Contracting

SoNE HEALTH has a long history of successful collaboration with health plans that resulted in mutually beneficial contractual relationships for both our physicians and hospital members, Credential & Enrollment, and payors. A key to our success is the work of the SoNE HEALTH Contracts and Financial Committee, comprised of both physician and hospital representation.

The Committee works Education & Training on behalf of the entire SoNE HEALTH network and our patient populations to ensure fair and equitable health plan agreements that provide the critical opportunity for our physician Population Health practices and hospitals to reinvest in services and facilities for the benefit of our patients.

Management

The world of healthcare is undergoing significant transformation. Relationships between clinically integrated networks and health plans must evolve from traditional fee-for-service arrangements to those that are patient-focused. The SoNE HEALTH Contracting Team, together with the Contracts and Financial Committee prioritize payment models that ensure long-term sustainability for our clinically integrated network in order to optimize quality care and patient health outcomes and promote the delivery of high-value care.

Our contracting efforts have resulted in agreements for Commercial (HMO,PPO) products, Medicare Advantage (HMO, PPO), and government contracts such as Medicaid Accountable Care Organization (ACO) in Mass and Medicare Shared Savings at the federal level. The team also works on projects that focus on alternative payment models like bundled payments, shared and full risk agreements where SoNE is responsible for the care a population of patients receives and their health outcomes. Recently during the COVID19 pandemic, the team negotiated telehealth services into all our contracts to provide continued access to healthcare services.

Throughout the year the SoNE HEALTH Contracting Team works with the payors to remain informed of evolving payor policies to ensure access for our patients, to our hospitals, and physician practices.

The list of payors we contract with includes but is not limited to:

In addition, we are committed to innovation in healthcare by engaging in new services such as contracting directly with employers to assist them with meeting the healthcare needs of their employees.