Contracting
Developing optimized managed care contracts that deliver efficacy and returns.
Managed care contracts are agreements between healthcare providers and insurance companies that define the terms of payment for services rendered to patients. These contracts can take many different forms, including fee-for-service, value-based, and risk-based agreements.
Managed care contracts go beyond fee-for-service and can benefit your practice if approached strategically. There are many different types of contracts and they all require ongoing analysis and maneuvering to optimize return, volume, and efficiency. Providers can receive compensation for lowering the global cost of a member’s care by making strategic choices such as site of service and frequency of ancillary services.
Some questions to consider:
- What contracts do you hold and what is your reimbursement rate with each?
- What patient volume are you receiving in return for any discount of billed charges?
- Do you know what is a good contract relative to the services you provide?
- Are you being paid correctly?
- Are you maximizing your potential?
- Would value-based or risk-based contracts be beneficial for your practice/organization?
- What is your current contracting strategy?
- Do you want to increase patient volume through an increased payer network strategy?
Welter Healthcare Partners can help you strategically optimize your returns and increase contract compliance.
Don't let lack of information hold your practice back!
Lack of information about contracts and reimbursement is common in practices. Given the constantly evolving managed care landscape and frequent updates, it’s essential to stay informed. Success requires strategic planning, similar to chess. We offer comprehensive independent research and strategic support for managed care contracting issues.
Stay ahead of the managed care game with our comprehensive research and strategic support.
Initiating New Contracts & Renegotiating Existing Contracts
Welter Healthcare Partners specializes in facilitating new contract opportunities for healthcare practices. Our expertise lies in identifying potential health plans and evaluating their value for your organization. With our skilled negotiation team, we work diligently to secure fair reimbursement rates and favorable contract terms on your behalf. Additionally, we can help you streamline your network options, including self-funded and direct-funded plans.
Our comprehensive range of services encompasses contract valuation, expected payment reporting, and fee schedule examination. We go above and beyond by assisting in the initial acquisition of managed care contracts and providing reassignment support as necessary. Our goal is to ensure that your organization maximizes its revenue potential.
Additionally, we have the capacity to renegotiate existing contracts, enabling us to secure better payment terms for the exceptional services you provide.
Ready to create or improve your practice’s managed care contracts?
Contract Modeling
At Welter Healthcare Partners we use advanced financial modeling techniques to assess the potential impact of a managed care contract on a healthcare provider’s revenue and profitability.
The process involves analyzing the terms of a managed care contract, such as:
- Reimbursement rates
- Patient volume
- Utilization patterns
We will then project the financial outcomes of those terms over time.
Welter Healthcare Partners helps healthcare providers make informed decisions about which managed care contracts to accept, which to negotiate better contract terms on, and develop strategies for optimizing revenue and profitability.
Start understanding the financial implications of your contracts and make data-driven decisions to support their bottom line
Reimbursement Strategy
Fee-for-service contracts are the most traditional model, where healthcare providers are paid based on the number of services they provide. Value-based contracts, on the other hand, incentivize providers to focus on quality of care rather than volume of services. In this model, providers are paid based on patient outcomes and overall value delivered, rather than simply the number of procedures performed. Risk-based contracts are a hybrid model that involve sharing financial risk between the healthcare provider and the insurance company. In this model, providers are incentivized to deliver high-quality care while also managing costs, as they are financially responsible for a portion of the cost of care.
Choosing the right type of managed care contract for your practice can be a complex and challenging process. That’s where Welter Healthcare Partners comes in. Our team of experts can help you assess the different options available and determine which one is best suited for your practice. We take into account a variety of factors, including your patient population, services offered, and financial goals, to help you make an informed decision. Additionally, we can provide support throughout the contract negotiation process to help ensure that you are getting the best possible terms and conditions for your practice. With our expertise and guidance, you can feel confident that you are making the right decision for your practice and your patients.
“Huge Thank you… Incredible partnership we have forged!”
A huge thank you to Mark, Todd, and the entire Welter Healthcare Partners team! Couldn’t have turned our Contract Management division around as quickly as we did without their deep payor market expertise, the trusted and well-established payor relationships, and the polished professional drive that the entire Welter Healthcare Partners team possesses and consistently delivers. Incredible partnership we have forged!
Thomas Zdrale
Regional Director Revenue Cycle
Panorama Eye Care