Managed Care Strategy & Payer Relations

The O’Sullivan Group is a leader in managed care contracting for healthcare providers of all types.

Optimize every revenue stream for your organization’s long term stability

The reimbursement rates and language terms negotiated with managed care companies in your market are significant and crucial contributors to a healthy bottom line. Obtaining profitable managed care contracts and maintaining those contracts on an ongoing basis is the proven method to maximize your patient revenue streams.

Since 1999, The O’Sullivan Group’s Managed Care team has been successful in securing competitive contracts for providers throughout the country.  Our team will work with you to determine if your organization is well positioned with each payer and define the steps necessary to improve your payer relationships.

 

You will benefit from working with a team of professionals who have 30+ years of experience contracting with managed care organizations as well as an established reputation of fairness and professionalism throughout the industry. You will benefit from who and what we know.

Areas of Focus include

Performance Review

The O’Sullivan Group provides a comprehensive review of all payer agreements and provides a full summary of terms and working with your RCM team provides a sample audit of payment rates to contract rates, denials, and timely payment.

Managed Care Strategy

In follow up to or separate from a Performance Review, The O’Sullivan Group, can perform market rate review, SWOT analysis, trend analysis, development of payer value propositions, and detailed action plans.

Negotiation Services

The O’Sullivan Group provides full contract solicitation services for new providers/services.  Additionally, we provide renegotiation of contract terms and rates for established providers.

Value Based & Risk Contracting

We assist with development of performance metrics, benchmarks and monitoring systems to effectively engage payers in upside and downside value based performance compensation.

We also help larger providers with population health and risk based contract strategy and evaluation and help identify administrative vendors to build or provide care management services.

Outsourcing

For clients looking for a comprehensive solution, we provide full outsourced managed care, credentialing and provider registration.  We can provide a full contracting and managed care department on an interim or ongoing basis.

Payer Relations

Providers looking to develop more strategic relationships with payers, explore exclusivity, population health, service expansion, and volume growth look to The O’Sullivan Group to facilitate meetings and relationships with health plan CEOs, VPs Sales, VPs Care Management, etc. and develop payer relations strategies and ongoing efforts.