John M.Kirsner

Partner

Columbus + 1.614.281.3700

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With 30 years experience, John Kirsner has a national practice representing health systems and large provider organizations on cutting-edge reform-driven transactions. John has assisted in the formation and operation of more than 25 clinically integrated networks and more than 15 MSSP ACOs (Medicare Shared Savings Program/accountable care organizations). He advises ACOs on creative uses of the ACO waivers. He assists in the negotiation of shared savings arrangements with payers as well as hospital quality and efficiency programs and co-management ventures. John is extremely conversant on the operation and regulatory implications of health care network messenger models. He has exceptional experience in the area of payer/provider contracting, including payer financial distress and preference matters. John has advised many telehealth providers on their payer negotiation strategies.

John has led multiple engagements creating innovative affiliations between large multispecialty physician group practices and hospital systems. He has created working foundation models, models similar to the Kaiser model, as well as looser affiliation structures. He has considered the impact of equity and debt financing in the context of these transactions including provider distress situations and has worked through the medical staff implications on such affiliation structures. He also has extensive experience in joint venture, joint operating agreement, and entity formation. He represents hospitals and other providers in transactional work, including M&A.

John serves as board advisor to several health care clients. He is past chair of the Ohio State Bar Association Health Care Committee and also served as the business development partner for Jones Day's Columbus Office from 2015 to 2018.

Experience

  • University of Pittsburgh Medical Center merges with Washington Health Care ServicesJones Day is acting as due diligence counsel to the University of Pittsburgh Medical Center in the merger with Washington Health Care Services.
  • Cardinal Health acquires the Bendcare CPO-GPO entity and makes a minority investment in the Bendcare MSOJones Day advised Cardinal Health, Inc. in the acquisition of the Bendcare group purchasing organization (CPO-GPO) entity and a minority investment in the Bendcare management services organization (MSO).
  • Health system utilizes value-based regulations to offer EHR and related digital health solutions to providersJones Day assisted a leading health system in the southern U.S. in offering innovative EHR and related digital health solutions to independent providers via the value-based exceptions and safe harbors.
  • Private equity-backed post-acute care organization forms CINJones Day assisted a for-profit, private equity-backed company in creating an innovative post-acute care clinically integrated network in the southwestern U.S.
  • Multiple single-specialty groups form statewide CINJones Day assisted several single-specialty physician groups, including groups backed by private equity, in the creation of a single-specialty statewide clinically integrated network.
  • Home care provider organization forms CIN, Messenger ModelJones Day assisted a Southeast-based private for-profit home care provider in forming a clinically integrated network and a messenger model.
  • Digital health companies, specialty hospitals, and health systems maintain compliance with multistate requirements through 50-state surveyJones Day is representing digital health companies, specialty hospitals, and health systems in maintaining compliance with multistate requirements through a regularly updated, extensive 50-state survey on state laws and regulations applicable to telehealth activities of physicians and other health care professionals including licensing, establishing patient relationships, provider-to-provider consulting, supervision and delegation among providers, and prescribing and treatment standards.
  • Methodist Health acquired by Deaconess Health SystemJones Day advised Methodist Health in Kentucky in its acquisition by Deaconess Health System, which included two hospitals, as well as associated physicians and post-acute care providers.
  • Accountable care organization implements innovative arrangement under Medicare Shared Savings Program participation waiverJones Day advised an accountable care organization (ACO) in implementing an innovative arrangement under the Medicare Shared Savings Program participation waiver for home health, including preparation and negotiation of agreements for laboratory and care coordination services.
  • Leading specialty telemedicine organization launches novel telemedicine-oriented revenue cycle management offeringJones Day provided health regulatory counsel to one of the Nation’s leading specialty telemedicine organizations for its innovative reimbursement, enrollment, contracting, compliance policies, data privacy, and billing arrangements regarding specialty telemedicine services across the U.S.
  • AKSM receives $550,000 investmentJones Day represented AKSM Ltd., a Columbus-based medical company, in connection with a $550,000 investment from undisclosed investors.
  • AKSM involved in joint ventures with urologists regarding lithotripsy, radiation therapy, and related urologic proceduresJones Day has been assisting American Kidney Stone Management, Ltd. ("AKSM"), a leading national lithotripsy provider, with joint venture syndication work relating to lithotripsy, as well as most ancillary urology related lines of business.
  • COUG enters into ASC, radiation therapy, lithotripsy, and other urological ventures as largest single specialty urology practice in OhioJones Day assisted Central Ohio Urology Group, the largest lithotripsy supergroup in Ohio, with the formation of an IMRT/IGRT enterprise and the later sale of a majority stake in that enterprise to a third party.
  • AKSM sells controlling interest to United Medical SystemsJones Day advised American Kidney Stone Management, Ltd. (AKSM) in its sale of a controlling interest to United Medical Systems (DE), Inc.
  • River Valley Health Partners acquired by Prime Healthcare FoundationJones Day advised River Valley Health Partners in its acquisition, which includes East Liverpool City Hospital in East Liverpool, OH, River Valley Physicians, LLC, and Ohio Valley Home Health Services, Inc., by Prime Healthcare Foundation.
  • Palos Community Hospital builds clinical affiliation with Loyola University Medical CenterJones Day assisted Palos Community Hospital in creating an innovative clinical affiliation with Loyola University Medical Center based in Illinois.
  • Health care system modernizes governance materialsJones Day represented the management and the board of directors of an independent not-for-profit health care system regarding charitable trust and nonprofit corporate law restrictions on changes in the use of assets and modernizing governance documents.
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    March 2022 Newsletters

