Managed Care Ask the Expert Answer – Payer Report Card

Q: We are beginning to develop a Payer Report Card and instead of “creating the wheel” do you have a report card that you have already developed that you would be willing to share with us?

A: Similar to your circumstances, our organization began informal efforts in 2008 to better substantiate comments from peripheral departments about the performance of managed care contracts – we determined that a formalized approach and documentation would not only help various operational areas track payer issues in their department but would also flow into the managed care contracting renewal process.

To date, our department identified key functional areas on an individual basis and discussed department specific metrics for that area. The followup steps in 2009 are to convene a larger workgroup to establish the actual format and process which will help each department better recognize how all the components on the report card will be tied together. At present, we do not have a formalized sample, but are happy to share a variety of metric questions and timelines.

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