Success in contract negotiations with health insurance companies can play a big part in the difference between healthcare organizations that thrive and those that struggle to achieve and maintain good profitability.
Rates for reimbursement for providers are not usually set based on skill, ability or even clinical outcomes. Payors default to offering the lowest number they think the practice will accept and that’s how it ends up working out in many situations. This happens because the healthcare organization frequently underestimate their leverage and because negotiations with insurers is an exercise that benefits from experience.f
For example, practices that can provide strong data and analysis regarding their cost effectiveness are in a stronger negotiating position to contract better reimbursement rates and potentially, carve-outs.
Our consulting team brings decades of experience to the table in working and negotiating with payors. Utilizing national benchmark data, we excel at reviewing and negotiating payor contracts that are profitable for healthcare practices.