Contractual Relationships Toolkit

Each toolkit will include a definition of the area being addressed, a checklist of recommended activities for that area an organization should consider in their move from fee-for-service to pay-for-value, and tools and resources associated with each line item. These toolkits, and the checklists associated with them, will grow and change as more information and resources become available, and as we respond to feedback received from those who access them.

For the purpose of the Contractual Relationships Discussion Guide, a contractual relationship is defined as an arrangement between two or more entities that is governed by an agreement which includes (1) an offer, (2) acceptance of the offer, and (3) valid (adequate and valuable) consideration. When these elements are all present, a legal contract has been formed. 

Alternative payment model (APM) contracting is complex and raises many legal issues. These issues are evolving constantly, and are linked to things such as changes in health care financing and general health care reform.

This Discussion Guide provides information on common questions and opportunities in APM contracting while offering some practical suggestions on how to deal with them. Together with the advice of your counsel, this Discussion Guide is intended to help organizations construct meaningful relationships with and among providers, patients, payors, and other business partners.

This Discussion Guide does not cover all contracting issues that might arise in an APM relationship. It does not provide legal advice. Individuals should consult with their own legal counsel for advice in dealing with the issues raised in this Discussion Guide.