Managed Care Contracting & Provider Payment

CPA Firm published Contract Negotiation Checklist

Here is another checklist from Reed Tinsley, CPA of things to consider when preparing to amend / renew a payor contract.  It is an excellent complementary list to some earlier posts: Part 1 and Part 2.
Thanks, Reed!

See checklist Reed Tinsley Negotiation checklist.

Another View on Managed Care Contract Negotiations

Reed Tinsley is an accountant from  Houston, Texas who represents many physicians. He also periodically writes a column and I’ve had a link to it for quite some time. Today (yesterday?) he wrote about a “win-win” approach to managed care contracting strategy. You may find it an interesting read. It’s all about the preparation….

Link to Column: Here

Recent Article Cites increasing Acrimony in Contract Negotiations between Insurers and Hospitals

The Arizona Star recently described a trend in nastier negotiations between insurers and hospitals. Story here. According to the article, insurers are under pressure to lower premiums, resulting in tighter price negotiations. Hospitals are the largest portion of the medical spend. The article analyzes differing views of which side has the current advantage and why. One increased use by payors of quality data to compare hospitals and put pressure on prices. Summary of article here.

Tips to achieve success during contract negotiations, Part 2

How hard should you push an issue with the payor? This article is the second in a series reprinted with permission from HCPro, the publisher.

Prepare the necessary data that support the issues you will raise with the payor to lay the groundwork for successful negotiations.

Last month’s tips encompassed everything from forming your negotiations team to gathering denials data. Now it is time to tackle your strategies for when you are actually seated across from the payor.

Tips to achieve success during contract negotiations

A recent article in HCPro’s Managed Care Contracting & Reimbursement Advisor contains tips for providers negotiating contracts with payors. (In the interests of full disclosure, I was a source for the article.) With all the new products & developments in the relationship between payors and health care providers, I am pleased to see this topic revisited. One change affecting the industry is the consolidation of payors into mega payors. Those negotiating for the provider often feel like David facing Goliath – and the payor’s contracting staff encourage this view.