3 Valuable Steps to Take Before Negotiating Contracts With Payors

Mary Igo, RN, CEO of Minneapolis-based Minnesota Gastroenterology, a physician practice that owns and operates six outpatient clinics and endoscopy centers, shares three steps she takes to better prepare for contract negotiations with payors.

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1. Demonstrate better clinical outcomes. By comparing the MNGI’s six surgery centers’ outcomes to national benchmarks and standards, such as the average number of colonoscopies, withdrawal times and complications rates, Ms. Igo is better able to negotiate contracts with payors.

“MNGI publishes clinical outcome reports that prove patients visiting its surgery centers receive high quality care,” Ms. Igo says. “Not every physician is a high quality provider, and we actually collect the data to confirm that each physician here is. You have to prove your case for why the payor should offer you’re a better contract.”

2. Track patient satisfaction rates. Distributing patient satisfaction surveys to patients after each procedure gives MNGI extra leverage for negotiations high case volume, which can give ASCs a selling point when negotiating contracts with payors. Higher case volumes at an ASC could possibly give payors the incentive to expand coverage to that facility.

“Our patient satisfaction surveys will come back with comments saying ‘It was easy to find the facility’ and ‘The staff was friendly and courteous,’ and sometimes the patients will recommend the facility to family and friends,” Ms. Igo says. “So if patients prefer to go there for their GI-related care, ASCs can use that as a point in contract negotiations.”

3. Use lower costs to increase patient volume. Ms. Igo suggests ASCs compare the pricing of endoscopy procedures at other facilities, if that information is readily available. ASCs can use that information to charge patients for procedures at more reasonable and competitive prices, which also drives up case volume.

“If you go to the Minnesota Hospital Association’s website, you can see what hospitals are charging for their GI procedures, so you can gauge what’s going on in your marketplace and be more cost-competitive with other providers,” she says. “ASCs don’t have the extra services to pay for that hospitals may have, such as an ER or a holding space in the OR, so ASCs have the ability to charge patients less.”

Learn more about Minnesota Gastroenterology.

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