Despite its critical role in driving on-going performance and facilitating strategic scaling, payer contracting is commonly one of the more opaque departments within the physician platform ecosystem. As practices Scale healthcare and payer contracting becomes an increasingly overwhelming task, practices frequently submit to unclear performance reporting and ambiguously defined goals.
However, given its importance and technical nature, we believe payer contracting requires a precise approach: invest in qualified oversight and transparent performance reporting as well as clearly, realistically, and proactively defined strategies.
"SCALE has been able to quickly understand our needs and goals, as well as implement practical solutions to help bring our growth and operational visions closer to reality. We are excited to continue our partnership with SCALE."
Ongoing Payer Strategy and Support
A thorough analysis of payer contracts and fee schedules is often much needed, especially post transaction, to lessen the number of potential obstacles that can occur in the future and create new or improved reimbursement rates and opportunities.
Ongoing Market
Intel
Ongoing market/payer research and intel to help guide successful strategies for future growth and improved reimbursement
Corporate Development and Partnerships
Develop relationships and build partnerships with payers, the government, and employers to help build reputation of the client and expand market share. Develop demonstration projects for new or novel services not offered by many providers
Other Operational Expertise
Benefit from the expertise from our broader team of senior operational executives including Marketing & Communications, Executive Search and Interim C-Suite Management as well as Practice Integration.
Our Client was out-of-network with several key payors with no strategy for moving in network. The Client’s payor contracting resource was new to the organization and the Client’s executive leadership and private equity Board wanted extra oversight of the process.
The Scale Physician Group payer contracting team oversaw the Client’s payer contracting team through weekly update calls. We worked with the Client to formalize priorities as well as executive summary reporting to cleanly and clearly track performance across priority contracts and key process milestones. We developed transparency of process status, accountability for the payer contracting team, and efficient prioritization of the task at hand.
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