This document provides guidance on developing a business plan for managed care contracting. It outlines several key steps: conducting an internal assessment of past performance; establishing objectives for a new contract; assessing the external environment; preparing a timeline for negotiations; negotiating contract terms; and monitoring performance after signing. The overall process involves thorough preparation, open communication with all parties, and ensuring contract terms can be administered effectively.

1. Managed Care Contracting 101 Building Your Contracting Business Plan

2. The Business Plan Conduct internal assessment Begin assessment at least 8 months prior to contract end/renewal date Review historical business volume among various payer or provider clients Evaluate current contract performance gaps Solicit internal stakeholder input Establish desired objectives under new contract Have financial team prepare pro-forma with future performance goals

3. The Business Plan Continued Assess current external business environment Inventory competitors, market share, best practices, short-comings Make best estimate of provider/payer business conditions Review governmental and regulatory conditions, current and projected Determine implications for your business

4. The Business Plan Continued Prepare a contracting calendar Prioritize projects by business volume/need for new contract Establish timeline for negotiations Set start date, milestones and end date Communicate timeline with internal stakeholders Record and communicate progress, barriers, action plans and resolution steps

5. The Business Plan Continued Contract negotiations process Conduct up kick-off meeting with client Share performance outcomes and objectives under new contract terms among parties Come prepared with business volume metrics Schedule follow-up meetings/feedback frequency Meet timelines for all parties and address issues promptly Ensure contract terms can be administered by all parties

6. The Business Plan Continued Post Negotiation Steps Communicate results with internal stakeholders Conduct informational meetings/distribute communication vehicle across organization Develop contract performance monitoring process Set up database retrieval format for monitoring Evaluate performance at least quarterly Investigate gaps between actual and desired performance; make corrections as necessary

7. The Business Plan Important Tips! Treat parties as business associates not adversaries Start negotiations early and communicate often Hold periodic meetings with client to ascertain issues and maintain favorable relationship Keep diary of meetings, follow-up actions and commitments Make sure contract terms can be administered