Payer-Provider Negotiation Mastery

Course
Navigator

Your complete guide to mastering healthcare contract negotiations

30 Chapters

4 Parts

7 Appendices

Course Progress0/30 chapters

Appendices0/7 completed

Part I: Foundations

Market dynamics, leverage assessment, and BATNA modeling

Chapter 1

Part II: Economic Architecture

FFS methodologies, escalators, and the VBC spectrum

Chapter 10

Reimbursement Architecture: Rates, Methodologies, and Payment Design

Read Chapter

Chapter 11

Value-Based Payment Models: The Full Spectrum

Read Chapter

Chapter 12

Risk and Protection Mechanisms: The Hidden Currency of VBC

Read Chapter

Part III: The Master Catalog

Quality metrics, network provisions, data/transparency/governance, and operational terms

Chapter 13

Quality, Outcomes, and Performance Metrics: Economic Levers Hiding in Plain Sight

Read Chapter

Chapter 14

Network Design, Access, and Steerage: The Invisible Hand

Read Chapter

Chapter 15

Operational, Administrative, and Legal Terms: The Boring Provisions That Determine If You Get Paid

Read Chapter

Part IV: Execution

Playbooks, tactics, modeling, and relationship management

Chapter 16

The Provider's Playbook: Preparation and Positioning

Read Chapter

Chapter 17

The Provider's Playbook: A Complete Guide to Winning at the Payer Contracting Table

Read Chapter

Chapter 18

The Provider's Playbook: At the Table

Read Chapter

Chapter 19

The Payer's Playbook: Preparation and Positioning

Read Chapter

Chapter 20

The Payer's Playbook: At the Table

Read Chapter

Chapter 21

Creating Maximum Value: The Integrative Playbook for Both Sides

Read Chapter

Chapter 22

Advanced Tactics, Gambits, and Counter-Moves

Read Chapter

Chapter 23

Financial Modeling for Negotiations

Read Chapter

Chapter 24

Data as a Weapon and a Bridge

Read Chapter

Chapter 25

Actuarial Science for Non-Actuaries

Read Chapter

Chapter 26

Regulatory Guardrails That Shape Every Negotiation

Read Chapter

Chapter 27

Contract Language: Reading, Writing, and Negotiating Terms

Read Chapter

Chapter 28

Post-Signature: Implementation and Ongoing Management

Read Chapter

Chapter 29

Relationship Architecture: The Infinite Game

Read Chapter

Chapter 30

The Future: Where Payer-Provider Negotiations Are Headed

Read Chapter

Appendices

Practical tools, templates, and reference materials

Appendix A

Master Negotiation Preparation Checklist (Provider Edition)

View Appendix

Appendix B

Master Negotiation Preparation Checklist (Payer Edition)

View Appendix

Appendix C

Comprehensive Glossary of Payer/Provider Contract Terms

View Appendix

Appendix D

Sample Contract Term Sheets

View Appendix

Appendix E

Interdependency Matrix

View Appendix

Appendix F

Negotiation Simulation Scenarios

View Appendix

Appendix G

CourseNavigator

Part I: Foundations

The Negotiation Crisis in American Healthcare

The Evolution: From Chargemaster Wars to Value-Based Architecture

The Two Economies: How Payers and Providers Make (and Lose) Money

The Negotiation Ecosystem: Every Player at the Table (and Behind It)

Breakthrough Mindset for Payer/Provider Negotiations

Power Dynamics: Who Has Leverage and How to Shift It

BATNA, WATNA, and the Walk-Away Calculus

Needs Analysis: What Each Side Actually Needs (vs. What They Demand)

The N.I.F.T.Y. Sequence in Payer/Provider Context

Part II: Economic Architecture

Reimbursement Architecture: Rates, Methodologies, and Payment Design

Value-Based Payment Models: The Full Spectrum

Risk and Protection Mechanisms: The Hidden Currency of VBC

Part III: The Master Catalog

Quality, Outcomes, and Performance Metrics: Economic Levers Hiding in Plain Sight

Network Design, Access, and Steerage: The Invisible Hand

Operational, Administrative, and Legal Terms: The Boring Provisions That Determine If You Get Paid

Part IV: Execution

The Provider's Playbook: Preparation and Positioning

The Provider's Playbook: A Complete Guide to Winning at the Payer Contracting Table

The Provider's Playbook: At the Table

The Payer's Playbook: Preparation and Positioning

The Payer's Playbook: At the Table

Creating Maximum Value: The Integrative Playbook for Both Sides

Advanced Tactics, Gambits, and Counter-Moves

Financial Modeling for Negotiations

Data as a Weapon and a Bridge

Actuarial Science for Non-Actuaries

Regulatory Guardrails That Shape Every Negotiation

Contract Language: Reading, Writing, and Negotiating Terms

Post-Signature: Implementation and Ongoing Management

Relationship Architecture: The Infinite Game

The Future: Where Payer-Provider Negotiations Are Headed

Appendices

Master Negotiation Preparation Checklist (Provider Edition)

Master Negotiation Preparation Checklist (Payer Edition)

Comprehensive Glossary of Payer/Provider Contract Terms

Sample Contract Term Sheets

Interdependency Matrix

Negotiation Simulation Scenarios

Recommended Reading and Resources

Course
Navigator