Client Success Story: Payer Contract Negotiations and Administration to Improve Yield

Challenge

A 100-bed hospital in the Southeast sought to improve its financial performance.

Ovation Healthcare Solutions

The Ovation team conducted a thorough analysis to measure contract performance for all of the hospital’s payers, and then used the analysis to lead payer negotiations on behalf of the hospital. In addition to payer contract negotiations, Ovation is monitoring ongoing performance through contract administration in order to steadily improve revenue over the long-term.

Results

The Ovation payer contract negotiations yielded $1 million in new revenue across multiple payers. Then, Ovation continued to measure the yield versus the contracted amount to identify additional opportunities to improve revenue. As shown below, the variance between actual payments (dark green) and the negotiated rates (dark blue) represents an even greater opportunity to improve the contract yield. Combining the negotiations with these payers with ongoing contract administration offers the potential of approximately $1.5 million in additional revenue.

Client Quote

“The expertise and professionalism the Ovation Managed Care Team brings to payer contract performance and negotiations are unparalleled. I wouldn’t want to go into a payer renegotiation without Ovation.”

C-Level Executive
Large Southeast Hospital