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.

Amplify Revenue Cycle Management Solutions

The Amplify 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, Amplify is monitoring ongoing performance through contract administration in order to steadily improve revenue over the long-term.

Results

The Amplify payer contract negotiations yielded $1 million in new revenue across multiple payers. Then, Amplify 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 Amplify Managed Care Team brings to payer contract performance and negotiations are unparalleled. I wouldn’t want to go into a payer renegotiation without Amplify.”

C-Level Executive
Large Southeast Hospital

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Scott Cooper Headshot

Scott Cooper

President

Scott brings more than 15 years of experience in revenue cycle management to Ovation Healthcare. His career began at companies athenahealth and Nexus Healthcare Solutions where he focused on building tech-enabled revenue cycle services coupled with offshore capabilities to help business find opportunities at scale. At McKinsey & Company, he advised national health systems and RCM service providers on large-scale, operational transformations and performance programs focused on yield improvement and cost reduction. Most recently at Tegria, he led all revenue cycle services, transformation, and integration across the enterprise.