Payor Relations: Managed Care Contracting

Physician Practices face important challenges and opportunities in the way in which they relate to third party payors.  A key advantage of an employed physician enterprise is the negotiating expertise and leverage it brings to managed care contracting.

Southwind management consultants assess and improve both existing and potential managed care contract opportunities.  The assessment includes the following key elements:

• Prioritize managed care contracting opportunities in the marketplace;
• Identify contractual and financial improvements in existing contracts;
• Analyze reimbursement and volume factors for each payor;
• Analyze capitated contracts and the risk management capabilities within the enterprise;
• Develop standard contracting policies and procedures that have the support of the senior executives of the health system and physician leadership of the group; and
• Define the ongoing contract management needs of the organization.

In accomplishing some or all of these tasks, Southwind ensures your employed physician enterprise is taking advantage of all its opportunities to optimize the financial and operating performance of its managed care contracts.