About Terri Welter

Terri’s expertise in the area of managed care is unmatched in the healthcare industry. The head of ECG’s Contracting and Reimbursement practice, Terri has spent nearly 20 years helping providers develop innovative payment approaches, negotiate contracts, devise reimbursement strategies, and ultimately improve revenues. Clients appreciate Terri’s forward thinking and her keen understanding of evolving payor/provider payment models, and she is highly regarded for her ability to achieve tangible, lasting results. She has provided strategic advisory services and led payor negotiations for numerous health systems, improving their annual bottom-line revenue by millions of dollars. She has worked with health plans and their provider risk partners to structure funds flow models that align the incentives of payors, hospitals, physicians, and other services within the care delivery system. Recently Terri has worked closely with health systems, hospitals, medical groups, and payors to establish contracting structures that facilitate clinical integration, helping them develop and execute the types of arrangements needed to successfully react to healthcare reform. This work includes national experience developing and implementing accountable care organizations, clinically integrated networks, and population health management organizations for Medicare, Medicaid, commercial, and employee health plan products.

Value-Based Enterprise Conversation Series: Responsive

In the era of health reform, new payment methodologies built around value and shared risk are replacing traditional fee-for-service reimbursement models. Shifting payment structures are symbolic of the changing healthcare landscape. Partnerships and mergers are reshaping local and regional markets; patients are expecting greater value, access, and transparency; and legislative and regulatory mandates – along with their associated opposition – are contributing to an air of uncertainty.

To survive, organizations must do more than simply react to the changing environment. Instead of being forced into action by external drivers, responsive organizations are proactively designing and executing near- and long-term positioning strategies. Leaders in these health systems understand the importance of responding quickly to changing market conditions, shifting payment models, and evolving patient needs.

As part of our ongoing series of conversations about the value-based enterprise, Terri Welter, head of ECG’s Contracting and Reimbursement practice, shares her thoughts on what it means to be a responsive organization in the era of reform. Continue reading