General Info

The strength of managed care contracts can have a huge impact on medical practice profitability, yet todays reimbursement is more difficult than ever to navigate. As medical practice revenue declines and overhead increases, guess what gets caught in the middle physician owner compensation! Overhead often increases from year to year but most medical practices have done a good job creating an efficient overhead structure in simpler terms, overhead needed to run the medical practice is lean and mean. This way, a medical practice can concentrate its efforts on increasing its top line - revenue. If revenue can be maximized and overhead contained, the result is increased monies for physician compensation. One way medical practices can increase their top line is by negotiating or re-negotiating with their managed care payers. When originally contracting with or renegotiating a provider contract with a managed care plan, the physician and the medical practice should strive for two specific goals: (1) to obtain the most favorable legal terms possible and (2) to obtain the most favorable financial terms possible. Every year physicians face important decisions as managed care contracts approach their anniversary dates. Will they allow their third-party contracts to roll over for another year, or will they review them with an eye toward renegotiation? Most practitioners are aware that the contracts will renew automatically under the existing (possibly unfavorable) terms, but assume that they have no negotiating power, and so do nothing. The result is the physicians lose and the third-party payers win. That kills me because it doesn't' have to be that way. Physicians dont have to lose.Get Help!First and foremost, dont allow yourself to be steamrollered by default. Managed care is all about survival of the fittest -- those with the most business savvy. To that end, dont try to do battle with third-party payers on your own. You need the guidance and advice of someone who understands the contracting process, what can and should be negotiated, and how to craft the deal. A relatively nominal expenditure for professional contracting help can prove to be miniscule when compared to the costs of financial and administrative nightmares some physicians have experienced as a result of signing when told, "Thats our standard contract. Everyone else is signing it."Contact me and I will physically go to your practice and evaluate your contracts as well as offer more contracting options with payers in your area. To your health!