Our Value Proposition

We bring Large System
Payer Negotiations Capabilities
to Community Hospitals

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Discover

Does Your Organization

  • Get the market share from the payers you want?

  • Understand why your contracts aren't producing the expected revenue?

  • Make a margin that allows you to invest?

    • We strategically negotiate your contracts to deliver the revenue while you stay in control and focus on your other priorities - leading to satisfied client endorsements.

    Then Let's Talk!

    Are Your Payer Contract Increases keeping up with Premium Increases?

    See Blog!

    Who We Serve

    Hear From Our Satisfied Clients

    Working with CMCS, we were able to make significant improvements to our most important payer contracts. Their analytical tools showed us why our current contract was producing the revenue that it was. Their negotiators used that model with input from our team to determine how best to structure our proposals with the payers new fee schedules and rates to negotiate a sizeable revenue increase. We had not been able to achieve these results in the past and look forward to working with them in the future.

    Penny Wallace, CFO, Guadalupe Medical Center

    Our organization has had a great relationship with CMCS. CMCS has provided a level of expertise that had been difficult to retain in-house for our largest payer agreements that are negotiated once every two or three years. Their analytical models provided insights on proposals that helped drive meaningful and impactful negotiations. All of this at a reasonable cost with an ROI well in excess of 50 times with a net revenue lift of several tens of millions over the last 5 years.

    Roger Mattke, CFO, Lafayette General Health System

    Baton Rouge General has worked with CMCS for three years and I am happy to recommend their services and share a little about our experience with their team.

    Overall, CMCS has helped BRG significantly in our payer negotiations, offering strategies and data that helped us exceed our goals in several of our recent negotiations. One major benefit to our work with CMCS is the platform they created that allowed us to review our system’s data wholistically. Working with our team, they helped us analyze contract components and develop new strategies that would align performance with our goals. Their team brought insights from their experience and understanding of payers that helped us to create and implement a successful plan.

    Kendall Johnson, EVP/CFO, General Health System, Baton Rouge General
    The CMCS Perspective

    We Are

    Experience on both sides.
    Focused on your success.

    Creative Managed Care Solutions

    Experienced leaders

    Leaders who have worked at large AMCs, for FP & NFP health systems, and national payers.

    A shared perspective

    We understand the challenges each side faces.

    Practical solutions

    We use this understanding to create solutions.

    • Strategic Approach
    • Expert Negotiators
    • Displined Process
    • Proven Results
    We use custom tools we specifically built to assess your actual claims, executed contracts, and remittances from each payer. Next, our team uses this assessment to identify the specific areas that cause these results. Once the tools are developed, we can see how and where to negotiate language, methodology, or rate changes to achieve your goals.
    Our team is built with executives who have payer and provider experience across the United States. This allows us to track trends and share experience, as well as develop client-specific solutions for the optimal outcome for each organization.
    All the information is shared with your team to help them understand and comply with the requirements of the contract. This helps ensure your system gets paid the hospital revenue you expected.
    As one of the industry’s top managed care consulting firms, we’re proud to offer experience you can depend on for every job. Whether you hire us to examine a single contract or review your entire operation’s negotiations, you can count on our team for careful attention to detail and keen insight.
    "Stronger payer relationships enable you to achieve your goals."

    With government payers moving to mangaged care models, the most significant opportunity to finance your strategic plans is to strengthen your payer relationships as a portfolio.

    CMCS process will put you in control of your negotiations so you have better tools, negotiators, and tactics than the payer so you can drive the outcome that best achieves your goals.

    John Montaine

    John Montaine

    From the CEO's desk

    Our Team