Engagement with Healthcare Payers: Lessons Learned

AbstractPurpose of ReviewThe 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 FindingsCurrent 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 administ rative burden for all parties. Furthermore, they must provide and communicate a better patient experience that results in a high patient satisfaction.SummaryWith 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.

Source: Current Otorhinolaryngology Reports - March 12, 2024 Category: ENT & OMF Source Type: research