Photo of Aytan Dahukey

Aytan Dahukey is a partner in the Corporate Practice Group in the firm’s Century City Office.

As you may have seen in our recent article on the Labor and Employment Law Blog, the California Supreme Court recently issued a landmark decision in the case of Dynamex Operations West, Inc. v. Superior Court. (The full text of the Dynamex decision can be found here.) In its ruling, the Court establishes a standard that makes it extremely difficult for companies (or individuals) in California to properly classify their workers as independent contractors.
Continue Reading Healthcare Industry Companies Must Be Wary of Classifying Any Workers As Independent Contractors, In Light of the California Supreme Court’s Dynamex Ruling

San Francisco (January 11, 2018) – The final day of the 2018 JP Morgan Healthcare Conference gave us food for thought about the topic of healthcare navigation, as well as updates on the home health sector. Post-acute has become the focus of more attention, especially with the recently announced purchase by Humana of Kindred’s home health business. Genesis Healthcare’s presentation today also shared that they (the largest skilled nursing facility (SNF) operator in the U.S.) were at 84.6% occupancy and, given the growth in senior citizens, expected the SNF industry to run out of beds somewhere between 2020 and 2025. That’s a daunting forecast and clearly also emphasizes the importance of home health. But first, let’s look at the interesting topic of patient engagement and healthcare navigation.
Continue Reading Day 4 Notes on the 2018 JP Morgan Healthcare Conference

San Francisco (Wednesday, January 10, 2018) – The third afternoon of the conference was a deep dive into data and analytics, with successive presentations by IBM Watson Health, Inovalon and AthenaHealth and an earlier morning presentation by Chinese genomics company BGI. Significant progress was reported and, interestingly, the more these companies (and others like them) can do, the more that the market expands with new requests and newly discovered needs (a la “what can you really use a tablet for anyway?”). Inovalon reported that the total addressable market has grown in their estimation from $84 billion (as calculated back in 2014) to $142 billion as of 2018. Breaking that down, they believe that there currently is about $40 billion of demand from the provider sector, $51 billion from pharma/life sciences, $17 billion from payors and $33 billion from consumers.
Continue Reading Day 3 Notes on the 2018 JP Morgan Healthcare Conference

San Francisco (Tuesday, January 9, 2018): Day 2 of the 2018 JP Morgan Healthcare Conference provided concrete examples of the trends that have been discussed in recent years – the impact of shifting healthcare delivery modalities on hospitals, the opportunity for retail medicine, the need for more effective management of chronic conditions and the increasing relevance of the Chinese markets. While some attendees complained about a lack of blockbuster announcements, today’s presentations were intriguing as an example of how the consulting and conference recommendations of the 2010 – 2014 period now are being played out in the real world of healthcare today. As the CEO of Advocate Health Care said, with tongue in cheek and quoting Game of Thrones, “Winter is coming….” and healthcare delivery will become even more difficult. There also was cause for optimism as well, as we saw multiple vibrant strategies for growth, including a continuing shift to value-based and risk-based reimbursement structures.
Continue Reading Notes on Day 2 of the JP Morgan Healthcare Conference

San Francisco (Monday, January 8, 2018): Outside it was raining heavily today in San Francisco, but inside the 2018 JP Morgan Healthcare Conference the weather was distinctly sunny. Nary a hint of gloom or pessimism was heard today from the hospitals and health plans presenting at the conference, even after the joys of last year’s “repeal and replace,” tax “relief” and the multiple redirections from CMS. Instead, we saw optimism, continuing implementation of prior strategic plans and, generally, continuing consensus of the need for greater scale; more analytics, digital engagement, big data and artificial intelligence; more population health management; and value-based/risk-based arrangements. Here’s some highlights from today’s proceedings:
Continue Reading Day 1 Notes from the 2018 JP Morgan Healthcare Conference in San Francisco

In a proposed rule published Tuesday, August 15, 2017, the Centers for Medicare & Medicaid Services (CMS) announced its intention to roll back a handful of payment models introduced under the Obama Administration. If implemented, the rule would cancel the Episode Payment Models (EPMs) and Cardiac Rehabilitation (CR) Incentive Payment Model, each currently set to begin next year. The rule would also cut the number of mandatory participation locations in the Comprehensive Care for Joint Replacement (CJR) Model from 67 to 34.
Continue Reading CMS Aims to Nix Obama-Era Payment Models

Dr. Mario Molina, CEO of Molina Healthcare, discusses the implications of potential cuts to cost sharing reduction payments under the Affordable Care Act by the Trump Administration.  Cost sharing reduction payments are viewed by many as essential in the provision of healthcare to low income individuals as they help to reduce co-pays and deductibles that may otherwise be out of reach for many.  Dr. Molina distills the issue into lay terms and provides some insight into the future of the government’s involvement in the healthcare markets under the new administration.
Continue Reading CEO of Molina Healthcare Discusses Implications of Cuts to Affordable Care Act

Addressing the Social Determinants of Health:  Is the healthcare industry pushing a rock up a hill?  We collectively are trying to provide healthcare with improved quality and reduced cost, but the structure of the nation’s healthcare system remains heavily siloed with the social determinants of health often falling wholly or partly outside the mandate and reach of the healthcare delivery system. Bernard Tyson of Kaiser on Monday noted studies that health is determined approximately 30% by family history and genetics, with the majority of the healthcare impact coming approximately 40% from personal behavior, 20% from environmental factors and 10% from healthcare services.  So, the playing field, if the above numbers are correct, is tilted much more toward nurture, rather than nature.  While we are aware of some hospitals starting to provide housing or other limited services to address the needs of their community and therefore also to address healthcare cost containment, those examples are the exception to date, rather than the rule.
Continue Reading Food for Thought (and Health): Day 2 Notes from the JP Morgan Healthcare Conference

A large amount of wind, much discussion about the U.S healthcare, and the public getting soaked again – if you were thinking about Washington, DC and the new Congress, you’re 3,000 miles away from the action. This is the week of the annual JP Morgan Healthcare conference in San Francisco, with many thousands of healthcare operators and investors flooding Union Square again only to be greeted by one of the worst storms and floods in the recent history of the Bay Area.  Can’t help thinking about the coincidence of nature providing us with a metaphor for the possible upcoming repeal of the Affordable Care Act.
Continue Reading Looking Forward/Looking Backward – Day 1 Notes from the JPMorgan Healthcare Conference

The Centers for Medicare and Medicaid (CMS) announced on March 10, 2015 that it is adding a new Accountable Care Organization (ACO) model to its cadre of innovative models.[1] Titled the “Next Generation ACO Model,” CMS’ new ACO model allows provider groups to assume higher levels of financial risk and reward than currently available under its Pioneer Model and Shared Savings Program model. CMS noted that the goal of the Next Generation ACO Model (Next Generation) is to “test whether strong financial incentives for ACOs can improve health outcomes and lower expenditures for Original Medicare fee-for-service (FFS) beneficiaries.”[2]
Continue Reading Medicare ACO v. 3.0—More Risk, More Money?