A Value-Based Approach to Managed Care Contracting
Harpeth Consulting managed care experts assess the current state of managed care operations (people, processes & technology) and executed agreements, assist clients in identifying executable improvement opportunities, and provide implementation assistance throughout the remediation and improvement process. Our experts develop improvement options that are focused on increasing net patient revenue as well as operational effectiveness. We advise our clients on all elements of contracting, including:

  • Strategic planning
  • Analysis and comparison tools
  • Managed care/revenue cycle technologies
  • Reimbursement rate benchmarking
  • Contract management/modeling
  • Internal controls and communication plans
  • Pre-negotiation preparation
  • Deep Industry Expertise

Our team of managed care professionals includes former Vice Presidents of Network Management, Directors of Managed Care and career consultants. We advise a wide variety of clients from large hospital management companies, academic medical centers and the federal government to community hospitals, physician groups and ancillary service providers.

Managed Care Contracting Review and Implementation Assistance
With continued downward pressure on managed care reimbursement rates and the move to increasingly complex payment schemes, healthcare providers are seeking advanced technological solutions for their managed care needs.  We can help you to assess your current state and select the appropriate technology to maximize underpayment recovery and modeling during negotiations with third-party payors.  Click here to download brochure.

Managed Care Contracting Review and Implementation Assistance
We begin by assessing the managed care strategy and contracting infrastructure. Then we assess the status of significant agreements and:

  • Compare negotiated rates among existing agreements, Medicare and average area commercial reimbursement
  • Understand business impact of key contract terms and conditions
  • Determine potential improvement opportunities and related implementation plan
  • Take action