You are the administrator of a 10-provider group of specialists (3 cardiologists, 2 pulmonologists, and 5 family practitioners) who serve in a wealthy geographical area. The payment mix currently is: 45% fee-for- service (FFS)/private pay 35% third party payers (primarily through employer such as BC/BS, Aetna, etc. and out of network) 15% Medicare 5% Medicaid (received primarily through coverage in the ER) However, the challenge has been to maintain revenue to meet expenses due to a shift in FFS/private pay patients, who paid full price for services, to third party payers and Medicare. In addition, the percentage of Medicaid patients has increased due to ER coverage and the ACA). You have presented your concerns to the group and introduced such options as becoming gatekeepers and joining more managed care organizations as PPOs and/or HMOs, etc. The specialists are not concerned as they say they have seen a steady flow of income; however, the family practitioners are seeing a slow decline in their income. Collectively, they are concerned about any future contracts stifling their practice conventions and being regulated such as they are through the Medicare P4P program. Analyze the situation and present a comprehensive response to this situation that you, as the healthcare leader, could present to your provider group. Aspects to consider would be reimbursement methodologies and fee schedules, charges and consistent revenue, quality and outcomes, risk, liability, networks, contract negotiations, etc. (This is a paper I need to work on but really did not know where to begin. Was looking for some ideas on where to begin and what to write about.) .