What are some of the considerations that need to be taken into account when deciding to implement contracts management? This is a question time and time again posed to me and my group from consumer product companies, information technology groups, and particularly health care companies alike. More and more companies are coming to market looking for a contract management solution —with sometimes not even an effective repository of contracts that provides visibility into contracts terms and commitments.
As our clients begin to position themselves for the challenges associated with Health Reform, there will be a tremendous amount of pressure in the provider contracting management area to:
1. Reduce cost
2. Digitize and protect information
3. Harness information within the organization to improve workflow and mitigate risk.
An optimized approach for Provider Contract Management will be to enable our clients to:
1. Dramatically reduce cycle times and associated costs
2. Improve relationships with the provider community
3. Remove manual workflow and associated analytics
When it’s all broken down, I like to relay to my clients some of the following elements for consideration when starting on their path of selecting a Contract Management solution:
Element 1: Start With Your End Goal In Mind
Develop your own vision that reflects your priorities and goals of the organization before you start any contract management initiative. In health care institutions particularly, it is common to have a number of disparate groups negotiating contracts for separate areas of the institution. With acquisitions and divestures or medical groups, it is very common to have differing practices and procedures throughout as it relates to contracts. A Health Care Institution needs to consider how a contracts management solution would fit into place in the organization. An example vision could be: A system with the ability to review, execute and maintain contracts in an electronic format that checks for approvals and compliance, has reporting capabilities, and is user friendly to the audience.
Element 2: Understand The Contract Management needs
Know the importance of understanding your processes (whether they are ‘to be’ or current) helps identify your ideal solution. With Health Care, incorporating HIPPA rules, medical practice rules, retention laws, and other important elements can all be baked into a solution. A diagram will assist you in putting all the pieces together and it ensures you don’t miss anything when creating your system requirements later.
Element 3: Get the Right People, Create the Right Team
Put together a team that will manage responsibility for the decision and implementation. This project team should gather all needs from various stakeholders, define requirements, create the process and workflow, and make sure the system can address the pain points that need to be solved. It’s important to have representatives from every team that uses, implements, or supports the system from all of the Health Care Groups, as they will be the end users of the solution. For it to become a success, all group input needs to be collected to create support of the solution. An ideal team could include IT, business development, compliance, finance, legal, sourcing, and physicians.
Element 4: Interview the Team
It’s our recommendation that interviews should be used when selecting a contract management process and solution. Interviews should include the end users who will send the contract out as well as the power users of the legal services group (legal ops, paralegals, etc.)
Sample questions can be along the lines of:
• What is the process for contract review?
• When is a contract required?
• What are your group’s specific health care regulations that need to be considered?
• Are the docs/nurses/medical staff going to be using this system? If so, in what capacity?
• Which provisions must be included?
• Who negotiates T’s and C’s?
• Who can sign off?
Element 5: Understand Barriers and Pain Points
Very important, from our perspective is to take time to understand external barriers, any disparate cultures between Health care groups, a change-resistant corporate culture, compliance challenges, HIPPA challenges, competing / disparate databases, competing projects, or even the internal perceptions of legal.
Element 6: Consider Integrations
What are the potential integrations that your company is considering with this system? What are the easy wins and more short term integrations, and what are the longer integrations? It is key to determine how they fit into the longer term strategy. Some examples of systems provider-based healthcare organizations typically integrate a Contract Management system with include, but are not limited, to the following:
• Medical Billing System – Trizetto FACETS / Portico Systems (McKesson), allows for revenue maximization, claims automation, and helps standardizes billing processes to allow for less time for claims to be spent in accounts receivable.
• Content Management System – IBM Filenet / EMC Documentum, allows for an organized manner of viewing contract attachments
• E-Signature – Echosign/Docusign, allows for increased throughput of contracts
• Active Directory – allows for Single Sign-On capabilities
Element 7: Think about Privacy and Security
Consider both privacy and security when selecting a solution, and recommended IT and legal work together to implement a solution that’s going to fully meet the needs and requirements of the organization.
Element 8: Review and analyze all the information you’ve gathered
The internal team should analyze all of the information gathered during the process before making a decision, inclusive of the following:
• Reviewing all Health Care policies and procedures, including rules, standards, and exceptions
• Reviewing and diagraming current methods and workarounds
• Considering solutions, such as enhanced processes, and weighing the pros and cons of an internal database system versus a dedicated vendor
Element 9: Define what you need
It is suggested that your group take the following into account when selecting a solution:
• How many licenses will you need?
• Will there be one central administrator or will everybody have access? Should they?
• Consider tiers for those that may need a license and who should have access to what
• Define who is a “must have” or a “nice to have”
• How any legacy records should be migrated?
Once you know your requirements, you can create a document that defines what to look for in a contract management solution.
A sound contract management implementation will allow provider-based healthcare organizations to achieve the following benefits:
• Reduce administrative costs, while increasing provider payment accuracy
• Integration with other systems enables the decrease of contracts to claims gap.
• Via contract reporting, improves visibility of standards adherence and clause usage/distribution
I have found some key features of a Contact Management solution that have particularly impressed provider-based healthcare organizations are as follows:
• Contract wizard functionality:
• Step-by-step series of questions presented to user to increase contract throughput and ease contract authoring process
• Automates customization of contracts for a given provider
• Centralized repository for provider contracts and images (ability to bulk load of legacy agreements)
• Standard/alternate contract clauses and templates
• Configurable contract workflows for end-to-end contract lifecycle management
• Rules-driven contracting stands, compliance enforcement, and reporting