Academic health systems (AHSs) deliver capabilities few other organizations can replicate, but their payer contracts do not always reflect that value. Their advanced services, specialized expertise, and essential community role carry costs that must be clearly understood and appropriately addressed in negotiations.

In this article, ECG’s managed care experts explain how AHS leaders can strengthen their negotiating position through disciplined preparation, protections for emerging therapies, and a more compelling articulation of value. They also examine how a collaborative approach can help health systems and payers pursue agreements that support access, affordability, and long-term sustainability.

Key Takeaways

• Build the case before negotiations begin. AHSs need a fact-based negotiating position that demonstrates their clinical performance, clarifies their true costs, and connects proposed terms to the organization’s strategic direction.
• Anticipate the next generation of contracting risk. Contracts should establish how high-cost therapies will be evaluated and reimbursed while creating practical safeguards that reduce delays and administrative friction.
• Turn distinctive capabilities into negotiating strength. AHS leaders must clearly connect higher costs to the advanced care, specialized expertise, and essential community capacity their organizations provide, then reinforce that value through more collaborative payer relationships.