Payer report cards a useful in managed care negotiations

In contract negotiations, payer report cards should be used as discussion points. The contents of the payer report card can be useful for contract language revisions and potential reimbursement considerations (e.g., possibly tying future payment rates to the level of administrative burden).

Payer report cards also have the potential to be tied to other future considerations, such as: (a) providing comparable information to plans, (b) evaluating performance of benefit plan designs given the increase in health reimbursement arrangements and health savings account activity and (c) evaluating presence of contracted carveouts.

Report cards are meant to provide useful feedback for payers, and submitting this data to payers allows them a chance to clarify things for you, the provider.

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.