Commercial health plans manage the benefits of more than half of all Americans, but for executive teams of provider organizations, working with health plans comes with many challenges. Health plans set clinical necessity and appropriateness criteria for services, determine payout rates, and are a critical source for referrals. To ensure financial sustainability and future growth, provider organizations need to be strategic to develop efficient working relationships with health plans. Hear from our case study presenters as they de-mystify health plans and explore:
- What health plans want, and what they don’t want
- Strategies for researching payers’ needs and market capacity to develop a growth strategy with health plans
- Steps to build successful and sustainable relationships with health plans