Join ECG’s Joe Mangrum at The 2026 Spring Managed Care Forum, April 23-24, 2026 in Orlando, FL.
Why Attend?
The Spring Forum brings together members and other healthcare executives from the American Association of Integrated Healthcare Delivery Systems (AAIHDS), the American Association of Managed Care Nurses (AAMCN) and the NAMCP Medical Directors Institute.
Speech:
Why Managed Care Agreements Underperform: A Payer-Side View Providers Rarely See
Thursday, April 23
Joe will give a speech discussing how Many managed care agreements appear sound at execution yet fail to deliver expected financial or operational results. Providers often attribute underperformance to payer behavior, while health plans point to utilization patterns, coding variability, or operational inconsistency. In practice, these agreements frequently underperform because payers and providers evaluate success through different lenses and respond to different incentives.
This session presents a payer-side perspective on why managed care agreements underperform after execution. Drawing on experience advising health plans across Medicare Advantage, Medicaid managed care, ACA exchange, and commercial risk arrangements, the presentation explains how payers actually evaluate provider performance, price risk, and determine when intervention, renegotiation, or disengagement is necessary.
Rather than focusing on contract language or high-level value-based care theory, the session examines how managed care agreements function operationally once they are live. Participants will gain insight into payer decision-making processes that are rarely visible to providers, including which performance signals matter most, how utilization trends are interpreted, and why certain provider behaviors trigger corrective action while others do not.
