Vaccine payment negotiations play a pivotal role in managing healthcare costs. By taking a comprehensive approach that includes all direct and indirect expenses, healthcare providers can maintain their financial health while delivering critical immunization services to patients. This not only ensures the sustainability of your practice’s vaccination program but also its efficiency and effectiveness.
Consider these tips to help your practice:
- Review both your direct and indirect vaccine expenses: When collecting your vaccine expenses remember to include indirect expenses like storage, insurance and inventory management. Talk to your payers about adequate payment rates using the AAP Business Case for Pricing Vaccines.
- Compare the payment from your largest payers to identify noncompetitive payers: Benchmark the payment from your largest payers against the CDC vaccine price list. This is critically as you will likely spend more time negotiating with payers that need to increase their payments to cover your cost.
- Outline the value of your vaccine administration program: Payers respond best to facts and data, so communicating your value and being able to quantify all aspects of your practice can go a long way to helping you get higher reimbursement rates.
- Foster strong relationships with payer representatives: Take time to get to know your payer representatives, not just during negotiations but throughout the year.
- Consider multi-year contracts with annual payment inflators: Multi-year contracts can save a lot of time when negotiating payment but it’s important to remind payers that vaccine manufacturers typically increase pricing on vaccines annually and their payments must keep up with that increase expense.
- Propose performance-based payment incentives for increasing immunization rates: Get creative when negotiating for increase payment on vaccines. Payers are looking for ways to obtain more value for their payments. If your practice knows their immunization rates you can establish reasonably goals for improvement.
- Reach out to an expert that can help negotiate with payers: Reaching out to an expert can provide practices with the knowledge and support needed to navigate the complexities of payer negotiations effectively, ultimately contributing to their financial success and strategic objectives.
Successful vaccine payments negotiations can foster stronger partnerships between healthcare providers and payers, leading to collaborative efforts in improving healthcare outcomes and patient experiences. CPP has resources to help negotiate vaccine payments.
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If you’re not a member and need some support, feel free to contact us at cpp@nationwidechildrens.org, we have resources available for you as well.