Deborah Farringer | Belmont University (original) (raw)

Papers by Deborah Farringer

Social Science Research Network, 2015

I. INTRODUCTION II. THE TRIPLE AIM AND THE ACA A. DISTINCTIONS BETWEEN THE TRIPLE AIM AND MANAGED... more I. INTRODUCTION II. THE TRIPLE AIM AND THE ACA A. DISTINCTIONS BETWEEN THE TRIPLE AIM AND MANAGED CARE B. DEVELOPMENT OF ACOS UNDER THE ACA III. CONSIDERING THE MAYO CLINIC AND ACOS UNDER THE ACA A. INTEGRATED DELIVERY SYSTEMS AND ACO PARTICIPATION IV. CURRENT STATUS OF ACOS UNDER THE ACA? A. ACO SUCCESSES B. ACO CHALLENGES C. DOES THE CURRENT ACO STRUCTURE FULFILL THE TRIPLE AIM? D. RECOMMENDATIONS V. CONCLUSION "At the end of the day, if the only successful ACOs are those from Geisinger, [Rochester, Minn.-based] Mayo Clinic and Kaiser Permanente, what has society gained? These organizations were already operating at the highest levels of confidence in respect to the triple aim."

Social Science Research Network, 2019

Her scholarship explores the operation and impact of health laws and health policy on providers a... more Her scholarship explores the operation and impact of health laws and health policy on providers and suppliers.

Social Science Research Network, 2018

Diego. I would like to thank my research assistants Andy Goldstein and Kimberly MacDonald for the... more Diego. I would like to thank my research assistants Andy Goldstein and Kimberly MacDonald for their work and help in bringing this article to fruition. Thanks also to Anne Conroy and all of the editorial staff of Brooklyn Law Review for their very helpful suggestions and edits to this article. Finally, thank you to my husband and children for their never-ending patience and support.

Social Science Research Network, Nov 1, 2001

A Tennessee teacher, John Scopes, was arrested for teaching evolution in a public high school con... more A Tennessee teacher, John Scopes, was arrested for teaching evolution in a public high school contrary to a state statute, and although the court did not find the law unconstitutional, the trial sparked the debate over the teaching of evolution and creationism in public schools that still rages today.

Social Science Research Network, 2020

Social Science Research Network, 2016

Social Science Research Network, 2018

Seattle University Law Review, Jun 29, 2017

Brooklyn law review, 2018

Diego. I would like to thank my research assistants Andy Goldstein and Kimberly MacDonald for the... more Diego. I would like to thank my research assistants Andy Goldstein and Kimberly MacDonald for their work and help in bringing this article to fruition. Thanks also to Anne Conroy and all of the editorial staff of Brooklyn Law Review for their very helpful suggestions and edits to this article. Finally, thank you to my husband and children for their never-ending patience and support.

Brooklyn law review, 2018

As federal district courts and courts of appeals attempt to apply the Supreme Court’s dictates in... more As federal district courts and courts of appeals attempt to apply the Supreme Court’s dictates in Universal Health Services, Inc. v. U.S. ex rel. Escobar, it is necessary to ask whether the Court succeeded in easing the complexity of this aspect of the Federal Claims Act (FCA). Have lower courts been able to consistently apply the new standards to assess materiality? Or, has the opinion, which arguably both broadened and narrowed application of the implied false certificate theory and when liability might attach, further muddied the waters for courts and parties attempting to determine whether behavior is of the sort that qualifies as “fraud”? Most importantly, what impact has the Escobar opinion had on providers and other government contractors for purposes of trying to determine whether noncompliance with a regulation of any sort constitutes fraud for purposes of the FCA? In reviewing lower court opinions analyzing FCA claims in accordance with the dictates of Escobar, this articl...

