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    Negotiating A Managed Care Contract

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    Managed care contracts are an important part of most healthcare organizations' financial strategies. Effectively negotiated contracts can preserve revenue and yield additional dollars through new products and models while also improving customer satisfaction by helping them access comprehensive treatment. Successful negotiation requires preparation, collaboration, and compromise from both parties to reach an agreement that mutually benefits them. While reimbursement rates are important, other factors like workflow impact, claims responsiveness, and credentialing processes are more significant to making contracts successful in the long run. Compromise is also critical, with both payers and hospitals needing to be willing to give some ground when disagreements arise.

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    Negotiating A Managed Care Contract

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    Managed care contracts are an important part of most healthcare organizations' financial strategies. Effectively negotiated contracts can preserve revenue and yield additional dollars through new products and models while also improving customer satisfaction by helping them access comprehensive treatment. Successful negotiation requires preparation, collaboration, and compromise from both parties to reach an agreement that mutually benefits them. While reimbursement rates are important, other factors like workflow impact, claims responsiveness, and credentialing processes are more significant to making contracts successful in the long run. Compromise is also critical, with both payers and hospitals needing to be willing to give some ground when disagreements arise.

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    Negotiating a Managed Care Contract

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    Managed care contracts are an important part of most healthcare organizations' financial strategies. Effectively negotiated contracts can preserve revenue and yield additional dollars through new products and models while also improving customer satisfaction by helping them access comprehensive treatment. Successful negotiation requires preparation, collaboration, and compromise from both parties to reach an agreement that mutually benefits them. While reimbursement rates are important, other factors like workflow impact, claims responsiveness, and credentialing processes are more significant to making contracts successful in the long run. Compromise is also critical, with both payers and hospitals needing to be willing to give some ground when disagreements arise.

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    © All Rights Reserved
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    Download as docx, pdf, or txt
    56 views1 page

    Negotiating A Managed Care Contract

    Uploaded by

    Premium Geeks
    Managed care contracts are an important part of most healthcare organizations' financial strategies. Effectively negotiated contracts can preserve revenue and yield additional dollars through new products and models while also improving customer satisfaction by helping them access comprehensive treatment. Successful negotiation requires preparation, collaboration, and compromise from both parties to reach an agreement that mutually benefits them. While reimbursement rates are important, other factors like workflow impact, claims responsiveness, and credentialing processes are more significant to making contracts successful in the long run. Compromise is also critical, with both payers and hospitals needing to be willing to give some ground when disagreements arise.

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    Negotiating a Managed Care Contract

    Most organizations use managed care contracts for their financial strategy. Managed care
    revenue can be a significant share of the healthcare income, and effectively negotiated contracts
    have a positive impact on preserving revenue as well as yielding additional dollars through new
    products and models. Additionally, effective managed care contracts improve customer
    satisfaction since they help them to access comprehensive treatment and services. In successfully
    negotiating a managed care contract, both parties should mutually benefit in multiple ways
    (Krohn, 2017). Essentially, reaching an agreement in any contract requires preparation,
    collaboration, and compromise. The organizations that have solidified their expectations in their
    contract are likely to attract acceptable terms. Setting an effective care contract requires keeping
    the focus away from the rates and establishing long-term goals for the agreement.
    While the amount the hospital gets as reimbursement is essential, it is less significant
    compared to other factors that make contracts successful. The facility should consider the impact
    the payer has on its overall workflow, issues such as responsiveness of the payer to the claims,
    execution of new policies, and whether or not they accept delegated credentialing. For instance,
    delegated credentialing streamlines the patient access to new services by lifting physicians and
    practicing swiftly. Additionally, the goals should stay put. When initiating a contract,
    organizations should consider the kind of payer-provider relationship they are after (Vega, 2018).
    One of the ways to determine where the contract will be successful is the length of time the
    payers are willing to commit. For instance, an organization could consider a long-term deal
    because they are assured of long-term revenue flow. Significantly, compromise is a critical
    element in managed care contracts. When disagreements arise between payers and hospitals due
    to differences in rates and provisions, each part should be willing to give a bit of ground. Ideally,
    successfully negotiated contracts require patience, determination, perseverance, and drive. When
    signed, all parties should feel they got most of what they were looking for.
    References

    Krohn, S. (2017). Successfully Negotiating Managed Care Contracts? Medium. Retrieved from

    https://medium.com/@stevekrohn/successfully-negotiating-managed-care-contracts-

    792b06ed7695

    Vega, K. B. (2018). Successfully Negotiating Managed Care Contracts. HFMA. Retrieved from

    https://www.hfma.org/Content.aspx?id=16658

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