12 Tips for Managing Medicare Advantage Contracts

12 Tips for Managing Medicare Advantage Contracts

The bargaining table is the new frontier for home health and hospice agencies seeing increasing numbers of patients with Medicare Advantage plans. At stake are ramifications for both today and tomorrow: adequate fees for services provided now and future admission to in-network insurance plans.

SimiTree experts say savvy agencies are sharpening both resumes and negotiating skills to land lucrative MA contracts.

“Agencies need to be pursuing MA contracts right now to ensure they don’t get shut out in the future, when in-network plans are full,” said Brian Harris, SimiTree Director of Financial Consulting.

Being able to clearly articulate skills and strengths to the Medicare Advantage Organizations (MAOs) they’re negotiating with is crucial to ensure agencies get favorable rates for services, Harris said.

“For many agencies, especially smaller agencies without a polished marketing team already touting their strengths and specialty services, or a robust set of analytics to rely on, there’s going to be a learning curve in being able to come to the negotiating table fully prepared to demonstrate value.

“But it’s an essential step right now,” he said. “MA plans are going to continue to grow, accounting for more than half of all patients in the next few years. Agencies have to step up and become effective negotiators.”