ERN: Regulation (IO) (Topic), 2017

As health insurers try to navigate the new limitations set forth under the ACA, including prohibi... more As health insurers try to navigate the new limitations set forth under the ACA, including prohibitions on denying individuals with pre-existing conditions and limitations on the rating of patients, insurers are looking towards models that will enable them to control costs without access to their usual tools. What they have developed is not so much a new insurance model, but actually a concept that first arose during the rise of managed care; that is, limited provider networks utilized within health maintenance organizations (“HMOs”). These “new” insurance products, often referred to as narrow networks or high-performance networks, offer beneficiaries a more limited network of physicians typically in exchange for lower premiums. These insurance plans are becoming increasingly common both on the federal and state health insurance exchanges as well as in insurance product offerings outside the exchanges. As these limited provider networks become more prevalent, there is evidence of a n...

Nevada Law Journal, 2018

Since the advent of the movement toward the use of electronic medical records, an axiom in the pr... more Since the advent of the movement toward the use of electronic medical records, an axiom in the promotion of electronic health records (EHRs) has been the idea that the use of EHRs will reduce medical errors. Certainly, there are countless examples of how technology can improve the health care experience and aid providers in reducing medical errors, including errors of medication administration, medication management, access to decision support tools, telemedicine, immediate access to diagnostic tests and other clinical information and treatment results—just to name a few. Even with such improvements, however, EHRs have not entirely eliminated medical errors and new technology has in fact created its own challenges and issues that might lead to liability in a different way. As the use of EHRs proliferates, so too does the reliance of healthcare workers on the systems themselves and the inevitable blame game wherein an individual claims that whatever errors occurred were the result of...

A discussion of the Health Care Industry Cybersecurity Task Force report regarding the preparedne... more A discussion of the Health Care Industry Cybersecurity Task Force report regarding the preparedness of the health care industry to respond to ever increasing cybersecurity threats.

A little more than four years after enactment of the Patient Protection and Affordable Care Act o... more A little more than four years after enactment of the Patient Protection and Affordable Care Act of 2010 (“ACA”), daily headlines still abound on newspapers and websites across the country highlighting both successes and failures of the ACA. In analyzing those successes and failures, especially in the context of care delivery, it is important to take a step back to consider the stated goals of the ACA, which goals have their origins in a premise first proposed by Dr. Donald M. Berwick and the Institute for Healthcare Improvement (“IHI”) in 2006 referred to as the “Triple Aim.” The Triple Aim is a framework for healthcare that, at its origin, was intended to “optimize population health, care experience, and cost.” It was with this Triple Aim in mind that legislators and policy makers established the framework for accountable care organizations (“ACOs”) and the Medicare Shared Savings Program (“MSSP”). This article examines the origins of the Triple Aim and its impact on the developmen...

If America wants to stay at the forefront of scientific study and remain competitive with other n... more If America wants to stay at the forefront of scientific study and remain competitive with other nations, its students must be taught scientific principles that are generally applied in the global scientific community. Thus, the implications involved in the latest battles over God and science extend beyond whether to teach controversial subjects, and could have a significant effect on the future of American schools. These problems warrant the development of a new test, or new legal analysis, that will enable the Court to deal with this latest chapter in the heated evolution and creationism debate. This Note examines the evidentiary factors that will be necessary to preserve First Amendment ideals and the consequences that may follow from adopting a more narrow, textualist approach when analyzing the Establishment Clause.

The Journal of Law, Medicine & Ethics

The health care industry has moved at a rapid pace away from paper records to an electronic platf... more The health care industry has moved at a rapid pace away from paper records to an electronic platform across almost all sectors — much of it at the encouragement and insistence of the federal government. Such rapid expansion has increased exponentially the risk to individuals in the privacy of their data and, increasingly, to their physical well-being when medical records are inaccessible through ransomware attacks. Recognizing the unique and critical nature of medical records, the United States Congress established the Health Care Industry Cybersecurity Task Force under the Cybersecurity Information Sharing Act of 2015 for the purpose of reviewing cybersecurity risks within the health care industry and identifying who will lead and coordinate efforts to address such risks among the various agencies. The Task Force has since issued a report setting forth six high-level imperatives that the health care industry needs to achieve in order to combat cybersecurity, and, notably, many of t...

