Contract Review for Rural Hospitals

YEAR OF COMPLETION: 1999

In the late 1990s, health plans began to negotiate agreements with many rural hospitals for services rendered to beneficiaries covered by the health plan.  Previously, most health plan agreements were basic and based on set fee schedules.  Many rural hospitals did not have the staff capacity to understand, analyze and negotiate detailed agreements, and it was costly to engage consultants and attorneys to do this on their behalf.  WHF used its staff to review proposed contracts, and provided advice to rural hospitals on the terms and conditions.

WHF APPROACH/RESOURCES COMMITTED: 

WHF hired staff with expertise in health plan contracts and operations.

KEY PARTNERS:

OUTCOMES/LESSONS LEARNED: 

A number of rural hospitals found the review process helpful.  Still, the service was under-used and WHF stopped this program after a couple of years when it was no longer financially feasible to maintain staff with this expertise.  WHF also had to be careful to manage this program so that it was not in any way jointly negotiating or positioning contracts on behalf of multiple rural hospitals.

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