Case Study
Created Sustainable Contracting Cycle and Team Redesign
Payer Provider Innovation
A large academic health system in the Northeast recently experienced high turnover of leadership and staff in its managed care department. Over the past three years, the organization entered shorter-term agreements, as payer dynamics around fee-for-service negotiations changed, resulting in multiple contracts coming to term in the next four months.
At the time BDC was engaged, the health system had numerous negations in process and planned, all set to close by the end of the year. With more complex payer relationships and high-stake open negotiations, the organization was at risk in the market.
The engagement included two focus areas:
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Supporting and executing open negotiations
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Creating a best-in-class managed care department through improved processes and framework
During the open negotiations, BDC offered strategic guidance, direct negotiation support and overarching project management, working toward tight deadlines and major decisions. To transform the department, BDC provided resources on processes, trainings, tools,
and templates which outlined what they had seen the top performing organizations implement nationally.
Through the engagement, BDC Advisors helped the team close multiple negotiations leaving the system with a much more sustainable contracting cycle and advantageous contract terms for the next 2-3 years.
BDC Advisors also helped the department reorganize, restructure, and rebuild leaving the team with new skills, tools and processes to improve on its already successful foundation and move toward a best-in-class organization
PAYER-PROVIDER
INNOVATION
Competitive Repositioning of a Regional Health System, CIN Creation
