How to Negotiate a Better Payer Contract: 3 Must-dos Before Signing
One of the biggest challenge facing physician independent practices is staying independent. In order to overcome it, practices must pay attention to payer contracts.
It’s safe to say the biggest challenge facing physician practices, in light of MACRA and other healthcare shifts, is actually staying independent. In order to overcome this, practices must pay attention to how they’re generating revenue. Of course, payer contracts are a big part of this.
But all too often, practices accept these contracts as-is, not realizing they aren’t as good as they look, or that a better negotiated contract could be possible. This needs to stop!
Here are a few things you should consider before signing any payer contract.
A RCM analysis also lets you see how a change—such as when a payer renegotiates a contract—will truly affect your practice. Let’s say a payer allows your practice to increase prices by three percent, in the aggregate. What does this increase really mean? How will this impact your pricing and revenues? A RCM analysis will help you know what to expect.
Think long and hard before you sign
In the current healthcare environment, it’s tough for practices to stay independent. And while contracts from large healthcare systems can seem lucrative in the near term, they often times are a detriment to your practice in the long run forcing you to give up your independence. Take time to understand the payer and, more importantly, your practice. By working with DS+B to determine break-event points and improve your revenue, you’ll be better positioned to accept—or reject—any contract that comes your way.