Social Science Research Network, 2015

I. INTRODUCTION II. THE TRIPLE AIM AND THE ACA A. DISTINCTIONS BETWEEN THE TRIPLE AIM AND MANAGED... more I. INTRODUCTION II. THE TRIPLE AIM AND THE ACA A. DISTINCTIONS BETWEEN THE TRIPLE AIM AND MANAGED CARE B. DEVELOPMENT OF ACOS UNDER THE ACA III. CONSIDERING THE MAYO CLINIC AND ACOS UNDER THE ACA A. INTEGRATED DELIVERY SYSTEMS AND ACO PARTICIPATION IV. CURRENT STATUS OF ACOS UNDER THE ACA? A. ACO SUCCESSES B. ACO CHALLENGES C. DOES THE CURRENT ACO STRUCTURE FULFILL THE TRIPLE AIM? D. RECOMMENDATIONS V. CONCLUSION "At the end of the day, if the only successful ACOs are those from Geisinger, [Rochester, Minn.-based] Mayo Clinic and Kaiser Permanente, what has society gained? These organizations were already operating at the highest levels of confidence in respect to the triple aim."

Social Science Research Network, 2019

Her scholarship explores the operation and impact of health laws and health policy on providers a... more Her scholarship explores the operation and impact of health laws and health policy on providers and suppliers.

Social Science Research Network, 2018

Diego. I would like to thank my research assistants Andy Goldstein and Kimberly MacDonald for the... more Diego. I would like to thank my research assistants Andy Goldstein and Kimberly MacDonald for their work and help in bringing this article to fruition. Thanks also to Anne Conroy and all of the editorial staff of Brooklyn Law Review for their very helpful suggestions and edits to this article. Finally, thank you to my husband and children for their never-ending patience and support.

Social Science Research Network, Nov 1, 2001

A Tennessee teacher, John Scopes, was arrested for teaching evolution in a public high school con... more A Tennessee teacher, John Scopes, was arrested for teaching evolution in a public high school contrary to a state statute, and although the court did not find the law unconstitutional, the trial sparked the debate over the teaching of evolution and creationism in public schools that still rages today.

Social Science Research Network, 2020

Social Science Research Network, 2016

Social Science Research Network, 2018

Seattle University Law Review, Jun 29, 2017

Brooklyn law review, 2018

Diego. I would like to thank my research assistants Andy Goldstein and Kimberly MacDonald for the... more Diego. I would like to thank my research assistants Andy Goldstein and Kimberly MacDonald for their work and help in bringing this article to fruition. Thanks also to Anne Conroy and all of the editorial staff of Brooklyn Law Review for their very helpful suggestions and edits to this article. Finally, thank you to my husband and children for their never-ending patience and support.

Brooklyn law review, 2018

As federal district courts and courts of appeals attempt to apply the Supreme Court’s dictates in... more As federal district courts and courts of appeals attempt to apply the Supreme Court’s dictates in Universal Health Services, Inc. v. U.S. ex rel. Escobar, it is necessary to ask whether the Court succeeded in easing the complexity of this aspect of the Federal Claims Act (FCA). Have lower courts been able to consistently apply the new standards to assess materiality? Or, has the opinion, which arguably both broadened and narrowed application of the implied false certificate theory and when liability might attach, further muddied the waters for courts and parties attempting to determine whether behavior is of the sort that qualifies as “fraud”? Most importantly, what impact has the Escobar opinion had on providers and other government contractors for purposes of trying to determine whether noncompliance with a regulation of any sort constitutes fraud for purposes of the FCA? In reviewing lower court opinions analyzing FCA claims in accordance with the dictates of Escobar, this articl...

