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Negotiating in a managed care world.

Barbara F Rubel1, Steve Roettele

  • 1Management Services Network, LLC, Atlanta, GA 30339, USA. bfrubel@mindspring.com

Journal of the American College of Radiology : JACR
|April 7, 2007
PubMed
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Managed care is now a primary factor in all medical practices. Physicians must develop strong negotiation skills to ensure the economic viability of managed care agreements.

Area of Science:

  • Healthcare Economics
  • Medical Practice Management

Background:

  • Managed care has evolved from a niche market influence to a dominant force in healthcare.
  • Managed care strategies significantly impact medical practices nationwide.

Purpose of the Study:

  • To highlight the pervasive nature of managed care in contemporary medical practice.
  • To emphasize the critical need for physicians to acquire effective negotiation skills for managed care contracts.

Main Methods:

  • Analysis of managed care strategies and their impact on provider economics.
  • Discussion of essential negotiation components beyond just reimbursement rates.

Main Results:

  • Managed care, including discounted rates, steerage, and utilization management, is a persistent reality for providers.

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  • Physicians' economic viability is directly tied to their ability to negotiate various aspects of managed care agreements.

    • Conclusions:

    • Physicians must proactively educate themselves on managed care principles.
    • Developing robust negotiation skills is imperative for ensuring financial success in managed care environments.