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North Star: Insurances

Reading Time - 2 min

 

Why you should spend 2 minutes reading this:

Developing a clear and long-term strategy for insurances is a top 5 best use of time to keep your provider group in business

 

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Patients receiving care are nudged by insurance companies to either use you or not. The intensity of their nudge varies:

 

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  1. You may be out of network (strong nudge against you)

  2. You may be their provider on a capitated contract (strong nudge for you)

  3. You may be in-network but not preferred (weak nudge against you)

  4. You may be in-network and preferred (weak nudge for you)

 

 

What’s critical to understand is, although you should work to provide care to everyone in your surrounding community, insurances need to do their part and offer reimbursement that will keep your practice/clinic running.

 

Your long-term goal becomes more apparent when you layer in the Nudge Matrix, the Winning Contract Matrix and the Cost of Loss.​

You want to move your most strategic accounts (via Cost of Loss) into both Strong For (Nudge Matrix) and Long-Term winners (the Winning Contract Matrix) (I'm unclear on the meaning of this)

 

You move strategic accounts towards this North Star via becoming irreplaceable. More on that here:

  1. I’m So Good, You Need Me

  2. Grow | In Size and Density

 

If you need support generating a central focus for your contract management team or any contract related topics, let us know below.

 

High-level actions you can take based on this article:

1. Understand the value of your accounts

2. Make sure you most valuable accounts nudge their patients correctly

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