Payer Relations

There are two primary common linkages between hospitals and physicians. One is the patient and the other is the payer organization. The patient’s welfare is best served when there is a thriving partnership between the hospital, the physician, and the payer.  Unfortunately, this is not always the case. The socio-medical environment today provides many opportunities to improve this partnership through numerous venues and mechanisms. The necessity to improve this relationship is driven as much by patients’ needs as by organizational and practice needs.

We provide a series of advisory and support services designed to build better working relationships with payer groups while helping ensure hospital and physician performance and success.

Professional Services

• PQRI and Other Quality Initiatives
• Pay for Performance
• Clinical Performance Measures
• Contract Mediation & Negotiation
• Community Health Needs Assessment
• Organizational Partnerships and Initiatives
• Compliance Management
• Managed Care Strategies
• Risk Contract Optimization
• Administrative Restructuring
• Contracting Strategies and Evaluation
• Predictive Modeling Applications
• Centers of Excellence Development
• Payer Outreach Processes