Chapter 8. Legal Issues

Regional Coalition Collaboration Guide

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.
Current as of April 2008
Internet Citation: Chapter 8. Legal Issues: Regional Coalition Collaboration Guide. April 2008. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/professionals/quality-patient-safety/quality-resources/tools/collabguide/collabguide8.html