Chapter 8. Legal Issues
During a regional coalition's startup phase,
legal issues usually are not the main focus as the coalition leaders recruit
members and build relationships among stakeholders. As the coalition
progresses, legal issues move more to the foreground and become more complex.
Contracting with participants can take much
longer than originally anticipated because of negotiations with stakeholders
and modifications to agreements. The larger an organization is, the more
complex and lengthy the legal issues can be.
Coalition leaders need to be up front with
stakeholders about their role in the coalition and how their data will be used.
Establishing a data sharing policy that addresses who is involved, how the data
will be used, liability issues, and so forth is helpful in clarifying the terms
of agreement for participants. Because of the rapidly changing nature of the
health care environment, it is also important to continually update the policy
and be prepared to renegotiate legal agreements with each new project.
Examples of unexpected legal issues encountered
by some of the Better Quality Information (BQI) sites follow.
- The Center for Health Information and Research found that,
because lawyers for prospective data partners challenged aspects of the
original agreements, the coalition needed to use more lawyers during the
startup phase than initially anticipated.
- When the California Cooperative Healthcare Reporting Initiative
asked health plans to contribute data for the BQI program, some of the health
plans raised confidentiality issues as a legal concern, stating that some of
their contracts with providers did not grant permission to share these data
with the initiative.
- A major legal consideration for Minnesota Community Measurement
arose early with regard to how health plans could collaborate on quality and
not become entangled with antitrust issues. After the coalition became a
nonprofit entity and other organizations, such as the Minnesota Medical
Association and purchasers, became involved, the antitrust concern of health
plans collaborating on quality efforts was no longer an issue. Nonetheless, the
coalition suggests working with an antitrust attorney when creating a regional
coalition.
Tip: Build in time up front to
understand and address legal issues, such as data use and sharing and
confidentiality agreements.
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