The following is an excerpt from Practice Perspectives: Vault's Guide to Legal Practice Areas.
Jayda Greco works at the intersection of healthcare regulatory, privacy, compliance, product counseling, and marketing law, with particular emphasis on devising creative and practical legal solutions for digital health initiatives to meet business objectives. As in-house counsel for a national virtual care company, Jayda advised cross-functional groups on the creation and implementation of new features and functionality across platforms and on the risks and liabilities of proposed commercial models and transactions. She has a keen understanding of the FTC Act, trademark, copyright, and state consumer protection and marketing laws related to medical services and pharmaceuticals. She provides guidance and training on key issues to help clients maximize marketing success while remaining in compliance with complex healthcare and life sciences marketing and advertising regulations.
Travis Jackson works with leading hospitals, health systems, and academic medical centers on complex and innovative mergers, acquisitions, and joint ventures. Through his counsel, Travis’s healthcare clients enhance operational efficiencies, improve care delivery, and strengthen relationships in a compliance-driven and cost-effective manner. Travis develops, negotiates, and implements transactions that streamline physician integration, increase brand recognition, and expand care offerings. He has a deep understanding of federal healthcare reform, transaction trends, the federal 340B Program, and healthcare corporate governance matters.
Travis is also a valuable partner to nonprofit healthcare providers navigating the complex state and federal requirements that govern their businesses, helping to structure relationships that comply with IRS rules; establish financial assistance, billing, collection, and other policies; and respond to audits and investigations, all while effectively managing enforcement risk.
Describe your practice area and what it entails.
Jayda: My practice focuses on advising digital health platforms and clients creating innovative care delivery models as they engage in state expansion efforts and compliance with the myriad of laws, regulations, and guidance that impact their platforms and patient care offerings.
Travis: I am a corporate transactions lawyer within the healthcare industry. My practice goes beyond working with clients to buy or sell companies. Our clients demand lawyers who are creative thinkers and who can help them navigate the ever-changing regulatory landscape of the healthcare industry. I often work with leading nonprofit health systems and investor-backed organizations early in the development of their business strategies and then on the implementation of those strategies through mergers, acquisitions, and joint ventures. I have worked with academic medical centers to understand how they may partner with community hospitals to make oncology and other specialized services available to patients in remote areas. I have also advised community hospitals in affiliating with medical schools to become teaching institutions that train the next generation of providers.
What types of clients do you represent?
Jayda: I represent a range of clients including healthcare startups that are new to the digital health and innovative care space and established Fortune 100 companies that are exploring health offerings. Most of the clients I work with are based within the United States and working within U.S. healthcare laws.
Travis: My clients represent the full spectrum of nonprofit and investor-backed healthcare organizations. I work with community hospitals, health systems, academic medical centers, clinical research organizations, physician practices, and other providers. Each type of client brings a different perspective and culture to the work, which makes every deal unique.
What types of cases/deals do you work on?
Jayda: I assist digital health platforms and professionals in meeting state and federal legal requirements as they intersect with their business models. This can range from navigating corporate practice laws and creating state expansion work plans to addressing various state laws surrounding the practice of telemedicine. Additionally, much of my work involves assisting clients in understanding and implementing protocols related to professional requirements such as physician collaboration and supervision requirements, state licensure requirements, prescribing requirements, and state board professional standards. I also support health transactions that involve digital health platforms.
Travis: I work on strategic corporate transactions. I represent health systems in buying or selling hospitals, physician practices, or other providers. I also counsel nonprofit healthcare organizations on corporate governance issues and the federal income tax implications of their activities. One recent transaction utilized both skill sets. Our client was a community-based nonprofit organization that owned a 50% interest in a hospital. The client desired to sell its interest in the hospital and use the sale proceeds to establish a community health foundation. This project was a great representation of the substantive legal work we do and demonstrated the value of our work to the community. The client recently announced that it would make more than $100 million from this transaction available to the community through grants to address rural health needs.
How did you choose this practice area?
Jayda: Prior to law school, I worked in an administrative role for a pediatric company, which allowed me to become familiar with HIPAA and the healthcare space early in my career. In law school, I interned at a telehealth startup based in Seattle and eventually began my legal career there as associate general counsel. When I joined McDermott, I knew I wanted to continue in this practice area and build my experience and knowledge in counseling healthcare clients.
