Win-Win Negotiations
Physician employment contracts, physician recruitment contracts, management service agreements, patient transfer agreements, technology licensing, executive compensation and employee benefit arrangements, joint ventures, purchased services, equipment sales and leasing, ancillary services, business associate agreements … The list of contract types a practice likely needs, and has, to meet the goals in its strategic plan could go on ad infinitum.
When negotiating contracts, the goal is to reach a win-win for both parties, Mr. Dahl said. He suggested listing your own goals, along with every potential way to achieve them and your approach in trying to achieve them—and then doing the same thing for the other party’s goals.
It’s crucial, he said, to be “willing to walk away.”
Preparation is the key: “Nothing is more important,” he said. This involves familiarizing yourself with the background and history of the situation, researching issues, anticipating your counterpart’s tactics and developing the rationale for your positions.
Mr. Dahl offered some advice:
- Stick to the facts;
- Come up with as many alternatives to reach your goals as possible;
- Identify the least you’re willing to accept;
- Negotiate with the right person;
- Give yourself room to maneuver, not giving away too much too soon;
- Be prepared to say no; and
- Make your word your bond.
Mr. Dahl cautioned against accepting a bad deal just to strike a deal.
APMs & Refining Your Practice
Karen Ferguson, practice administrator for Arthritis Northwest, Spokane, Wash., offered lessons from her experience in helping refine a seven-rheumatologist, 60-employee practice’s habits of documentation, patient communication and handling referrals. The idea has been to link rheumatologists, primary care physicians and patients throughout the care process, putting the foundation to succeed under new payment models—a key element of success in any practice’s strategic plan.
Arthritis Northwest was recognized with Patient-Centered Specialty Program Certification, and it recently marked a milestone when it entered into a value-based contract with Premera Blue Cross.
The practice developed a platform that provides a total care management system for patients, with real-time treatment decision support to help direct the course of care for the physician. It also handles necessary documentation and pre-authorization process support, which greatly simplifies the administrative burden for staff, said Ms. Ferguson. This arms the practice with the data it needs to show that it’s meeting the requirements of value-based agreements and federal programs.
To reduce the administrative burden of reporting under MIPS (the Merit-Based Incentive Payment System used by the Centers for Medicare and Medicaid Services, the practice uses its platform to submit MIPS quality measures directly to Medicare’s Quality Payment Program website.
Ms. Ferguson said alternative payment models (APMs) will likely become more prevalent under MIPS. Although still in their infancy, she said, APMs hold promise to show reduced costs with a higher quality of care.
Arthritis Northwest’s planned transition to an APM is based on three main principles:
First is to improve the patient experience—and that means embracing technology. “We’re going to need a technology platform to increase efficiency and information sharing so we can have a better experience for our patients,” including patient access to their records wherever they happen to be, Ms. Ferguson said.
