‘We will reconsider higher reimbursement rates after a year in-network….’
Really?….
When contracting with funders it’s so important that providers seek budget-based, sustainable rates, so that they can honor obligations to other stakeholders over time.
Operating costs including salaries will go up, and meeting industry standards for quality and ethics can be costly. These things are interwoven with outcomes.
Some funders may tell you they will reconsider higher reimbursement rates after a year in-network and after you demonstrate quality or outcomes.
They have no obligation to honor this unless it’s in writing, and should be in *your contact*. Track records speak for themselves.
Have listed in writing, in your contact, criteria that are objective and understandable. This includes time and definition of applicable quality and/or outcomes standards / metrics.
If they plan to offer increases based on this in the future, there is no reason they shouldn’t be able to define that for you at the time of contracting.
What has your experience been?
Brandon Herscovitch, Ph.D., LABA, BCBA-D
Partners Behavioral Health can help position your ABA practice for standards, success, sustainability
