HOTEL DISCOUNTS: Inn at Entrada, 2588 West Sinagua Trail, St. George, UT 84770
(Our 20% discount includes studio suite, continental breakfast each morning, free Wi-Fi, spa and golf access)
DRESS CODE: Country Club Resort Attire - Be Comfortable!
WHAT TO BRING: A redacted, deidentified contract, a laptop computer that can edit MS Word® documents. All course materials supplied on a USB drive.
St George, Utah
In The Art of Payer Contract Analysis® you’ll learn what works, why it works, and how to defend your business when someone offers a managed care payer contract to you.
Preparation is important. Maria Todd has been teaching the public and in-house customized preparation for contracting in her award winning signature workshops and seminars on Analyzing Managed Care Agreements for over 25 years to help participants achieve higher and more accurate reimbursements with fewer administrative hassles. In that class, participants come away with tools to help them plan more effectively and how to come up with mutually rewarding relationships between payers and providers. They bring home extensive take home materials for future reference and to speed up the analytical process.
But contract analysis requires skills that many people lack. You can use a checklist, but you must also know how to read for what is missing, not only the language that is present on the paper. You must also have a library of contracting snippets you can use to suggest revisions that you know for sure others have been able to negotiate into their contracts. And that's exactly what Maria Todd teaches in this Master Class on The Art of Payer Contract Analysis®.
Once you learn HOW to analyze a contract, opportunities you didn’t see in advance will pop up. So will obstacles and mirages.
Preferences, options and relationships are typically in flux. The context of payer contract offers in healthcare changes with the type of payer (for profit insurer, not-for profit health plan, self-funded employer or union health and welfare benefit plan) and the type of provider (clinic, hospital, lab, DME, pharmaceutical manufacturer, etc.) We hope you can join us at this public or in-house workshop. You’ll come away with ideas you want to put to use that very evening.
About the Workshop Leader: Maria Todd
Maria Todd specializes in business improvement strategies and tactics for healthcare and health tourism organizations. Her public and in-house seminars and workshops on negotiation, contract management, analysis, marketing and branding are highly regarded on five continents. She is the author of 15 internationally published handbooks on contracting, medical tourism, concierge medicine, and physician integration and alignment. Her customers include some the largest and best-managed healthcare and tourism industry providers in the world. Since 1983, Maria Todd has trained more than 60,000 healthcare industry professionals in over 2800 presentations. She brings her programs on payer contract analysis and negotiation to clients on request. All Maria’s programs are available for a modest flat fee enabling you to provide training for an unlimited number of staff members. Call 800-209-7263 for more information.
The Art of Payer Contract Analysis® is a powerful, two-day, interactive workshop with the doyenne of managed care contracting. Maria Todd. Most of her students agree that they know what they want to achieve, but they aren’t sure how to go about getting it. Managed care payer negotiation is not linear. Payers view the value of a healthcare provider differently than the healthcare provider sees itself. No matter how diligently healthcare providers and suppliers prepare – they encounter surprises. Some surprises infuriate you, some frustrate you, and others change your perspective.
Course Learning Objectives
The Art of Payer Contract Analysis® workshop focuses on how to conduct your fact finding, brand value assessment, payer due diligence, learning your customers’ objectives and goals, and accepting that there will be things you cannot know in advance. Then you make it your business to prepare for what you can and do know. You learn the scope and issues that the payer wants to focus on, you prepare several options to resolve each one of them, and you study the nature of your current and past relationship with your counterpart. But then, on arrival at the appointed meeting time and place, armed with data and information, your job as a negotiator is to be prepared to learn, adapt and influence – on the fly. Those who fail in payer contract analysis often fail because they expect to be able to read the contract, decide if the fee schedule is adequate and hurry to sign. The language analysis is usually their weakest skillset. And it isn't full of legaleze. It's right there in plain language, just nobody taught you how to perform the critical analysis of the words on the page.
In The Art of Payer Contract Analysis® workshop, Maria Todd teaches participants the art of critical thinking, reading, and spotting loopholes. That’s how you learn your counterpart’s hidden agenda, constraints, objectives and goals. It is also where you discover opportunities, mutuality, and the nature of your value proposition – as seen from your counterpart’s perspective. In the interactions that lead to your negotiation meeting, you must have a roadmap and system that helps you conduct due diligence, verify references and conduct towards others, determine your leverage and build a negotiation strategy that identifies the value on what it is you can bring to the deal.
Many bloggers, consultants and speakers at conferences talk and write about contracting strategy. Their speeches and slides, webinars, and blog articles offer popular and intriguing cookie cutter strategies that crumble in the real-world analytical phase. Many of their articles and speeches fail to take into account real-life and real-time nuance, history, relationships, and market realities that are all critical to the deployment of their recommended cookie-cutter strategy. Very few of these marketers have actually mastered payer contract analysis themselves. The proof is in the complaints of poor reimbursement and bad contract terms found in most payer agreements for hospitals, labs, pharma, imaging, clinics, medical supply, and other provider participation agreements. Further proof is found in how they play out in terms of getting paid what they negotiated and expected more often than not.
