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Provider Contracting One Approach

Provider Contracting One Approach. Maine Medical Association April 4, 2014 Stephen M. Gauthier Vice President Contracting & Business Development Central Maine Healthcare (CMHC) gauthst@cmhc.org. “To Contract or not Contract”.

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Provider Contracting One Approach

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  1. Provider ContractingOne Approach Maine Medical Association April 4, 2014 Stephen M. Gauthier Vice President Contracting & Business Development Central Maine Healthcare (CMHC) gauthst@cmhc.org

  2. “To Contract or not Contract” • CMHC utilizes employment agreements for the majority of its providers • Clarifies general expectations related to employment • Supports a predictable transition as providers exit • Serves as a communication tool for benefits, quality, and compensation plan changes

  3. “Less is More” • Contracts should be easy to read, clearly & logically laid out • Term • Practice location(s) • Status (FT/PT) • Annual Compensation • Termination provisions • Malpractice & tail coverage • Call or no call • Little variation, contract to contract, particularly within like-provider groups

  4. “Less is More” – Continued • Contracts should adapt without a redraft in specific areas: • Annual compensation plan • Annual benefits plan • Annual quality plan/metric determination • Leadership changes/medical directorships • Interim call coverage changes

  5. Consistency Does Not Trump Creativity • Be as consistent as possible with contracting practices, while allowing for controlled variability: • Be mindful of base pay within provider groups, adjusted for experience, credentialing, productivity, etc. • Be consistent with benefits and the impact of quality and productivity to base pay • Keep base agreement consistent, with a separate attachment for short term considerations/compensation, benefits, quality, etc. • Call coverage consistent within provider groups

  6. “Too Many Cooks Do Spoil the Broth”Team Roles Should be Clearly Identified • Provider negotiations should be strictly limited to a select few individuals • Standard interview procedure & core team (team additions by specialty) • Standard onboarding process • Standard credentialing process • Standard relocation process (assistance may vary depending on distance)

  7. Ongoing Challenges • With 300+ Providers under contract, challenges include: • Maintaining equity, within provider groups, as new recruitments are made • Maintaining consistency and integrity of contract as physician’s increasingly retain outside counsel. • Bringing old “evergreen” contracts “into the fold” • Visibility is high…assume that any deviations will become known • Establishing meaningful quality metrics across provider specialty-groups

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