Travis: I chose healthcare law because I really wanted my practice to help people. I grew up knowing how vital it is for a community to have access to affordable healthcare services. My hometown is Shattuck, a small town in northwest Oklahoma with a population of about 1,200. Unlike many rural communities today, Shattuck still has a small hospital—Newman Memorial Hospital—that serves the community’s health needs. Growing up in Shattuck gave me an ingrained understanding of how important hospitals like Newman Memorial are to the health and economic vitality of communities. I like to think my practice helps me ensure that these organizations remain viable in an increasingly difficult regulatory and financial environment.
What is a “typical” day like and/or what are some common tasks you perform?
Jayda: My typical day usually involves a mix of internal and client meetings and drafting various client deliverables. On any given day, I may be conducting research or reviewing a research project and emailing clients about ongoing matters or questions they have on existing work. Supervising junior associates and paralegals in ongoing work efforts is also a common part of my typical day.
Travis: My to-do list typically involves drafting or reviewing asset purchase agreements, membership substitution agreements, professional services agreements, or other key transactional documents. I also regularly meet with clients to discuss deal points or terms that need to be negotiated with the other parties to these agreements and strategize what business goals we want to achieve in the agreement and how best to achieve them. This requires critical thinking about the position that we are taking in these negotiations and about how the other parties may respond. Finally, I try to spend time each day reading about new healthcare regulatory developments or transactions in the industry. This practice helps me anticipate our clients’ needs.
What training, classes, experience, or skills development would you recommend to someone who wishes to enter your practice area?
Jayda: I would recommend that someone interested in this practice area, particularly in digital health and innovative care delivery model counseling, familiarize themselves with technology companies and the operational aspects of those businesses (e.g., understanding mobile health platforms and website-based platforms). General industry knowledge of companies in this space is really helpful to serve as a comparison point and also to understand the look and feel of these platforms, from a patient, provider, and developer standpoint.
Travis: I would encourage anyone who is interested in a corporate practice to take an Accounting for Lawyers class, particularly if you do not have an undergraduate background in business or finance. Key decision-makers at our clients speak in financial terms. Having early familiarity with key financial concepts will give you an advantage over those who must learn these terms on the job. I would also encourage students interested in heavily regulated practices such as healthcare to take administrative law courses. Understanding the regulations that shape the industry and the processes government agencies go through to issue those regulations can set you apart in developing a practice. In addition to these substantive areas, courses in negotiating or participating in mock negotiations can provide practical experience in successfully navigating a corporate transaction from letter of intent to definitive agreement and help you see how much of the art in becoming a successful lawyer occurs beyond the classroom. Being a skilled negotiator depends on how well you think on your feet and what people skills you develop.
What is the most challenging aspect of practicing in this area?
Jayda: The most challenging aspect of practicing in this area is that the laws are always evolving, so there is always something happening or something new to dig into. Additionally, even with the evolution of digital health and innovative care models, many laws and regulations have not caught up with the technologies that many of our clients’ platforms use today. This results in a substantial ambiguity, which we help our clients navigate as they further assess their operations.
What do you like best about your practice area?
Travis: The best part about being a transactional healthcare lawyer is seeing the impact of my work in communities. My career has afforded me the opportunity to see how the profession can positively impact people. I’ve worked with clients to save local hospitals from closure, to bring needed healthcare services to a community, and to develop programs that train future healthcare providers. Our work allows us to feel good about what we do and why we do it.
What are some typical tasks that a junior lawyer would perform in this practice area?
Jayda: Junior lawyers perform a number of tasks to support this practice area. They are instrumental in assisting with research projects, conducting due diligence related to transactions, tracking and analyzing new legislation or proposed rulemaking, writing on any of these topics, and performing outreach to state regulators on nuances in laws and regulations.
How do you see this practice area evolving in the future?
Travis: Healthcare is only going to become more competitive, diversified, and complex as new market entrants (such as big-box retailers and technology companies) invest in the delivery of healthcare services. These competitive pressures—occurring against a backdrop of increased regulatory and reimbursement scrutiny—are going to result in greater transaction volume and more complex corporate transactions.