The Leveraged Negotiations Approach
You have more leverage than you realize. We help you find it and get higher reimbursements from payers.
So how do providers tip the scales in their favor and get a fair contract? The term we use is Leveraged Negotiations: negotiating from a position of strength. It means controlling the process, it means being resolute, it means having full enterprise alignment before you start your negotiations.
Payers’ leverage comes from consolidation and the emergence of dominant regional and national plans.
Providers' leverage comes from the relationships they have with their patients, their staff and the community. Payers understand that without providers in their network they have no product to sell to their customers and are severely limited in their ability to grow in that market.
With 30+ years of experience on the other side of the table, we understand the payer mindset and how to anticipate their moves.
The landscape of contract negotiations is skewed in favor of payers, tilting the balance against providers. Payer approach is often characterized by a predisposition to play hardball, accompanied by an extensive list of reasons justifying the impossibility of accommodating provider requests.
Payer motivations and objectives during contract negotiations vary based on the payer. It’s important to understand who you are negotiating with and their goals. Payers always try to make the negotiations about them and what they need. Providers need to combat this by establishing their goal early on and supporting it with data and analytics.
Ellsworth Consulting helps you establish your goals early on, backed by a foundation of data and analytics.
The ability to engage patients, the community, and key stakeholders is the real leverage providers hold. How and when to leverage this is strategically important and can make the difference between success and failure.
Contact us today to see how we can help.
Featured: Client Success Stories
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Could contentious payer-provider negotiations become the post-COVID norm?
This article highlights the rising costs to deliver care, partnered with falling reimbursement rates. The Leveraged Negotiations support provided to Bon Secours Mercy Health successfully secured higher annual rate increases and reimbursement rates.
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Bon Secours Mercy Health, Anthem reach contract deal following monthslong spat
The Leveraged Negotiations support provided to Bon Secours Mercy Health successfully secured a multi-year arrangement with Anthem BCBS and a more collaborative environment for future negotiations.