As Featured In:
Ellsworth Consulting in Becker’s Hospital Review and HFMA Magazine.
Hospitals' Medicare Advantage problem hits an inflection point
"Medicare Advantage net reimbursement right now is terrible for hospitals — our clients average about 85 cents on the dollar, and it's only getting worse," Mr. Ellsworth said. "MA is a race to the bottom and I would argue that we've hit that bottom.
How providers can optimize payer contract negotiations
How healthcare providers can initiate the process from a position of strength when entering contract negotiations with payers.
2024 HFMA Region 5 Summit Presentation with BSMH
Scott Ellsworth spoke to a national audience on how to optimize payer negotiations to get higher reimbursements with Bon Secours Mercy Health.
What happened when Scripps quit Medicare Advantage
Medicare Advantage insurers should be wary, [Scott] Ellsworth said. “They are going to have to look at the reimbursement rates, and they're going to have to make adjustments. If they don't, they're going to run the risk of losing significant chunks of the network,” he said.
Turning the tables: How providers can maximize their leverage in payer negotiations
The negotiation table is not merely a battleground for rates; it’s a strategic arena where savvy maneuvering can transform the prospects for both providers and their patients.
Why the ACA health insurance exchange is the next reimbursement battle ground
[ICHRA] has the potential to be incredibly disruptive to providers given the negative impact this shift could have on overall reimbursement and provider margins…Providers need to have a robust strategy around HIX contracting and be very selective on who they contract with and at what rates.
Understand Your Value When Negotiating with Insurance Companies
Scott Ellsworth, MBA, president and founder of Ellsworth Consulting in Newport Coast, Calif., underscored the importance of developing a solid strategy when negotiating with payers.
Don’t go into negotiations unprepared. Don’t go in without the data, without knowing, for example, how your rates compare to others in the same market.” — Scott Ellsworth, MBA