    Vital Signs: Digital Health Law Update | Winter 2022

    August 2021 Newsletters

    Vital Signs: Digital Health Law Update | Summer 2021

    April 2021 Newsletters

    Vital Signs: Digital Health Law Update | Spring 2021

    February 2021 Commentary

    Recent Changes to the Anti-Kickback Statute’s Personal Services Safe Harbor

    January 2021 Newsletters

    Vital Signs: Digital Health Law Update | Winter 2021

    January 2021 Commentary

    OIG and CMS Modify AKS Safe Harbor and Stark Law Exception for EHR Donations

    January 2021 Commentary

    CMS Finalizes and Clarifies Key Valuation Terms in the Stark Law

    January 2021 Commentary

    New Stark Law and Anti-Kickback Statute Protections for Cybersecurity Technology

    January 2021 Commentary

    New Limited Remuneration Exception and Additional Tools to Ensure Compliance with the Stark Law

    January 2021 Commentary

    CMS Finalizes New Limitations to the Isolated Transactions Exception to the Stark Law
    View All

    Additional Publications

    • February 2021
      Health Plans Contracting Handbook: Eighth Edition, Chapter 3 - Antitrust Issues in Payer/Provider Contracting
    • September 2015
      Health Plans Contracting Handbook, 7th Edition, Chapter 3 Antitrust Issues in Payer-Provider Contracting

    Publications Prior to Jones Day

    November 2011
    Health Plans Contracting Handbook:  A Guide for Payors and Providers, Sixth Edition, Chapter 3, Antitrust Issues in Payor-Provider Contracting

    November 2011
    Resources for ACOs:  The Final Rule and New Opportunities

    2008
    Health Plans Contracting Handbook:  A Guide for Payors and Providers, Fifth Edition, Chapter 2, Antitrust Issues in Managed Care Contracting

    2001
    Managed Care Contracting Handbook:  A Guide for Payors and Providers, Chapter 10 Protecting Against Insolvency

    December 1995-May 1997
    Editor, Health Law Advisor.

    November 1996
    IRS Eases Limits on Hospital Board Representation, OHIO MEDICINE, at 20

    July 1996
    The Gatekeeper Role of Physicians:  Key Issues and Compensation Concerns, Practicing in an Integrated Delivery System, at 1

    April 1995
    Q&A: What are the Five Most Important Business Issues Physicians Should Consider When Developing a Group Practice or Other Physician Organization?, Integrated Delivery Systems in Practice, at 6

    Autumn 1994
    Professional Limited Liability Companies, Lawtrends, Autumn 1994

    Autumn 1994
    Michigan Bulletproof LLCs: Is the Armor Too Restrictive?, Lawtrends, Autumn 1994

    1994
    Discipline Versus Democracy:  Party Discipline in Canadian Politics, Contemporary Political Issues at 194 (with David Kilgour and Ken McConnell)

    March 1989
    Call Off the Party, Policy Options Politiques

    Autumn 1988
    Party Discipline and Canadian Democracy, Canadian Parliamentary Review

