Government and commercial payers are contracting in new models such as ACOs, bundled payments, narrow networks or reference pricing, via private label plans, as well as acquiring provider organizations and entering the retail health business. Now is the time for organizations to examine their payer contracting strategies to determine how best to create value-based networks with health plans.

However, following the same tried-and-true playbook will not work in this new environment. Adaptability and flexibility are key, taking into account payer speed of adoption of value-based reimbursement, an understanding of readiness for clinical integration, and a variety of payment methods and market segmentation strategies.

At GE Healthcare Partners, we have more than 25 years of experience in helping hospitals and physician organizations develop and implement customized managed care strategies. We advise clinically integrated networks, IPAs, medical groups, and ACOs throughout the country and facilitate hospital-physician group relationships relative to managed care strategy.

The linkage between financial and market strategies is key to determining how to maintain/grow your health system’s commercial business and respond to government-based risk business (Medicare Advantage and Medicaid managed care). Our experts use financial models and risk assessment tools to guide you in preparing to adopt risk- and value-based arrangements with payers.

Want to know more about how we can help with Payer Strategy, Performance Improvement, and Contracting? Contact Us