Managed Care Payor-Provider Contracting: New Directions Risks and StrategiesManaged Care Information CenterMay 21, 2009 SKU: HP2677773 |
| Speakers Russell Foster Principal with pmpm Consulting Group; Gregory Pepe Principal with ,Neubert Pepe & Monteith; and Heather Burke President of Healthcare Provider Connections LLC discussed how both health insurance plan payors and healthcare providers have much at stake in the next round of contracting negotiations. For healthcare providers managed care contracts are one of the most important drivers of a healthcare organization’s financial reimbursement cash flow and profitability. Developing strategic contracting language can dramatically improve providers’ revenue stream. But failing to clarify certain payment terms could also lead to long-term financial problems. Payors have much at stake in today’s challenging economic environment. It is even more important to know the latest strategies to effectively negotiate managed care contracts to maximize revenue in today’s global turmoil. ,There are new legal contractual and financial risks in today’s managed care environment that must be taken into consideration during the negotiation process. Discover how to recognize contract issues before they become compliance problems! AGENDA: * Overview of the changes in contracting activity * The payor-provider negotiation climate * Techniques to set up quality incentives * How the stimulus plan affects contracting * How to increase reimbursement * Introduction of the newest breed of MC provider plans * New methods Medicare advantage plans are using to remain competitive * How to find quality providers * Payor contract evaluation and management methods * Conducting contract discussions involving pay-for-performance and quality-based reimbursement programs * Understanding the challenges in enhancing contract performance * The “fine” print negotiating the “No” in managed care agreements * Reimbursement and contract issues in negotiations * The importance of contractual provisions: Risk shifting Authorizations Claims denials * Question and Answer |
