If your contract still references rates from 2009, you’re basically billing like it’s the Stone Age. Inflation, regulatory changes, and rising costs mean outdated rates are revenue killers. Here’s how to make your contract smarter—and keep it current every year.
Why Future-Proofing Matters
Healthcare costs don’t stand still. Neither should your reimbursement. Silent PPOs and outdated fee schedules can quietly erode your margins over time. If your contract doesn’t have built-in mechanisms for updates, you’re leaving money on the table.
Key Strategies to Stay Ahead
1.Tie Rates to an Index, Not a Static Number
Instead of locking in a flat dollar amount, peg your rates to a recognized benchmark like CPI for Medical Services or a commercial payer index. This ensures automatic adjustments without renegotiation every year.
2. Add Escalation Clauses
Include language that guarantees annual increases (e.g., 3–5%) or aligns with inflation. This prevents your rates from stagnating while costs rise.
3. Define Update Triggers
Specify events that require renegotiation—such as major regulatory changes, new coding guidelines, or payer network shifts. This keeps your contract responsive to industry changes.
4. Audit Silent PPO Access
Require transparency on network leasing and demand written consent before your rates are shared with third parties. Silent PPOs often exploit outdated contracts, so lock down your terms.
Sample Language to Consider
- “Rates shall adjust annually based on the Consumer Price Index for Medical Care Services.”
- “Provider reimbursement shall increase by 4% annually unless otherwise renegotiated.”
Bottom Line
Future-proofing isn’t about predicting the future—it’s about building flexibility into your contracts so you’re never stuck billing like it’s 2009. A smart contract evolves with the market, protects your revenue, and keeps silent PPOs from exploiting outdated terms.