Carenodes

Out-of-network isn’t a freedom pass—it often means payment at UCR rates, not billed charges or contracted rates. It shifts the collection burden to your practice, increases staff friction, and can trap you in a No Surprises Act maze. For behavioral health operators expanding across markets, going out-of-network is a constraint, not a growth strategy. The real question isn’t whether to contract with payers, but how to do it strategically—fully weighing operational and financial trade-offs to sustain scale and care quality.
https://www.vbcapodcast.com/deciding-to-contract-with-a-payor-joining-the-network/
Based Care Advisory (VBCA)

Deciding to Contract with a Payor: Joining "the Network" Got a contract. The fee schedule is fine. Not great — fine. And now the question isn't can we do this. It's should we, and on what terms?

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Deciding to contract with a payor? Think beyond just the fee schedule. In this episode, Alex discusses the true nature of payer contracting as a market entry decision, emphasizing six key factors every health operator should consider. Key takeaways include the importance of operational alignment, the impact of high-concentration markets, leveraging your value proposition, and the necessity of experienced legal counsel for complex agreements. What are your thoughts on payer contracting? Share in the comments! https://www.vbcapodcast.com/deciding-to-contract-with-a-payor-joining-the-network/

Deciding to contract with a payor? Think beyond just the fee schedule. In this episode, Alex discusses the true nature of payer contracting as a market entry decision, emphasizing six key factors every health operator should consider. Key takeaways include the importance of operational alignment, the impact of high-concentration markets, leveraging your value proposition, and the necessity of experienced legal counsel for complex agreements. What are your thoughts on payer contracting? Share in the comments!

Deciding to Contract with a Payor: Joining "the Network" Got a contract. The fee schedule is fine. Not great — fine. And now the question isn't can we do this. It's should we, and on what terms?

New Episode! "Medicare Advantage 2026 Playbook: What Payers Won’t Tell Providers (and How to Win Anyway)"

Medicare Advantage 2026 isn’t something that’s about to happen—it’s already happening. In this episode, Alex Yarijanian breaks down what’s actually showing up in payer conversations right now, long before final rules are publ...

Medicare Advantage 2026 Playbook: What Payers Won’t Tell Providers (and How to Win Anyway) Medicare Advantage 2026 Playbook: What Payers Won’t Tell Providers (and How to Win Anyway) page for VBCA Podcast