Revenue management is more complex requiring a balanced approach in managing current revenue streams for services provided balanced with emerging reimbursement systems that are clinically integrated in support of the health of a population. These complexities require greater discipline in managed care contracting aligned with strategic positioning for accountable care. Managed care contracting is more than negotiation of annual rate increases. It is living in two worlds of revenue management—fee for revenue and value based—that requires greater use of data transformed into information understanding financial, quality and operational impact of health services provided.
Managed Care Contracting Includes:
- Payment for services
- Payment for quality
- Payment for health of a population
- Potential for investment in pilot programs’ and development of new innovative programs supporting accountability for care across the continuum
Freed Maxick Healthcare will work with you and your teams to optimize revenue management for quality of care and services provided through managed care contracting strategy development and management.
- Be prepared:
- Assess the payer, competitor, emerging collaborative health system, and health industry market
- Assess financial performance
- Assess quality performance
- Assess internal operations management
- Build a financial model for analysis and development of managed care contracting strategy and negotiation plan.
- Develop managed care contracting strategy including financial modeling, contractual terms, and key operational requirements in support of your health systems priorities for:
- Growth and development in service offerings, care coordination, and clinical integration of a population
- Quality performance
- Financial performance
- Administrative efficiency and effectiveness
- Engage your negotiation team and assist in development of your managed care contract approach.