Payer Strategy & Negotiation
Our team can negotiate better payer contracts for your organization.
Payer Contract Negotiation Services for the Healthcare Industry
Rising costs and declining reimbursement – the issue that our clients are facing. At PayrAdvisors, we help clients negotiate better reimbursement from their contracted payers so that each practice‘s profitability aligns with its costs. Our team will mobilize a robust strategy that optimizes your organization’s pursuit of revenue goals, helping to negotiate on equal footing.
- 12,000 payer agreements negotiated and counting
- 12-times average return compared to the invested capital
Engaging with PayrAdvisors means partnering with a team that acts as an extension of your organization. We align with your internal stakeholders, define success metrics and begin building a roadmap, short-term wins and long-term sustainability in your payer relationships.
Hospitals and Health Systems
Negotiating with payers is a challenging and arduous process. It takes years of experience and a team capable of modeling financials to ensure you are negotiating the best possible deal. Payers have significant resources around data analytics — our team has the resources to provide this for your health system at scale. We have substantial experience working with health system C-suite personnel to develop long-term, sustainable payer strategies that focus on growth and partnership between physicians, patients and payers.
Infusion Centers
We have a team of experts focused on the pharmaceutical industry to help you navigate the changing landscape of complex infusion drug delivery. We have helped hospitals, 340B programs, free-standing infusion centers and large national cancer treatment groups negotiate better drug reimbursement. We are focused on helping clients achieve margin growth for a sustainable future in treating patients with complex illnesses.
Physician Groups
Whether you’re an independent physician practice or part of a multi-specialty physician group, we can help navigate the challenges of growth. We offer multiple capabilities, from formulating strategies around acquisition and de novo growth to building complex data dashboards. Our company has helped practices in GI, dermatology, orthopedics and more.
Private Equity Firms
Private equity has grown rapidly within the healthcare space. Much of this growth is due to the fragmentation of providers and their inability to develop scale and growth or sustain profitable growth. We work with PE firms from both a diligence perspective on acquisitions and de novo growth to hands on assistance of their portfolio companies. Our firm has created significant return on invested capital for many PE groups by helping them navigate the entire payer portfolio process. If your firm is considering buying, expanding or looking to develop stronger margins, our team is here to help.
Contract Types We Negotiate
Commercial
Maximizing reimbursement and optimizing language to reflect your true market value.
Medicare Advantage
Navigating federal regulations while pushing for terms that support high-quality care.
Managed Medicaid
Securing sustainable rates and clear language to support care delivery in a complex, state-driven environment.
Types of Reimbursement
We work across multiple reimbursement models and help you understand and optimize each:
Fee-for-Service (FFS)
Traditional models still play a role; we help you secure competitive rates and coding terms.
Value-Based Care (VBC)
From quality metrics to shared savings, we negotiate terms that align performance with profit.
Capitated
We evaluate population health risk, utilization assumptions, and contract mechanics to ensure fair capitation.
Case Rates
Whether per diem, episodic, or bundled, we structure case rates to drive stability and predictability.
Strategic Payer Engagement & Complex Negotiation Support
We lead all negotiations with a strategic and proactive approach—bringing professionalism, data, and experience to every conversation with payers. Whether we’re advocating for higher rates, addressing outdated terms, or building new agreements from the ground up, our team ensures that your value is fully represented.
For complex or high-stakes negotiations, we bring additional tools to the table:
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Leverage Assessment & Out-of-Network Strategy – We evaluate your market strength, patient volume, and payer dependency to determine if walking away—or threatening to—is in your best interest.
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Patient & Broker Communications – When necessary, we draft letters and outreach strategies that activate employers, brokers, and patients to support your position.
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Regulatory Support – If payer behavior warrants escalation, we assist in preparing and submitting complaints to Departments of Insurance (DOI) to apply formal pressure.
Every tactic is tailored. Every move is calculated. You stay in control, with our team behind you.
Negotiating Language & Terms
The fine print matters. We dig deep into contract language to ensure your rights are protected and obligations are realistic. We address:
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Payment timelines
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Authorization requirements
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Termination clauses
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Dispute resolution
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Audit procedures
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Quality metrics & penalties
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Risk adjustment methodologies
Our teams work hand-in-hand to ensure the contract terms are as strong as the rates.
Finalizing the Contract Life Cycle
We don’t disappear once the deal is signed. We oversee every step of the contract life cycle—drafting redlines, facilitating signature, and coordinating implementation.
You’ll receive clean, organized deliverables including fee schedules, contract summaries, and training materials for your staff. We also support updates to your billing and revenue cycle systems to reflect new terms, so you see results right away.
With Payr Advisors, you get more than just a contract—you get a partner who sees it through.
Why Trust Us to Lead Your Payer Contract Negotiations?
PayrAdvisors has an experienced, tenacious contract negotiation team that delivers measurable revenue growth. Partner with us to experience the qualities that have made PayrAdvisors a widely trusted name in healthcare payer contract negotiations.
Our qualified pricing analysts, contract strategists and payer relationship managers collaborate to develop robust negotiation plans. Each plan strives to achieve specific financial outcomes that align with the client’s revenue requirements. As an extension of your organization, we will convey your worth in an effort to secure profitable contracts.
Payer agreements negotiated & counting!
Average return on invested capital
Our credibility is evident in the ROI we have helped generate and the relationships we have forged throughout the healthcare industry with companies such as UHC, Aetna and Cigna. We have delivered favorable outcomes for numerous hospitals, physician groups, private equity firms and other clients that provide medical services. Many of our partners have seen revenue from multiple accounts rise by a factor of 10% or greater. Their positive testimonials corroborate our success as ROI advocates and dedicated partners.
Contact PayrAdvisors to Discuss Payer Contract Negotiations
With PayrAdvisors, you can trust that each payer contract aligns with the value you provide and the goals you strive to achieve. We can collaborate with you to optimize your payer negotiation strategy, so contact us online to request a consultation.
We understand the unique challenges that providers and their staff face, which is why we are dedicated to offering exceptional services tailored to your individual needs.
7901 4th St N # 21403 St. Petersburg, FL 33702