Managed Care Do’s and Don’ts

If medical practices want patients and therefore a cash flow revenue stream, then you are more than likely going to have to participate in managed care plans. However, when dealing with managed care, always remember these key points: 

• Never sign a managed care contract without carefully review the terms of the contract and its reimbursement rates.
• Always negotiate contract issues you do not like. You never know if you can change the contract unless you try first!
• Constantly monitor financial performance.
• Annually grade your managed care relationships and create an overall hassle factor or grade factor (again, using the sample worksheet above).
• Don’t be scared. If you need to terminate a managed care contract, do so.
• If a decision is made to terminate, make sure both patients and colleagues are notified.

Before any contract is terminated, always make sure that you create a strategy on how any potential revenue lost as a result of the termination will be replaced.

About the Author

Reed Tinsley CPA

This article is written by Reed Tinsley, a Houston, TX-based CPA with over 30 years of experience advising physicians and medical practices across Texas and the United States. Reed holds certifications as a Certified Valuation Analyst (CVA), Certified Healthcare Business Consultant (CHBC), and Certified Financial Planner (CFP), specializing exclusively in the healthcare sector. He is a published author, nationally recognized speaker, and trusted advisor to physicians on accounting & tax, practice management, and financial planning. Schedule a Free Consultation.