131: Your Managed Care Contract Called: It Wants a Raise

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131: Your Managed Care Contract Called: It Wants a Raise

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Episode Description

Your managed care contract called. It might be time for a raise.

In this episode, Hannah is joined by Joe Russell, founder and CEO of YieldHealth, to unpack what home health agencies need to know about managed care contracts, payer negotiations, and the revenue (or terms) that may be hiding in plain sight.

Joe explains why agencies are often underpaid by contract, not by accident, and why a payment is not necessarily the same thing as the right payment. They discuss how outdated rates, missed escalators, auto-renewals, underpayments, denials, and administrative requirements can quietly reduce an agency’s actual margin.

You’ll learn:

  • The difference between your contracted rate and your realized rate
  • What to review first in your managed care contracts
  • How to build leverage before approaching a payer
  • Which quality and operational metrics matter during negotiations
  • Why smaller agencies can win through better terms, timing, and proof
  • How clinically integrated networks can give providers greater collective power

If your managed care contracts have been sitting untouched for years, consider this your reminder to pull them out, check the dates, and do the math.