Managed Care Specialists Win Big for QHR Hospital Clients

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QHR managed care consultants are yielding big results for its hospital clients nationwide. Two South Carolina hospitals - a 248-bed facility and a 62-bed facility - are among the many seeing big changes in their bottom line as a result of QHR's expertise in negotiating/renegotiating managed care contracts.

Dave Clemens, one of the QHR associates who contributed to these particular success stories, is to be commended for his hard work and dedication to helping these hospitals enjoy managed care success.

QHR managed care consultants are yielding big results for its hospital clients nationwide. Two South Carolina hospitals - a 248-bed facility and a 62-bed facility - are among the many seeing big changes in their bottom line as a result of QHR's expertise in negotiating/renegotiating managed care contracts.

During the period January 1, 2007 to December 31, 2007, QHR negotiated five payment rate increases with the larger hospital's existing managed care payors and established new participation agreements with six other payors. These changes resulted in an estimated $3.67 million annual increase to the hospital's revenue, with additional increases scheduled for 2008 and 2009.

At the smaller hospital, during the period April 1, 2007 to March 31, 2008, QHR renegotiated six of the hospital's existing managed care contracts and negotiate new agreements with four other payors. The financial impact of these contract changes and additions are estimated to increase the hospital's revenue by approximately $225,000 annually, again, with additional increases scheduled in the coming years.

"QHR's managed care specialists have the skills, experience and tools necessary to be successful in managed care contract negotiations. The work we do on our hospital clients' behalf really impacts their bottom line. For many hospitals, our work can mean the difference between operating in the black and operating in the red," said QHR Associate Vice President of Managed Care Services Howard Green. "Dave Clemens, one of the QHR associates who contributed to these particular success stories, is to be commended for his hard work and dedication to helping these hospitals enjoy managed care success."

In addition to overseeing direct contract negotiations for each of these hospitals, QHR has provided additional value by:

  • Serving on the South Carolina Hospital Association's legislative committee working on prompt pay and quality standards issues;
  • Meeting with the previous and current directors of the South Carolina Department of Insurance regarding payor conduct issues that impact South Carolina hospitals;
  • Serving as a representative on the South Carolina Department of Health & Human Services Managed Care Reimbursement Issues Work Group; and
  • Serving as past president and current board member for the SC Society of Managed Care Professionals.

QHR is a family of brands that has provided consulting, management and education resources to hospitals and health systems for three decades. QHR Management Services is the dominant market leader in hospital management resources, with nearly 170 current multi-year clients across the United States. QHR Consulting Services is among the 15 largest healthcare management consulting firms in the United States, with more than 150 consultants providing financial, operational and strategic support to hospitals. Each year, the QHR Learning Institute trains more than 8,000 healthcare professionals to achieve business goals by improving their leadership and management capabilities. For more information, go to http://www.qhr.com.

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Laura Alabed
QHR
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