traded health care entities, are rapidly expanding, making it harder for smaller practices to compete for patients, talent, and market share.
In the face of these pressures, many physician groups are exploring strategic transactions to achieve operational scale, access to capital, and long-term stability.
Our Experience in Physician Transactions
Baker Donelson has extensive experience advising physician groups of all sizes and specialties nationwide on a vast array of strategic transactions to position them for success, including:
- Sales and consolidations with national physician services companies and private equity-backed platforms.
- Restructurings to form management services organizations (MSOs) and administrative services organizations (ASOs).
- Medical group combinations to form larger "mega groups", "supergroups" and specialty networks.
- Mergers and consolidations of larger medical groups and hospital systems.
- Affiliations with hospitals and health systems, such as professional service agreements (PSAs) and service-line co-management agreements with hospitals.
- Joint ventures for clinical service lines with hospitals and national companies (e.g., ambulatory surgery centers (ASCs), imaging centers, urgent care, etc.).
- Formation and acquisitions of accountable care organizations (ACOs), clinically integrated networks (CINs), and independent practice associations (IPAs).
Regulatory Compliance
Our team has decades of experience navigating the complex regulatory requirements that affect physician practices and play a critical role in due diligence for these transactions. Our attorneys provide guidance on:
- Stark Law and Anti-Kickback Statute compliance, and similar state laws, including financial relationship structuring, referral arrangements, and fair market value determinations.
- Corporate practice of medicine and fee-splitting regulations for each state.
- Medicare and Medicaid regulations, including billing, documentation, provider enrollment, and reimbursement requirements.
- State health care transaction review laws, which can elongate the sign-to-close period and introduce regulatory risk into the dealmaking process.
- HIPAA compliance, including business associate agreements, cybersecurity policies, and breach notification requirements.
- State medical board licensing, credentialing, and disciplinary requirements.
- Federal and State employment and benefits laws, including overtime laws, family leave laws, anti-discrimination laws (disability/ADA, racial, age, gender, etc.), and ERISA/benefit plan compliance.
This comprehensive approach to regulatory compliance is essential, as physician groups today operate in a health care environment defined by rapid change and increasing complexity.
To succeed in this landscape, physician groups are pursuing innovative strategies, including the development and expansion of ancillary services tailored to their specialty, and forming strategic partnerships to access capital, operational experience, and executive leadership. By collaborating with experienced teams of CEOs, COOs, CFOs, and VPs in managed care, human resources, IT, and revenue cycle management, practices can streamline workflows, optimize reimbursement and compliance, invest in technology, expand service offerings, and foster a culture of continuous improvement.
Our deep experience spans a broad range of specialties, including:
- Cardiology
- Concierge Medicine and Primary Care
- Dermatology, Aesthetics, and Plastic Surgery
- Ear, Nose, and Throat (ENT) and Allergy
- Fertility, Reproductive Medicine, and Women's Health
- Gastroenterology
- Neurosurgery and Neurology
- Oncology
- Ophthalmology, Retina, and Optometry
- Orthopedics, Spine Surgery, and Pain Management
- Pediatrics
- Urology
- Vascular and Vein
This experience uniquely positions us to deliver tailored strategies that support physician groups in achieving clinical excellence and sustainable growth.