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    2025 MGMA Focus Financial Conference

    Business Intelligence

    WS1: Transparency in Coverage - Putting Payer Negotiated Rate Data to Work for Your Practice

    Sunday, April 13, 2025
    12:30 PM – 1:30 PM EDT
    Eligible for: ACMPE: 3| ACHE: 3| CEU: 3| CME(AAPC*): 3| CPE: 3.6| PDC: 3
    Intermediate | Interactive | Evaluation
    *Lunch will not be served during this workshop.

    This intensive workshop is designed for participants ready to understand and apply payer negotiated rate data to their financial and managed care strategy, and to consider inputs that will help leaders draft and implement a payer contracting strategy for their organization. The session provides an overview of the Transparency in Coverage (TiC) data set for payer negotiated rates. Instructors will guide attendees through a step-by-step process, learning how to query meaningful data and actually put it to work in payer contract negotiations. The group will use case studies to illustrate applications for the data from start to finish as well as ancillary uses of this data set for revenue cycle staff. From gathering relevant data and evaluating contracts to refining negotiation skills and establishing a contract performance monitoring system, this bootcamp provides tactical guidance essential for financial leaders and payer contracting professionals.

    Learning Objectives:

    1. Determine essential components required to establish and execute an effective payer contracting strategy
    2. Analyze current contracts and develop an approach to payers, including proposal development, value proposition creation, and consideration of value-based factors
    3. Define short-term and long-term goals for payer contracting, establishing a clear path for ongoing success