By Kirsten Shepard, CIC, CISR Elite, CRM and Brett Findlay, ARM, CRIS
Construction is built on coordination and shared effort. Owners, general contractors, subcontractors, and suppliers work together to complete a project successfully. But when something goes wrong, that coordination can quickly expose contractors to unexpected risk if responsibilities are not clearly defined.
For contractors, contractual risk transfer is one of the most effective tools for managing that exposure. More than legal language, it is the framework that determines responsibility, insurance response, and whether a single incident becomes a long-term financial issue.
WHAT CONTRACTUAL RISK TRANSFER REALLY MEANS
Contractual risk transfer aims to place the financial burden of certain losses on the party with the greatest ability to prevent or manage those risks. These contracts establish how risk is shared among project participants and who is held accountable, should an incident occur.
From a risk management perspective, several provisions have a major impact on outcomes: indemnification clauses, insurance requirements, additional insured provisions, primary and non-contributory wording, and waivers of subrogation. Individually, each provision plays a role. When aligned, they help ensure risk is borne by the party best positioned to control it. When misaligned, they can unintentionally push liability onto parties with little involvement or ability to prevent the loss.
WHY CONSTRUCTION IS ESPECIALLY VULNERABLE
In construction, risk typically flows downhill. Owners look to general contractors, general contractors look to subcontractors, and subcontractors may look even further down the chain. When contracts are properly structured, this system works as intended and responsibility follows the work.
Problems arise when contracts are vague, overly broad, or inconsistent with insurance coverage. Contractors may then find themselves defending claims caused by others, leading to higher insurance costs, strained business relationships, reduced bonding capacity, and difficulty securing coverage for future projects.
THE LIMITS OF STANDARD CONTRACTS
Many contractors rely on industry-standard agreements, assuming they provide balanced protection. While these forms are widely accepted, they are not automatically equitable. Contracts often incorporate other documents by reference, such as prime contracts, specifications, or project manuals.
When a contract incorporates another agreement, all referenced terms become enforceable. Contractors who have not evaluated the entire contract structure may unknowingly accept risk far beyond their role on the project.
INDEMNIFICATION AND INSURANCE
Indemnification provisions define who pays when a loss occurs. Fair indemnification language generally limits responsibility to losses caused by a contractor’s own negligence or the actions of parties under its control.
Insurance is what funds indemnification obligations. Reviewing coverage requirements early helps ensure policies align with contractual commitments and reduces the risk of coverage gaps.
GETTING AHEAD OF RISK
Contractual risk transfer should be treated as a strategic business decision, not an administrative task. Reviewing contracts carefully, involving legal counsel, and aligning insurance coverage with contractual obligations before work begins can help contractors protect what they have built.
The best way to prevent that is to slow things down on the front end. Reviewing contracts, asking questions about unclear language, and understanding how responsibility is being assigned can help avoid surprises later. Involving your insurance broker and legal counsel before work begins makes it easier to spot gaps between contract requirements and actual coverage.
Contractual risk transfer is about making sure the risks you take on are fair, manageable, and tied to the work you control, so one claim doesn’t put your business or livelihood at risk.
About the Authors
Kirsten Shepard is a Senior Risk Management Consultant at OneGroup specializing in contractual risk transfer, working with construction firms to evaluate contract language and risk allocation before projects begin.
Brett Findlay is Senior Vice President and Construction Practice Leader at OneGroup, advising construction businesses on insurance and risk management strategies across Central New York.
A four-year construction industry curriculum in public high schools represents a strategic and forward-thinking investment in both students and the broader economy. For students who intend to enter the workforce immediately after graduation, such a program provides a structured pathway to sustainable, well-paying careers with excellent benefits, while addressing critical labor shortages across New York’s construction sector.
Berlucchi had previously worked for Lancaster General Hospital in Lancaster, Pennsylvania and had come to understand how important OBGYN care is for women in rural and underserved populations. “I know what it’s like to be geographically separated from a maternity center,” he explained. Berlucchi partnered with Crouse Hospital to maintain obstetrical services at Auburn Community Hospital.
ACH as Chief of Obstetrics and Gynecology. A primary reason she decided to join ACH is the small-town community feeling where she can grow meaningful relationships with patients.
Dr. Bonilla-Martir explained that she also felt drawn to ACH because the obstetrics and gynecology programs are integrated, and that while some complicated cases may need to be referred out to providers in Rochester or Syracuse, they are able to take on many high-risk patients as well as normal pregnancies. 
