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Best Practices for Provider Contracting: Insights from Central Maine Healthcare

In this insightful presentation, Stephen M. Gauthier, Vice President of Contracting & Business Development at Central Maine Healthcare, discusses the essential approaches to contracting with medical providers. Emphasizing clear and concise contracts, he outlines the importance of employment agreements, predictable transitions, and effective communication tools. Gauthier highlights the need for consistency while allowing for controlled variability in provider agreements. Addressing ongoing challenges, he advocates for maintaining equity among providers and establishing meaningful quality metrics.

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Best Practices for Provider Contracting: Insights from Central Maine Healthcare

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Presentation Transcript

  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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