Current Trends in Managed Care & Provider Relations: How to Avoid & Manage Disputes
Managed care plans face increasing pressure to provide greater, more efficient service to its participants, yet control premium costs and increase payments to healthcare providers. Providers are facing increasing pressure from managed care plans and governmental program payers on their reimbursement rates, and are increasingly combining to increase their bargaining power against payers. In addition to identifying and discussing these trends, this presentation suggests practical considerations, such as contract language and best practices in conducting business for dealing with contract parties. It also suggests regulatory and antitrust considerations payers and providers should consider.