Reimbursement has become increasingly complex as managed care organizations have experimented with different models in attempts to manage costs and share risk. At Presscott Associates, we assist our payor and provider clients by examining the amount of risk they are able to share and manage, respectively. We provide our clients with the tools they need and share the experience that we have gained during the last three decades to help them make informed decisions when developing their approach to negotiating and agreeing upon various reimbursement methodologies.

Presscott Associates assists healthcare organizations in evaluating risk-sharing arrangements and capitation fee structures. As managed care organizations look to share the risk of insuring their members to providers, new opportunities are being made available to hospitals, physician groups, and integrated delivery systems to participate in innovative reimbursement models. We support our clients with the information and expertise needed to assess and negotiate favorable arrangements, assess the up-side and down-side risks, recommend appropriate levels of reinsurance protection, and avoid the pitfalls that can often exist. To help providers maintain robust revenues from their managed care arrangements, we provide detailed analyses of all types of reimbursement arrangements. We also negotiate reimbursement arrangements on our clients' behalf. Experience allows us to ascertain what managed care organizations will and will not accept, so that negotiations move along efficiently to a favorable conclusion.

Idealism if fine, but as it approaches reality the cost becomes prohibitive.
-- William Buckley --