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Payer Relationships: It's Good to Have a Vendor Ally

by Tom Mohr, MD

Narrowing networks, high-deductible plans, and declining reimbursement have made the administrative burden of running a medical practice more onerous today than when I entered medicine decades ago. These are just a few of the changes with which my pediatric practice is dealing. ICD-10 regulation appears to have a fighting chance at implementation as of October 1st, and the highly anticipated, but little understood, transition from fee-for-service to value-based reimbursement has my practice reevaluating how to make the numbers work. And now, with potential payer consolidation looming large, even more uncertainty is on the horizon.

One would think that this is a time to pull back and separate from payers. Many practices are focused on increasing their self-pay collections, or hiring staff to battle with payers over the narrow margins they still have to collect. But this overlooks the very real opportunities for payers and practices to align. 

Continue reading Dr. Mohr’s post on payer relationships on Physicians Practice.

For a snapshot of trends, results and overall payer performance, including a pulse on ICD-10 readiness, view our State of the Payer infographic. – Michelle Mangino, Editorial Manager 

State of the Payer Infographic

Tom Mohr, MD, is president and CEO of Pediatric Partners
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