What is the best way to measure the success of your healthcare provider and insurer negotiations?

In negotiating for your client, setting SMART goals is not just a procedural step; it's your strategic compass. Specific, measurable, achievable, relevant, and time-bound objectives provide a clear roadmap. For instance, aiming to cut a medication copay by 50% in two weeks or securing a prior authorization in three days gives your negotiation direction and purpose. SMART goals serve as your performance metrics, guiding focused negotiations, monitoring progress, and quantifying the tangible outcomes you seek for your client.

Goal-setting is the process of identifying something you want to accomplish for your team or customer and establishing specific objectives to achieve it. Goals are your desired results that you or your team are committed to achieving within a specific time frame. It involves setting long-term and short-term objectives that help you stay focused on your goals, track your progress, and attain the desired result.

Setting goals is an important part of setting yourself up for success. It helps to maintain focus, goals and direct efforts and actions.

Clearly articulate your objectives before entering negotiations with healthcare providers and insurers. Establish measurable and realistic goals that align with your organization's overall strategic priorities. This may include cost savings, improved quality of care, expanded network access, or enhanced member satisfaction.

Document all actions taken during negotiations. Keep records of communication, proposals, and any adjustments made during the process. This helps in analyzing the negotiation strategies and tactics that were most effective, providing valuable insights for future negotiations.

Properly tracking action items can significantly improve a team's efficiency. If you manage teams, tracking action items can help you make sure that every team member completes their assigned tasks. Knowing how to track action items can be a valuable skill, and you can improve it through research and practice.

It is important to take time to reflect and track progress towards goals. This can help to identify steps that need to be taken towards successful achievement of goals and also to acknowledge how far you have come, as it sometimes may not be that obvious.

Indicators are specific, measurable, and observable data points that are used to monitor and evaluate progress towards achieving specific goals and objectives. Indicators are an essential component of monitoring and evaluation, as they provide a basis for measuring progress, identifying successes and challenges, and informing decision-making. There are several types of indicators that can be used in monitoring and evaluation, including: Efficiency, Effectiveness, Quality and Impact.

Measuring the success of insurer negotiations requires a multifaceted approach. Key indicators include the agreement's financial terms, like reimbursement rates, and how they compare to industry benchmarks and previous contracts. Another critical factor is the scope of services covered, ensuring a comprehensive range of patient needs are met. Additionally, assess the administrative ease, such as streamlined claims processing, which impacts overall efficiency. Patient access to care should also be a priority, evaluating if the negotiation results in improved or maintained access to essential healthcare services. Ultimately, a successful negotiation balances fiscal responsibility with patient-centric care.

Be sure that your goals are measurable, meaningful and in line with your goals. Do not compare your goals with others nor their progress. Be proud of the progress you make and invest in your success.