Local payors are not always the enemy; they can be a source of revenue and referrals. Though many treatment centers turn to patient or provider marketing to increase revenue, they often overlook their relationship with their payors.
By developing a good relationship with your local payors, you can work to negotiate higher reimbursement and earn more patient referrals. A thriving program and good payor relationship can help overcome low reimbursement rates that often accompany going in-network. You can improve your payor relationship with these tactics:
Communicate with Payors
Payors can’t know about your quality care or evidence-based services unless you tell them. As you grow and offer more treatment options or services to your patients, ensure that your local payors are aware of the changes. If you demonstrate that you provide comprehensive care that leads to better outcomes, payors will trust you to treat their members. This can help with contract negotiations and overall referrals to your facility.
Specialize Your Services
If you are looking to increase your payor referrals, one way to stand out is to offer specialty programs that differentiate you from your competitors. For instance, if you offer specialized programs for athletes, tech employees, or patients of a particular religion, your payor may remember that and be more likely to refer that demographic to your facility.
Again, you need to communicate these programs to your in-network payors. If they don’t know, they can’t refer.
Share Your Outcomes with Payors
Payors want data. They want proof that their patients are benefitting from your program and that with your outcomes, their will be a reduction in future health costs. Be stringent about documentation, data collection, and outcomes tracking. When you do have new outcomes data, share it with your payor. Show them that your treatment is effective and that you are the best provider for their members.
Offer a Full Spectrum of Care
Patients are likely to have greater success in programs that offer long-term support. Typically, these are the programs that have a full continuum of care - residential and outpatient treatment, medication assisted treatment (MAT), and a strong alumni program. If your program does not offer all of these services, you can still benefit by aligning with other providers.