Meeting NewsVideo

VIDEO: Information, compromise ‘king’ in payer negotiations

PHILADELPHIA – In this exclusive video from the American College of Gastroenterology Annual Meeting, Costas Kefalas, MD, MMM, FACG, from Akron Digestive Disease Consultants, discusses his presentation on negotiating payer contracts.

“Information is king,” he told Healio Gastroenterology and Liver Disease. “You have to have information not only about your practice ... but also information of your competitors, as well as payer information. That’s the starting point of any contract negotiation.”

Kefalas also went over a few of the other primary points of his talk, including the importance of having a relationship with payer reps and being forward about asking for what you want.

In smaller, rural practices, Kefalas suggested focusing on quality metrics that can be brought to payers and used to negotiate more favorable terms.

“Finally, compromise may need to be part of the process,” he said. “Make sure there are things you’re willing to give up for things that you can gain. A win-win scenario where both sides can create value is a great deal.”

Reference :

Kefalas C. “Negotiating Payer Contracts in the Age of Cost and Quality.” Presented at: American College of Gastroenterology Annual Scientific Meeting; Oct. 5-10, 2018; Philadelphia.

Disclosure: Kefalas reports no relevant financial disclosures.

PHILADELPHIA – In this exclusive video from the American College of Gastroenterology Annual Meeting, Costas Kefalas, MD, MMM, FACG, from Akron Digestive Disease Consultants, discusses his presentation on negotiating payer contracts.

“Information is king,” he told Healio Gastroenterology and Liver Disease. “You have to have information not only about your practice ... but also information of your competitors, as well as payer information. That’s the starting point of any contract negotiation.”

Kefalas also went over a few of the other primary points of his talk, including the importance of having a relationship with payer reps and being forward about asking for what you want.

In smaller, rural practices, Kefalas suggested focusing on quality metrics that can be brought to payers and used to negotiate more favorable terms.

“Finally, compromise may need to be part of the process,” he said. “Make sure there are things you’re willing to give up for things that you can gain. A win-win scenario where both sides can create value is a great deal.”

Reference :

Kefalas C. “Negotiating Payer Contracts in the Age of Cost and Quality.” Presented at: American College of Gastroenterology Annual Scientific Meeting; Oct. 5-10, 2018; Philadelphia.

Disclosure: Kefalas reports no relevant financial disclosures.

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