Payor Contract Negotiations
Project Overview
A critical situation had developed where payor contracts had remained stagnant for over a decade, with:
- No contract reviews or negotiations conducted in 10 years
- Outdated reimbursement rates affecting practice viability
- Missed opportunities for revenue optimization
Goals
- Achieve significant increase in reimbursement rates
- Establish regular contract review processes
- Improve relationship with key payers
- Secure more favorable contract terms
Our Approach
Recognizing the urgent need for contract modernization, our team initiated direct engagement with major payers and Medicare advantage plans. This comprehensive approach involved analyzing existing contracts, identifying areas of potential improvement, and developing data-driven negotiation strategies. We established structured communication channels with payers and leveraged market data to support our position for improved reimbursement rates.
What We Did
Conducted thorough analysis of existing contracts
Identified areas of potential revenue improvement
Developed compelling value propositions for each payer
Led structured negotiations with multiple payers simultaneously
Results
Through our targeted negotiation efforts, we achieved a remarkable 25% increase in contract rates across the practice’s top four payers. This significant improvement established a new baseline for future negotiations and was complemented by the implementation of a regular contract review schedule, ensuring ongoing optimization of payor relationships and reimbursement rates.
Increase in contract rates across the practice’s top four payers
“Thank you for managing the contracts for us, I continue to be surprised at how low our reimbursement is and that no one was looking at this before you guys took over our practice. I am so grateful that you care, and you are always doing what is best for us.”
“Thank you for managing the contracts for us, I continue to be surprised at how low our reimbursement is and that no one was looking at this before you guys took over our practice. I am so grateful that you care, and you are always doing what is best for us.”