We provide executive level managed care expertise to help
hospitals negotiate stronger contracts.
Our team of managed care negotiators has worked with national
payers to successfully negotiate hospital and physician
contracts that deliver improved revenues to achieve client
goals.
This knowledge makes us extremely adept in negotiating
agreements between your hospital and your payers that support
your strategies.
Use our 25 years of experience and industry knowledge of your
challenges combined with our superior analytics to develop
solutions that best position you to compete successfully in
your market.
We follow a disciplined process in our approach using these pillars throughout our engagments to develop the best proposal to achieve our clients goals.
We use custom tools we specifically built to assess your actual claims, executed contracts, and remittances from each payer.
Next, our team uses this assessment to identify the specific areas that cause these results. Once the tools are developed, we can see how and where to negotiate language, methodology, or rate changes to achieve your goals.
Our negotiators have senior level experience in both payer and provider systems.
They use our superior analytical tools with their experience and relationships to give our clients unique insights into the payers thinking which allows us to develop successful proposals to meet your goals.
Have your negotiations resulted in contracts that are operationally efficient and financially effective?
All the information is shared with your team to help them understand and comply with the requirements of the contract. This helps ensure your system gets paid the hospital revenue you expected.
Working with CMCS, we were able to make significant improvements to our most important payer contracts. Their analytical tools showed us why our current contract was producing the revenue that it was. Their negotiators used that model with input from our team to determine how best to structure our proposals with the payers new fee schedules and rates to negotiate a sizeable revenue increase. We had not been able to achieve these results in the past and look forward to working with them in the future.
Penny Wallace, CFO, Guadalupe Medical Center
Our organization has had a great relationship with CMCS. CMCS has provided a level of expertise that had been difficult to retain in-house for our largest payer agreements that are negotiated once every two or three years. Their analytical models provided insights on proposals that helped drive meaningful and impactful negotiations. All of this at a reasonable cost with an ROI well in excess of 50 times with a net revenue lift of several tens of millions over the last 5 years.
Roger Mattke, CFO, Lafayette General Health System
"Stronger payer relationships enable you to achieve your goals."
With government payers moving to mangaged care models, the most significant opportunity to finance your strategic plans is to strengthen your payer relationships as a portfolio.
CMCS process will put you in control of your negotiations so you have better tools, negotiators, and tactics than the payer so you can drive the outcome that best achieves your goals.
John Montaine