109: Payer Rate Negotiations with Nathaniel Arana, NGA Healthcare
Update: 2019-08-13
Description
Nathaniel Arana of NGA Healthcare explains the nuances of payer rate negotiations and some of the pitfalls physicians face when trying to go it alone.
This issue (23:38 ):
- Overview of the decline and stagnation in payer reimbursement over the last decade
- How most providers tend to accept the rates and the difficulty in negotiating
- How a provider can attempt to negotiate rates on their own and the pitfalls of doing it on your own
- The types of leverage providers have and what goes into a value proposition
- The importance of negotiating based on the right 'fee schedule' (for example, negotiating on the Medicare fee schedule versus the payer fee schedule)
- How rate negotiations can make the difference between keeping a practice open and having to consolidate with a provider group
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