Service
Managed Care Services
Payer Strategy & Contracting
Zephyr Healthcare Advisors brings deep expertise and a results-driven approach to managed care strategy, empowering hospitals, medical groups, and health systems to optimize their payor relationships and financial performance. We partner with healthcare organizations to navigate the complexity of managed care contracting, risk arrangements, and strategic planning.
Key Elements
Profitability & Strategy
- Hospital managed care profitability analysis
- Overall managed care strategy evaluation
- Payor contracting review (language, carve outs, out-of-network, etc.)
Contract Review & Negotiation
Health plan contract review and negotiation (shared risk and full risk) for hospitals and medical groups
Structures, Risk & Compliance
Hospital/medical group structures and relationships
Hospital full-risk capitation program review, analysis, and recommendations
DOFR claims payment compliance audit
Interim Management
Temporary organizational support on managing and implementing managed care contracting and strategy
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