Tag Archives: medical cost management

Use data to prepare for payer/provider risk contract negotiations

In my experience negotiating risk contracts with providers on behalf of payers, I saw some significant differences in the way provider organizations approached these negotiations. Some providers came to the negotiating table with data, analytics and a clear strategy to support their position. Others would accept proposed terms without fully evaluating and analyzing the cost […]
Read More »

Leveraging benchmarks to target best opportunities for improving medical cost management

Health plans and risk-bearing providers are under increasing pressure to explore business models that allow for the reduction of medical loss ratios (MLRs), strengthen clinical performance and enhance relationships with providers. New forces at the local, state and federal levels are requiring plans to rethink their business models and identify new approaches to growth, and […]
Read More »