providers

Providers
Case Studies

Contract Negotiations

Summary

FluidEdge Consulting helped an integrated health network enter into risk and value-based payment models by establishing strategy plans and key metrics, leading all contract negotiations, and more.

Challenge

  • A community-based integrated health, social service delivery and financing system providing healthcare, homecare and life-care services wanted to enter into risk and value-based payment models
  • The system wanted to implement a risk arrangement with a clinically integrated network of physicians
  • Database integration was also identified as a need in order to successfully operate in the new payment model

Approach

  • Our team conducted  a kickoff meeting to establish a strategy and communication plan, status updates, documentation, goals and success criteria
  • We identified prospective payers and products ,and also established key metrics
  • Our team identified ACO team members and their respective roles and responsibilities
  • We lead all contract negotiations with the health plan including shared savings, care coordination fees, stop loss provisions, tools for wellness visits and risk score optimization

Results

  • Our work resulted in 2 million in shared saving for the 90 participating doctors
  • Our work also generated 5 million in incentive-based revenue
  • A successful, organized and aligned approach to contract negotiations was developed by our team