The need to evaluate managed care relationships has become top priority for hospitals and other healthcare providers seeking financial improvement. With the continual fiscal pressures from governmental reimbursement programs, the need to have positive relationships with commercial health plans is oftentimes essential to providing a positive margin from operations. Through the health plan contract evaluation process, CHC Consulting will conduct a review of current financial information for the top payers for the organization.
- An onsite discussion with key administrative members of the organization sets the priorities most critical to improve in the system’s payor relationships.
- The project team collaborates to develop tactical recommendations related to relationships, structured negotiations, contract performance and compliance.
- Assessing an organization’s “Top Five” managed care contracts helps the hospital maximize results from improving contract terms and carve-outs.
CHC VP Health Plan Contracting