In this episode we are joined by Amy Coletti, Principal at ECG Management Consultants & Kevin Dowdy, Associate Principal at ECG Management Consultants. They discuss the everchanging payer landscape and what changes they expect to see in the near future, as well as how ASCs can be more strategic in their discussions with payers. This episode is sponsored by ECG Management Consultants.
Summary
ECG Management Consultants Discusses Payer Landscape for ASCs
Introduction
Amy Coletti, Principal at ECG Management Consultants & Kevin Dowdy, Associate Principal at ECG Management Consultants join us in this episode to discuss the changing payer landscape and strategic negotiation tactics for ASCs. This episode is sponsored by ECG Management Consultants.
Key Trends in Payer Contract Negotiations
Payers have their own reimbursement methodologies, and it is crucial to verify their fee schedule to negotiate effectively. Payers may update their methodologies without renegotiating contracts, leading to reduced reimbursements. To reduce total care costs, payers are offering lower rates for narrow networks and exchange plans. They also incentivize lower cost settings such as office and ASCs. ASCs should be wary when signing contracts with larger payers who may have access to low rates acquired from smaller payers.
Effective Strategies for Contract Negotiations
Developing a managed care plan, building a business case, being patient, and negotiating contract language are crucial for successful negotiations. ASCs should be strategic by understanding their existing and new business, refraining from performing loss leader cases before reaching a correct reimbursement rate, and backing their negotiation stance with data.
Conclusion
Kevin and Amy provided important insights into the payer landscape, and negotiation tactics that ASCs could use. Additionally, they thanked ECG Management Consultants, the sponsor of this episode, and encouraged listeners to check out more podcasts from Becker's Healthcare.
Note: This is an AI generated transcript, not edited by a staff writer and is solely intended for educational purposes. If you have any questions/concerns, reach out to podcasts@beckershealthcare.com
This episode aired on 12/29/2022 and can be listened here.
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