The Art of Payer Contract Analysis® is all about critical analysis of an offer (both language and rates). Maria teaches participants how to develop fall back strategies if the offer you’d like to negotiate isn’t what’s on the table. She teaches a framework for obtaining clarifications without seeming confrontational.
Most health facilities, physicians, laboratories, pharmaceutical manufacturers and integrated health systems cannot approach managed care payer contract analysis casually. They face the harsh reality that when they are analyzing a payer contract with one insurer or third-party payer, their must have a specific list of objectives they need to ensure are included in the deal. The time to plan for that and set it up is before the negotiation meeting, not while at the table or on the phone.
The Art of Payer Contract Analysis® is about precision that a due diligence demands. It is also about understanding the more than 25 types of payers in the market, each with different rules and laws and regulations. It is also about knowing where to find helpful information that you were always told was "Proprietary", but maybe isn't.
The two-day, interactive workshop, The Art of Payer Contract Analysis® is broken up into three focus sections over the 12 hours that account for the majority of healthcare reimbursement contracts:
- Analyzing Medicare Advantage and Managed Medicaid plan contracts
- Analyzing contracts from for profit and not-for profit health plans (HMOs, PPOs, EPOs) and health insurers
- Analyzing (and drafting) contracts that are direct relationships with self-funded and self-insured employers and labor unions (the term for this is "disintermediated" because it doesn't go through an HMO or PPO or TPA.)
Maria Todd begins the Master Class and workshop from the point where you are faced with developing a strategy, have not yet performed the due diligence, and must analyze contract language and determine what changes you’d like to achieve. If you believe you need more training on these pre-negotiation steps, you should register for this Master Class right away. This course should be completed before attending The Art of Payer Contract Negotiation® for maximum benefit. Maria spends time with each student in front of the others so that everybody learns from their peers as well as from Dr Todd. She teaches the workshop participants how to be more critical and effective analysts and researchers. She explains how to deal with what they find, what they don’t like and how to determine how much it matters -- before the appointment at the negotiation table or on the phone. In The Art of Payer Contract Analysis®, Maria shows participants how important aspect of analysis is in due diligence, market research.
In The Art of Payer Contract Analysis®, Maria Todd zeros in on language loopholes and rate calculations at a strategic level. She connects healthcare product and service marketing, branding, quality, safety, service and accreditation to situational awareness. She teaches how to deal through the landmines that await most providers. She explains how to tweak language loopholes to level the playing field. Relative novices and those with lots of experience will benefit from the workshop and will give you a fresh and practical slant that will push you to rethink your habits and assumptions about Payer contract analysis.
DATE: DATES: Oct 16-17
LOCATION: Entrada Country Club at Snow Canyon, St George, Utah (Airport: SGU)
ACCOMMODATION: Inn at Entrada (Please note: We have discounts of 20% available when you register by phone through our office.)
The Art of Payer Contract Analysis® is a registered trademark of Maria K Todd
What Maria Todd Covers in this Master Class
We want to ensure that you get the training you need. If the skills you want and need include:
- Understanding opportunities, payment models and payer organizations
- How to analyze the language and fee schedules of the boilerplate offer
- How to analyze the payer’s book of business, market conduct, history and brand value
- How to conduct payer and negotiation due diligence during the pre-negotiation phase
- How to develop business rules for every contract
- How to analyze and react to “all payer” or “all products” contracts (that blend HMO, PPO, Government payer, exchanges and self-funded ERISA and Taft Hartley employer plans and discount programs)
- Alternative model language to protect your interests
- Internal and external data mining and interpretation
- How to respond if the payer locks you out of participation
This is the course you should plan to attend.
What Maria Does Not Cover in The Art of Payer Contract Analysis®
If the skills listed below are the lessons you need, you should sign up for The Art of Payer Contract Negotiation®, instead
- How to deal with and capitalize on the dynamic nature of payer contract negotiations
- Understanding power and leverage
- Developing a strategy for when to say yes, when to walk away and how to negotiate alternatives
- How to present your differentiation from competitors
- How to present your brand’s value proposition in a meaningful and relevant way to the buyer
- How to react if the meeting veers off in a direction you didn’t anticipate or to a place you don’t want to go
- How to reject unacceptable offers and counteroffer something unexpected
- Tactics for timing the negotiation
- How to overcome roadblocks with flexibility and creativity
- How to break a deadlock
- Taking on a firm price
- Building trust in payer relationships
- How to decide when you should compromise and when to stand firm