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

One of the major challenges facing health law attorneys today is how to best track the changes that are taking place in programs that effect clients. Over the past five years, the rapid pace of change has often been driven by implementation of the Affordable Care Act.

The “flood” of regulations and procedures has made it difficult for attorneys to stay current with all issues that affect client decisions. Now, on the fifth anniversary of the Affordable Care Act (2010-2015), the situation promises to become even more demanding. Numerous changes to the Act, and to Medicare and Medicaid, are being considered by Congress, as budget pressures continue to be felt.

In response to this environment, we have developed new approaches to enhancing the ways in which attorneys may access the insights that they need. New types of “dense” written narratives have been prepared to describe program changes, and how organizations are reacting to these changes. New developments in qualitative analysis (describing program details with words, not with numbers) and typological analysis (using scales with categories, such as “very large impact,” “large impact,” “medium impact,” “small impact,” or “no impact”), when applied to organizational studies, have been shown to provide many insights into the changes that are taking place and to match the types of issues that are being encountered. These techniques allow written narratives to contain a great deal of relevant information in an easy-to-access form. And, these “dense” narratives allow health law attorneys to more rapidly find the information that they need. In addition, the narratives allow enhanced “issue-spotting techniques” that may be used to quickly identify the issues of interest and suggest further directions of legal research.

The “knowledge base” of such materials is helping attorneys—and other professionals—in their efforts to best deal with the rapid changes taking place in health care. The pace of change for health programs shows no sign of slowing. Through our recent books on the subject, we are continuing to support attorneys in their efforts to develop new insights and skills.

Background information on our health practice books for attorneys, published by Thomson Reuters, is given on the ACA Blog at

We have also recently completed a new Curriculum Guide that allows these materials to be applied for law-school classes in health law. This Guide is being made available to all health law faculty.

In addition, twice-monthly postings may be found on the Legal Solutions blog at under the tag “ACA and legal practices.”

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.


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