Provider Contracting

National physician group seeks contracting blueprint for the future.

Client Profile

Large national physician group.

Challenge

With the shift from fee-for-service to value-based payment models, this physician group recognized the need to be proactive in its approach, yet it had many concerns regarding this change in payment and how it would affect its providers. The group was working with a large national consulting firm to help it study the impact and make recommendations; however, the firm assigned a junior consultant to the project who lacked the necessary experience and expertise. After seeing a lack of progress and results, the physician group fired the consulting firm and hired us for the project.

Solution

We conducted an extensive study that reviewed internal resources, contracts, billing volumes by market segment, emerging reimbursement methods and levels, and Accountable Care Organization (ACO) development.