Speech Understanding State Health Exchanges to Optimize Managed Care Contracts

Understanding State Health Exchanges to Optimize Managed Care Contracts

Providers need to understand the potential impact of state health exchanges to their hospital system and physicians. This presentation discusses the type of data hospitals need to examine in order to prepare for negotiations with insurance companies that are working through a health exchange. Other topics include how hospitals can best use that data for determining negotiations and rate justifications with payors, contract structure, out-of-network benefits and payments to providers, premium grace periods, and the redirection of non-contracted health plan patients to providers that are contracted.