ERN: Regulation (IO) (Topic), 2017

As health insurers try to navigate the new limitations set forth under the ACA, including prohibi... more As health insurers try to navigate the new limitations set forth under the ACA, including prohibitions on denying individuals with pre-existing conditions and limitations on the rating of patients, insurers are looking towards models that will enable them to control costs without access to their usual tools. What they have developed is not so much a new insurance model, but actually a concept that first arose during the rise of managed care; that is, limited provider networks utilized within health maintenance organizations (“HMOs”). These “new” insurance products, often referred to as narrow networks or high-performance networks, offer beneficiaries a more limited network of physicians typically in exchange for lower premiums. These insurance plans are becoming increasingly common both on the federal and state health insurance exchanges as well as in insurance product offerings outside the exchanges. As these limited provider networks become more prevalent, there is evidence of a n...

Nevada Law Journal, 2018

Since the advent of the movement toward the use of electronic medical records, an axiom in the pr... more Since the advent of the movement toward the use of electronic medical records, an axiom in the promotion of electronic health records (EHRs) has been the idea that the use of EHRs will reduce medical errors. Certainly, there are countless examples of how technology can improve the health care experience and aid providers in reducing medical errors, including errors of medication administration, medication management, access to decision support tools, telemedicine, immediate access to diagnostic tests and other clinical information and treatment results—just to name a few. Even with such improvements, however, EHRs have not entirely eliminated medical errors and new technology has in fact created its own challenges and issues that might lead to liability in a different way. As the use of EHRs proliferates, so too does the reliance of healthcare workers on the systems themselves and the inevitable blame game wherein an individual claims that whatever errors occurred were the result of...

A discussion of the Health Care Industry Cybersecurity Task Force report regarding the preparedne... more A discussion of the Health Care Industry Cybersecurity Task Force report regarding the preparedness of the health care industry to respond to ever increasing cybersecurity threats.

A little more than four years after enactment of the Patient Protection and Affordable Care Act o... more A little more than four years after enactment of the Patient Protection and Affordable Care Act of 2010 (“ACA”), daily headlines still abound on newspapers and websites across the country highlighting both successes and failures of the ACA. In analyzing those successes and failures, especially in the context of care delivery, it is important to take a step back to consider the stated goals of the ACA, which goals have their origins in a premise first proposed by Dr. Donald M. Berwick and the Institute for Healthcare Improvement (“IHI”) in 2006 referred to as the “Triple Aim.” The Triple Aim is a framework for healthcare that, at its origin, was intended to “optimize population health, care experience, and cost.” It was with this Triple Aim in mind that legislators and policy makers established the framework for accountable care organizations (“ACOs”) and the Medicare Shared Savings Program (“MSSP”). This article examines the origins of the Triple Aim and its impact on the developmen...

If America wants to stay at the forefront of scientific study and remain competitive with other n... more If America wants to stay at the forefront of scientific study and remain competitive with other nations, its students must be taught scientific principles that are generally applied in the global scientific community. Thus, the implications involved in the latest battles over God and science extend beyond whether to teach controversial subjects, and could have a significant effect on the future of American schools. These problems warrant the development of a new test, or new legal analysis, that will enable the Court to deal with this latest chapter in the heated evolution and creationism debate. This Note examines the evidentiary factors that will be necessary to preserve First Amendment ideals and the consequences that may follow from adopting a more narrow, textualist approach when analyzing the Establishment Clause.

The Journal of Law, Medicine & Ethics

The health care industry has moved at a rapid pace away from paper records to an electronic platf... more The health care industry has moved at a rapid pace away from paper records to an electronic platform across almost all sectors — much of it at the encouragement and insistence of the federal government. Such rapid expansion has increased exponentially the risk to individuals in the privacy of their data and, increasingly, to their physical well-being when medical records are inaccessible through ransomware attacks. Recognizing the unique and critical nature of medical records, the United States Congress established the Health Care Industry Cybersecurity Task Force under the Cybersecurity Information Sharing Act of 2015 for the purpose of reviewing cybersecurity risks within the health care industry and identifying who will lead and coordinate efforts to address such risks among the various agencies. The Task Force has since issued a report setting forth six high-level imperatives that the health care industry needs to achieve in order to combat cybersecurity, and, notably, many of t...