Overview
Greg Mitchell works with healthcare payors and providers to meet the full spectrum of their managed care and reimbursement arrangement needs. He helps managed care organizations, third-party administrators, independent practice associations (IPAs), risk-bearing entities, management services organizations, hospitals and health systems, digital healthcare providers, and other organizations both large and small negotiate and draft a range of managed care and value-based agreements. Greg has experience with a variety of arrangements and models, including fee-for-service, bundled payment, shared savings and shared loss models, gainsharing and capitation arrangements.
Greg advises clients on all aspects of value-based contracting, from internal structuring to crafting risk-based arrangements and ensuring ongoing compliance. With a deep understanding of state and federal regulations—including insurance laws, state risk-bearing entity regulations and physician incentive plan regulations—Greg is well-positioned to guide clients through the arrangement process from beginning to end. He has particular knowledge of the New York and New Jersey markets, with substantial experience in the formation, operation, and ongoing compliance of New York IPAs and New Jersey Organized Delivery Systems.
In addition to his legal experience, Greg holds an MS in Bioethics, which gives him a unique perspective on the impact of health policy on his clients and the individuals they serve.
Results
- Providing managed care support to a large population health management provider focusing on social determinants of health, including ongoing contracting support for total cost of care risk arrangements with payors, state-by-state financial risk assumption, and federal and state managed care-related compliance support.
- Assisting statewide payor organization in its value-based contracting initiatives, including advising on drafting and negotiating value-based agreements with hospitals, physician groups and digital health providers.
- Advised various digital health providers in negotiation of risk-based reimbursement arrangements with various national payors.
- Successfully assisted a health system in a dispute and arbitration with a payor regarding the calculation of shared savings payments.
- Advised national healthcare provider in establishing vehicles for assumption of financial risk in New York and New Jersey.
Recognitions
- Best Lawyers: Ones to Watch in America, Healthcare Law, 2021-2025
Credentials
Education
Emory University School of Law, JD, 2013
Union Graduate College & Mount Sinai School of Medicine, MS, 2013
Union College, BA, cum laude, 2010
Admissions
New Jersey
New York
Courts/Agencies
US District Court for the Eastern District of New York
US District Court for the Southern District of New York
