Preparation for Negotiation

Negotiations in healthcare often involve significant information asymmetry, where one party—whether payer or provider—lacks the full depth of knowledge held by the other. For instance, providers may not fully understand payer priorities or budgetary constraints, while payers may lack detailed insights into the clinical and economic value of a treatment or service. This imbalance can lead to suboptimal outcomes, where critical details are overlooked, and agreements fail to meet their potential for mutual benefit. We bridge this gap by providing short-term, targeted expertise to review and refine negotiation strategies on both sides.

Our services focus on reducing this asymmetry by conducting a thorough review of negotiation materials, including evidence submissions, cost analyses, and proposed payment models. For payers, we evaluate the clinical and economic assumptions underpinning a provider’s proposal, ensuring alignment with budgetary goals and health system priorities. For providers, we identify how their value proposition aligns with payer needs, recommending data points and outcome measures that resonate with decision-makers. This dual capability allows us to support either party in preparing robust, well-informed arguments that improve their position during negotiations.

Through this approach, we deliver actionable insights and strategic recommendations tailored to the specific negotiation context. Whether it involves reviewing a value-based payment model, assisting in the selection of critical outcome measures, or preparing counterarguments to strengthen a proposal, we provide the tools needed to navigate complex discussions effectively. By engaging our expertise, clients gain confidence in achieving fair, sustainable agreements that balance clinical outcomes, financial realities, and system-wide value.