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Contract Assessment and Return on Investment (CARI)
Historically, being “in network” with an MA plan was thought to be the optimal position. As MA plans have adjusted payments and operational requirements, being part of their network may not always be worth the administrative burden that continues to increase. The more complex it is to work with an MA plan, the more time staff must divert from their daily responsibilities. There is an opportunity cost and quantifying the costs associated with every contract, is part of the current imperative. Further, because of the growing penetration of varying MA plans in geographical locations, being in network with all MA plans in your location may no longer be necessary. What may be more important is deciphering which particular MA plans are the best for your organization, rather than taking a “contract with all” approach.
This tool walks providers through the process for evaluating and understanding the real Return on Investment (ROI) of their Medicare Advantage contracts, ultimately assisting providers in determining whether remaining a network provider is worthwhile, or if other strategies may be more advantageous for both the provider and the residents.
This is free to AHCA/NCAL members.