Contracting

Managing and Measuring Payer Performance

Healthcare providers should have a contract management system as the framework for managing the four components of the governance/communication processes―contract analysis and modeling, payment calculations, variance monitoring workflow, and payer scorecard and reporting. 

Greg Kay July 13, 2017

Ask the Experts: Contracting with Small Health Plans

When negotiating with large and small health plans, what areas of comparison should I look at to be sure I am getting the same levels of service from the various plans?

HFMA April 24, 2017

Video: Tips for Direct-to-Employer Contracts from UNC Health

Understanding the time commitment and negotiation strategies around direct-to-employer contracts are key areas for payment and reimbursement leaders to consider.

HFMA February 16, 2017

Demand Fuels Expansion of Tiered-Benefit Insurance Products

Stephen T. Swift of BlueCross BlueShield of Western New York writes that collaboration with local healthcare providers spawned a popular tiered-benefit insurance product.

Stephen T. Swift January 26, 2017

Negotiating a Joint-Venture Health Plan

Aspirus is one of many health systems that partner with insurance companies to form joint-venture health plans that bring healthcare financing and delivery closer together.

Lola Butcher November 28, 2016

Contracting for Chronic Disease Management

Illinois Gastroenterology Group negotiated a specialty intensive medical home contract with the state’s largest private payer.

Lola Butcher October 11, 2016

Partnering With Healthcare Purchasers

Mount Sinai Health System partnered with a trade union to develop a bundled-payment program designed to improve patient outcomes and reduce the purchaser’s costs.

Lola Butcher August 10, 2016

Winning Direct Contracts with Employers

Pacific Business Group on Health, a leader in direct contracting, uses an extensive evaluation process to choose the provider organizations for its Employers Centers of Excellence Network.

Lola Butcher July 11, 2016

Hospitals with PBGH Joint Replacement Contracts

Pacific Business Group on Health (PBGH), a membership organization that includes many of America’s largest healthcare purchasers, has developed direct contracts for joint replacements, spine procedures, and bariatric surgery with hospitals across the country.

Sidebar July 11, 2016

Ask the Expert: PMPM Payments for Case Management

PMPM payments for case management.

HFMA October 25, 2012
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