Well-negotiated managed care relationships deliver long lasting value to payors, providers, and patients—but what constitutes a thorough and successful negotiation, and how is that achieved? Power and leverage can drive a contract negotiation the same way that brute force might drive a street fight: without finesse, and without the promise of a long-term solution. Similarly, less than accurate language or fancy word play can net a quick return, but at high cost to reputation and business ethics—not to mention the results of the next negotiation.
A payor that was last year an irrelevant insurer among a basket of commercial payors to a given hospital could the next year be acquired by a major player or start serving as third-party administrator to a large local employer. Likewise, a community hospital surrounded by competitors could rise to the top of payors new quality ratings, driving beneficiaries with deductible or coinsurance incentives to the hospital in large numbers in the next year.
In short, today’s contracting teams cannot rely solely on power or gamesmanship to drive long-term value in contracting. Successful managed care contracting involves a mature and careful consideration of both business and legal issues, and it is our belief that the integration of these disciplines into the contracting team is a key determinant of such success.
We offer call center staffing on a full-time or project basis for network development.
Southwest Medical is a market innovator and leader in “expedited network development”. Our teams processes enhance the probability of often improbable requirements if initiated under typical organizational constraints. Southwest Medical Consultants deliver speed and results.
Our network development approach is different from internal client initiatives due to a unique fusion of direct response techniques, tactical strategies, geographical and dispersion analysis and intensity of applied resources. Southwest Medical Consultants is prepared to gear up and down in 24 – 48 hours, modify direction on the fly and provide both tactical and strategic guidance.
What Are the Determinants of Success?
A successful negotiation is one in which a contract team achieves the broad variety of goals inherent in an agreed resolution. While agreement on pricing is the most obvious goal, other goals are also important. The determinants of success include:
- Stability in the relationship.
- Predictability with respect to pricing and payments over the course of the contract.
- Connections that allow for a positive working relationship and efficient approaches to resolving disputes.
Relevant Experience and Innovative Approach:
Southwest Medical Consultants have significant relationships in both the provider and payor communities that create leverage, insight and the ability to deliver promised results. We fully recognize the difference between recruitment and sales and coupled with strong direct response and data management techniques utilize a proven approach to meet client objectives.
Out of the gate, there are immediate results, no need to hire and train resources, no increase to salary wage and benefits and no unnecessary resources post project completion.