The SCALE Healthcare Leadership Conference featured many insightful workshops throughout the day.

The workshop “Payer Contracting Strategy,” led by Margaret C. Braxton (SCALE Healthcare) and Patrick Kiss, CPA (Growth Orthopedics), explored the essential role of payer contracting in the processes of mergers, acquisitions, and consolidations. It began with the identification of merger opportunities and an evaluation of assets based on contracted rates, contract language, and payer notification requirements, ensuring compliance with proprietary and confidential payer contracts during due diligence.

Margaret and Patrick discussed the requirements for change of ownership, including payer notifications, necessary documentation, and timelines for contract renegotiation. They also reviewed federal and state compliance requirements, with specific considerations for Commercial, Medicare Advantage, and Medicaid lines of business.

Following the transaction, the workshop addressed contract integration, focusing on aligning and combining individual contracts into group agreements. Finally, they outlined strategies for structuring healthcare assets to promote sustained success and growth in a competitive market.