“Many patients love Dr. Balaya,” said Dr. Bonilla Martir. “As of the beginning of April, he has become a full time physician with us and will be helping us continue to deliver the high-quality care that women in the community need.”
Another stand-out aspect of the team of OBGYN providers at ACH is the personalized care provided by the staff of midwives. Jennifer MacBlane, CNM, had been coming to ACH on and off for several years before joining the team full time in August of 2025. She echoed the sentiments of her colleagues when it comes to the small community feel of ACH and of the wider Auburn community.
“The word ‘midwife’ means ‘with woman.’ The whole idea is that we’re with them to help them and develop whatever they need,” MacBlane said. “It’s all-encompassing. Midwives kind of look at the big picture, so we include everybody – your family, your social history, your medical history. We put it all together. It’s a really nice, unique experience because you get a little bit of the warm and fuzzy, but we also do the medical side. We can get you medicine, lab work, testing, we can get you an epidural – we’re qualified to do that. We just look at it a little differently, and we work a little closer with the patient while they’re in labor.”
“We work together as a group,” shared MacBlane. “Midwives are independent in New York State, but we work together with the physicians to kind of cover our patients and determine the plan for their care collaboratively, which is really nice.”
recent years and now includes a dedicated women’s imaging center within the hospital. Jubin Jacob, MD, Chair of Radiology at ACH, highlighted advancements in mammography technology offered to women at ACH, including stereotactic biopsies utilizing mammographic guidance and ultrasound equipment that provides 3D images while keeping radiation doses as low as possible. He emphasized how all the technological advancements offered to women at ACH are aimed at enhancing patient experience.
With the opening of the new Interventional Radiology suite and the recent addition of a physician assistant who will primarily work on further expansion of radiology services, Dr. Jacob said several other advanced treatments and procedures are being offered to women at ACH. Examples of these new offerings are minimally invasive procedures to treat symptomatic fibroids, adenomyosis, and pelvic venous insufficiency, as well as curative ablation treatments for breast cancer tumors in patients who are not surgical candidates. In addition, the team has access to the best quality PET scanner in the region.
With anticipated changes to the demographics of people in areas surrounding ACH – including a population that’s both aging and also growing due to developments like Micron – Berlucchi is passionate about continuing to expand the OBGYN practice at the health center. Currently in the process of obtaining a grant with the Department of Health, Berlucchi is leading the team toward a vision of comprehensive healthcare for women of all ages including OBGYN and beyond.
I am an avid reader, belong to two book clubs, and receive a steady stream of great recommendations from my health news feed. Recently, I had the opportunity to read two excellent books by local physician authors: Dr. Mary Jumbelic, retired Chief Medical Examiner of Onondaga County, and Dr. Sarah Matt, surgeon and health technology expert. Two very different books, but both outstanding and musts for your reading list.
I asked Dr. Jumbelic when she first realized she wanted to write. Throughout her career, she kept journals and notes about her work, not realizing how important they would be later in life. After retiring, she entered a writing contest and then began taking classes, evolving into a seasoned author with an incredible voice that merges technical forensic expertise with deeply personal reflection.
Dr. Sarah Matt has also drawn on her surgical and technical expertise to write a strategic and highly readable look at the future of technology in health care. A mid-career physician, she has broadened her impact by working across the health technology landscape, including leadership roles with health technology companies and digital health initiatives.
To safeguard patient care from corporate interference in clinical decisionmaking, New York maintains one of the strictest corporate practice of medicine (“CPOM”) prohibitions in the United States. Under New York law, medical services may be provided only by licensed medical professionals, by professional entities that are owned and controlled exclusively by licensed medical professionals, or by hospitals and other entities expressly authorized under the Public Health Law.
The arrival of Dr. Jorge Romero as Section Chief of Cardiac Electrophysiology and Director of Cardiovascular Research and Innovation is a prime example of increased convenience and accessibility for patients, bringing cutting edge treatments directly into their community. Dr. Taub noted that she initially connected with Dr. Romero to refer a patient for a procedure that couldn’t be done locally.
