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Health system-payer negotiations 'coming to a head'

By Admin | May 30, 2024

Contract negotiations between health systems and payers are a routine part of doing business, but ongoing cost and workforce pressures, inflation and widespread Medicare Advantage challenges are forcing health systems to push back against the dynamics of the payer-provider relationship.

Health systems continue to recover after a tumultuous few years, but many still operate with margins below or close to zero. The nation's largest payers, on the other hand, reported billions in profits in 2023.  

At $16.4 billion in total earnings in 2023, a 14.2% year-over-year increase, UnitedHealthcare's earnings were the highest among commercial payers and it has been among the most difficult to renegotiate contracts with, Stuart Kilpinen, Trinity Health's senior vice president of payer strategy and product development, told Becker's.

"We've had difficult negotiations with...(More)

For more info please read, Health system-payer negotiations 'coming to a head', by Becker's Hospital CFO Report

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