Abstract
Purpose of Review
The current healthcare landscape necessitates a greater emphasis on managing payer contracts and connections. However, many providers do not have an effective roadmap for navigating this process.
Recent Findings
Current practice expense increases greatly outpace reimbursement gains. To improve reimbursement, providers must create a contracting strategy that addresses payers’ goals which include cost containment, quality of care, and network adequacy. To accomplish this, providers need effective lines of communication with their payers and maintain consistent communication channels. They must utilize technology to demonstrate appropriate metrics and minimize administrative burden for all parties. Furthermore, they must provide and communicate a better patient experience that results in a high patient satisfaction.
Summary
With rising overhead costs, changing reimbursement models, and shifting markets, it is vital for providers to maintain robust communication channels with their payers to find a viable path towards sustainable agreements.
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Data Availability
No datasets were generated or analyzed during the current study.
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DM wrote the main manuscript. MD wrote the abstract and created the tables. All authors reviewed the manuscript.
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Dan Marano, CHFP: Senior Manager, Lighthouse Healthcare Advisors. Marc Dubin, MD: No relevant disclosures.
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Marano, D., Dubin, M.G. Engagement with Healthcare Payers: Lessons Learned. Curr Otorhinolaryngol Rep (2024). https://doi.org/10.1007/s40136-024-00500-w
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DOI: https://doi.org/10.1007/s40136-024-00500-w