“Instead of heating or freezing the tissue, we are creating small holes in the cell membrane, called electroporation. The beauty of this technology is that the cardiac muscle is uniquely sensitive. We only need a small dose of energy to eliminate the triggers for atrial fibrillation located in the pulmonary veins of the patient,” Dr. Romero said, which avoids damage to the smooth muscle of the esophagus, phrenic nerves, and other adjacent structures. This has eliminated the risk of atrial esophageal fistula, a deadly complication that used to happen in 0.2% of ablation cases, but which hasn’t occurred in the 800,000 cases of PFA that have been performed so far worldwide. This new, safer technology greatly benefits the older population, mostly over the ages of 70, who are most likely to suffer from atrial fibrillation, offering improved quality of life and reducing longterm risks. Dr. Romero successfully performed Upstate’s first ablation using the Affera Mapping and Ablation System with the Sphere-9 catheter, a multi-purpose catheter not found at any other facility in New York State outside New York city and Long Island.
“It’s less morbid; recovery is fast, and outcomes are very similar to open-heart surgery,” said Dr. Kalra. “Transcatheter techniques for the aortic valve are becoming the procedure of choice. Even patients who are at low risk for complications following open heart surgery are eligible for and favor the transcatheter heart valve due to significantly less morbidity following the procedure, and faster return to normal life.”
Foundational to cardiovascular care is cardiovascular imaging, which is used not only for visualizing and diagnosing cardiac disease, but also during interventional procedures. Under the guidance of Dr. Adeeb Al-Quthami, Director of Cardiovascular Imaging, significant investments in the latest technology have been secured for the benefit of Upstate’s patients.
“We can visualize the heart to a very high degree in terms of tiny detail,” he said. “If you try to take a picture of something that’s moving, it’s going to blur, especially if what you’re trying to take a picture of is small. With the advancements in technology, we can take a picture of the heart within a fraction of a heartbeat,” identifying patients’ unique anatomy and offering precise, personalized treatment for each patient.
Launched within the last year, AI assisted plaque analysis software, called HeartFlow, is now helping the Upstate cardiovascular team to better assess a patient’s risk for a future heart attack. Dr. Al-Quthami explained how this new technology offers improvement over the traditional coronary calcium scan.
By recruiting more cardiovascular experts to Upstate and continuing to invest in the innovative technologies they use, Dr. Tucker highlighted how the Upstate cardiovascular program is committed to staying at the forefront of cardiovascular care.
Clinicians hear it every day, stressed patients, and stressed staff. The pressures of changing systems, social media chatter, and a world that seems to be restructuring at every level.
When Melanie McNally, MD first began practicing urology, she didn’t anticipate developing a focus on urologic issues specific to women. However, about five years into her practice, she found many women were experiencing urologic health concerns that gynecology was illequipped to manage.
Stallone has held two unwavering truths: he wanted to be a physician, and he wanted to serve his country. Both were anchored by clear purpose.
He went on to earn both an MD and MBA simultaneously from the University of Pennsylvania, and later an MA in National Security Policy Studies from the U.S. Naval War College. He also serves as an Air Force Colonel and has been with the New York Air National Guard for more than 28 years, the past seven as the New York State Air Surgeon. These accomplishments reflect a career built on discipline, leadership, and a breadth of perspective informed by medicine, business, and service.
As his career evolved, Dr. Stallone stepped into health system leadership roles, including serving as a hospitalist, physician leader, and former health system CEO, gaining a broader view of how care is delivered and where it often breaks down. He saw firsthand the pressures facing providers, the operational realities behind clinical decisions, and the importance of aligning strategy with real world practice.
That belief drew him to Excellus BlueCross BlueShield (Excellus BCBS) well before his executive appointment. Through his involvement on the plan’s Central New York and Southern Tier regional advisory boards and governing board of directors, Dr. Stallone developed a deeper understanding of the organization’s nonprofit mission and its commitment to community-focused care. Just as important, he learned the value of listening. “You have to understand providers, the community, payors, and the people doing the work,” he says. “That’s how you design programs that actually make a difference.”
At the core of his vision is partnership. Drawing on his experience as both a physician and a former health system CEO, Dr. Stallone sees collaboration as the most effective path forward in an increasingly complex healthcare environment. He designs practical, sustainable, and impactful programs by grounding his strategy in the real challenges facing the healthcare system, including rising costs. 
Dr. Stallone envisions Excellus BCBS as a bridge-builder, bringing together providers, health systems, and community partners to solve problems collaboratively. His focus is on creating pathways that strengthen relationships, improve coordination, and deliver measurable improvements in care—all while staying true to the organization’s mission.