Managed Care Strategy & Contracting
Managed care contracting and reimbursement is becoming increasingly complex – straining health system resources, pressuring finances, and influencing strategic initiatives. In the face of mounting financial and regulatory challenges, a revised and comprehensive managed care strategy can help health systems protect and grow margin.
Optimize payer contracts with data-driven strategies
We leverage data-driven reimbursement rate benchmarking, strategic portfolio assessments, and network optimization to help organizations realign their managed care contracting strategy, maximizing contract value across both hospital and physician reimbursement.
Our team of former managed care operators, clinicians, and financial strategists brings expertise in payer negotiations and reimbursement strategies. We align with industry best practices, bridging payer and provider perspectives to achieve effective negotiations and sustainable financial, strategic, and quality outcomes.
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How to reposition managed care contracting to advance strategic and economic priorities
Managed care contracting was historically successful with just-in-time negotiation execution and budget adherence. But today’s challenges require a differentiated, strategic approach.
Our Managed Care Strategy & Contracting leaders
Nick Herro
Nick Herro is a Senior Partner in Strategic Transformation. His experience includes advising healthcare providers, health plans, and investors in buy/sell-side transaction diligence, value-based care, and strategic planning.
Steve Prosser
Steve Prosser is a Partner in the Strategic Transformation line of business. He has over 25 years of management consulting and healthcare industry experience spanning clinic operations, revenue management, and network management across health systems and payer domains.
Semyon Shtulberg
Semyon “Sem” Shtulberg is a Partner with Chartis in the Strategic Transformation Practice. Sem is a trusted healthcare strategy leader and executive advisor with over 18 years of management consulting and industry experience, specializing in growth strategy, managed care strategy, and value-based reimbursement models.
Craig Nurnberg
Craig Nurnberg is a Senior Partner in Financial Transformation at Chartis. He is a seasoned healthcare executive with over two decades of experience in the healthcare revenue cycle management sector.
