In today’s post reform era, your provider network must meet more difficult demands than ever before. More specialists for the Medicare population, pediatricians for Medicaid, and providers near enough to serve your rural members. And yet, simply getting more providers contracted without a sound strategy that protects your quality ratings and empowers appropriate risk sharing is not the answer.
In the past five years alone, Gorman Health Group has negotiated over 65,000 provider contracts on behalf of its managed care clients. In addition to our continuing work launching new entrants into government health programs, we are helping many experienced plans by developing smart networks: accountable care, shadow capitation, and payment bundling within their current service areas and networks. We’re developing some of the most innovative bonus and incentive arrangements in the industry by adhering to the dictum that trends may be national, but all health care is local.
GHG will assess the alignment of your products, your current network, your market, and your network requirements. We’ll help you track results – both positive and negative – back to related network components. From there, we assist in developing and executing a networking strategy, from contracting targets to model contract terms, to payment terms that match your budgets and the capabilities of your claim payment systems.
From ACO-type incentives to bundled payments and contract capitation, to full professional and global capitation – where the potential is promising, we can help design and implement these arrangements. Let’s get started. Contact us today.