The negotiation state of mind: specifics in negotiating managed care contracts

Physicians are now finding that the contracts they signed so uncritically in the early years of managed care have left them a legacy of bad contracts, poor fee schedules, and dysfunctional relationships with payors. The negotiating process offers physicians an alternative strategy for effectively achieving their goals in their relationships with the payors. This article explores three specific scenarios--relationships with an economically failing health plan, disputes over coding and bundling of services, and fee discussions between payors and physicians--and illustrates strategies that practices can use to bring about outcomes that are favorable to physicians.