The checklist, which can be downloaded below, will walk you through a series of common considerations for contracts you may receive from payers, with a specific focus on contracts that include value-based payment components. This checklist is a supplement to our Module 1: Value-Based Payment Basics for FQHCs, which uses the HCP-LAN APM Framework as its basis. Review both before using this checklist; they are linked below.
Work through this checklist to be sure you understand these considerations and to help you flag any outstanding issues for legal and/or consultant review prior to execution of the contract.
It is important to understand, contracts can be complicated and no one tool can effectively address all possible contract configurations and their potential issues. Use this as a guide with other resources, access outside expertise when needed, and apply your own knowledge and understanding of your business. It also never hurts to ask the health plan representatives if something is not clearly understood.
The information presented in the checklist attached does not take the place of individual legal and/or expert advice on specific situations found in payer contracts. There is no substitute for individualized guidance before agreeing to terms and conditions. Always defer to a qualified professional when entering relationships with payers.