    Speaking Engagements

    • July 28, 2922
      PYA 2022 Summer CPE Symposium: Understanding the Business Case for Using Value-Based Exceptions
    • July 22, 2021
      HFMA's Value Based Healthcare Innovation Council:Regulatory Flashpoints - The New Value Base Rules: Practical Examples and Uses
    • June 21, 2021
      The Four Pillars of Healthcare Valuation: Regulatory Overview for Valuation Professionals
    • June 11, 2020
      The Post-Pandemic Landscape: Payer-Provider Relationships (Health Care on the Other Side) (BDO)
    • May 20, 2020
      Telehealth in a COVID 19 World and Beyond (DHG)
    • May 15, 2020
      Regulatory Overview for Valuation Professionals (NACVA)
    • May 14, 2020
      Are Patients, Employers & Payors Ready for Telehealth?
    • June 7, 2019
      DHG Symposium: Thoughtful Physician Alignment for Success in the RC 2.0 Environment
    • May 14, 2019
      Leveraging ACO Waivers - An Investment Opportunity for physician Led ACOs
    • December 4, 2018
      Jones Day CLE Academy: Year-End Review: The Latest Trends and Issues in Health Care
    • October 25, 2018
      ABA Webinar: Fundamentals of Value-Based Care: Risk Capability and the Ability to Optimize Value for CINs/ACOs
    • October 23, 2018
      2018 Advanced Payment Summit - "A Legal Perspective"
    • May 15-18, 2018
      DHG Symposium: Rethinking Strategic Alignment and Integration for the Clinically Integrated Network and Accountable Care Organization
    • December 7, 2017
      Jones Day CLE Academy: Innovative Uses of Technology in an Era of Health Care Reform
    • June 27, 2017
      AHLA Annual Meeting: Mastering the Hospital Quality and Efficiency Program
    • May 3, 2017
      DHG Symposium: Clinically Integrated Networks 2.0
    • May 16, 2016
      ATA Conference - ACO's and Telehealth - Using ACO Waivers to Get HIT into the Hands of Doctors
    • May 5, 2016
      DHG Symposium 2016 - Healthcare Enterprise Solutions: A Case Study in Transforming Employee Health Plans
    • March 14-15, 2016
      Contracting Strategies for Value Based Payment Models, Compliance Wars 2016: Achieving Compliance in a Hostile Environment
    • January 25, 2016
      AHLA: New Developments in Managed Care Contracting
    • December 9, 2015
      Healthcare Education Associates: The Value Based Care Master Class
    • November 18, 2015
      2015 BDO USA Leadership Conference: Current State of the Healthcare M&A Market - Implications of Increased Risk
    • October 16, 2015
      ASA HSIG "The Four Pillars of the Healthcare Industry" Conference, Regulatory Environment of Healthcare Industry Presentation
    • September 11, 2015
      CIN:Roundtable Developing Your Clinically Integrated Network
    • June 28, 2015
      Bridges & Battlefields: Issues in Unified Medical Staffing Models (AHLA In-House Counsel Program)
    • June 25, 2015
      "Opting Out" of a Unified Medical Staff
    • May 15, 2015
      The 2015 Network Building & Contracting Forum/ Connecting the Dots: From Value-Based Contracting to Performance-Based Incentives
    • May 7, 2015
      DHG Healthcare Symposium 2015/ Transformational Initiatives for Established Clinically Integrated Networks

    April 11-13, 2014

    ACO's What Anesthesiologists Need to Know, Advanced Institute for Anesthesia Practice

    Las Vegas, Nevada

    February 27-28, 2014

    The Network Participation Imperative: To Participate or Not to Participate, The 2014 Network Contracting Congress

    Las Vegas, Nevada

    February 10-11, 2014

    Acing Contract Management in a Shifting Marketplace, Best Practices in Network Development & Contract Management

    Miami, Florida

    October 28, 2013

    Sourcing the Right Change Leader and Managing Key Legal Transactional Issues, Healthcare Consolidation & Acquisitions Leadership Forum

    Atlanta, Georgia

    September 23, 2013

    Mastering the Nuances of Contract Management in a Changing Marketplace, Best Practices in Network Development & Contract Management

    New York, New York

    May 9, 2013

    Approved Models to Align Incentives Between Hospitals and Their Physicians, Dixon Hughes Goodman 2013 Annual Healthcare Symposium

    Isle of Palms, South Carolina

    April 25-26, 2013

    Into the Labyrinth: Successfully Guiding Clients Through Fully Integrated Delivery System Transaction, AHLA Healthcare Transactions Conference

    Nashville, Tennessee

    May 16-18, 2012

    Alignment Across the Continuum, Dixon Hughes Goodman Annual Hospital Symposium

    Isle of Palms, South Carolina

    April 23, 2012

    Healthcare 2012 and Beyond:  Analysis and Value Proposition

    Columbus, Ohio

    November 3, 2011

    ACO's The Final Rule and New Opportunity

    Webinar

    September 22, 2011

    Health IT/EHR

    Webinar

    September 20, 2011

    Never Events, HACs and Other Payer Hot Topics, SCHFMA Revenue Cycle Bootcamp

    Columbia, South Carolina

    June 27-29, 2011

    Marcus Welby MD Revisited: Patient Centered Medical Home, AHLA Annual Meeting

    Boston, Massachusetts

    April 8, 2011

    ACO Regulation Review and Application Preparation

    Webinar

    March 30-April 1, 2011

    ACOs, Medical Homes and Related Integration Initiatives, AHLA's Institute on Medicare and Medicaid Payment Issues

    Baltimore, Maryland

    May 3-4, 2010

    Developing A New Cancer Center of Excellence
    Structuring Physician Agreements for Mutual Success

    Dallas, Texas

    May 14, 2008

    Council of Delegates & General Assembly:  Future of the Legal Profession Study

    Convention Center, Columbus, Ohio

    January 30, 2002

    AHLA, Managed Care Contracting Issues for Payors and Providers

    Teleconference Presentation

    November 8, 1996

    Update, Confidentiality of Medical Records

    Cleveland, Ohio

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