This post was written by Ferd H. Mitchell and Cheryl C. Mitchell, Thomson Reuters authors and attorney partners at Mitchell Law Office in Spokane, WA.

The practice of health care law is being reshaped rapidly, as change impacts how health organizations function and how people approach the need for health services. After decades of more-orderly evolution in the health care system, more recent years have seen something new—rapid, more disruptive change.

Over the past four years, the Professional Development Group at Thomson Reuters has been nurturing the development of new books that can support the needs of attorneys in this environment.

As Thomson Reuters authors, we have developed a two-book set of resource materials that start with the rapid changes taking place in the health care system, and lead to the legal practice implications of these changes—for both organizations and individuals.

Disruption has been fed by the financial pressures from the Great Recession and stresses associated with implementation of the Affordable Care Act (ACA). We have been evaluating these changes in annually-updated books since 2010.

We are seeing the rapid growth of large organized health delivery systems (to maximize provider leverage) and a shift from fee-for-service to “value” care (with physicians required to manage both costs and care). Other trends feeding into the situation have been rapid increases in the numbers of individuals without ready access to health care services, and rapid growth in the costs of medical technology and prescription drugs. These combined factors are “shaking loose” the accommodations and balancing acts that have allowed a degree of stability to settle over the health care system in past years.

While the situation was more-or-less stable, organizations were able to carve out their “turf”, compromises were reached, and interlocking interests were sufficient to prevent major change. But this comfortable world has now been disrupted, and organizations are struggling to carve out new roles and protect their interests.

The first volume of our health care set traces how the ACA has evolved over the past four years, where the situation is now, and what this means for legal practices. The second volume of this set provides an overview of the larger health care system, and how the ACA and other changes are reshaping the system. Blog postings provide ongoing discussions of these themes.

For additional resources on the Affordable Care Act and to order the publications, visit the ACA resource page on

Ferd H. Mitchell and his wife, Cheryl, are attorney partners at Mitchell Law Office in Spokane, WA. They are active in elder law and health law practice areas. They have been working together on programs and activities on behalf of the elderly and in health care for over 25 years. During their studies, they have visited and evaluated the health care systems of Japan and several countries in Europe to learn how the needs of the elderly are assessed and met in other countries, and they have been better able to understand the U.S. health care system and related care issues from these visits.

Related book titles:
Practice Guide for Obtaining Funding & Access to Health Care for Dependents
Legal Practice Implications of the Affordable Care Act, Medicare and Medicaid, 2013-2014 ed.

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