Participating Providers and the Direct Contracting Entity: Building and Nourishing Relationships

“The statements contained in this document are solely those of the authors and do not necessarily reflect the views or policies of CMS. The authors assume responsibility for the accuracy and completeness of the information contained in this document.”


When contracting with a healthcare provider, one of the keys to success is building a credible relationship with the provider and their team.  Many organizations will have a provider support representative, or a Provider Rep, assigned to manage the participating provider’s account.  This individual will build and nourish the relationship with the provider over time.  The Provider Rep will become the communication conduit from the Direct Contracting Entity (DCE) to the participating provider, and vice versa.  The success of the provider and the DCE balances on the provider’s engagement with the Provider Rep.

I have spent the last 10 years building relationships with providers, office administrators and staff.  I wanted to share five points to incorporate when communicating with your providers and office administrators.  These points relate directly to the monthly performance reviews shared with the participating provider and office administrator.

1.

Arrive early to your meetings – I cannot stress this enough; being on time is like being late. When you are walking into an office for an appointment at the schedule time, you may feel like you have done your job, but you have missed out on a huge opportunity. Getting there 20 minutes early allows for you to:

  • gather your thoughts and review your agenda.
  • interact with the staff and ask questions to see things from their point of view.
  • review the lobby marketing materials and ask beneficiaries for their opinions.
  • offer the extra time back to the provider so they can enjoy an unforeseen break.

When I arrive at the office, I always tell the front desk or office administrator, “I am early, but please do not feel rushed.  I can answer some emails and get prepared for our meeting during this time.  Unless you want to start now and have some free time enjoy before getting back to your day? It’s up to you…I can adjust accordingly.”

You would not believe how appreciative a provider or office manager is when you are giving time back to them.  Normally, they use the time for extra questions or small talk, which also builds the relationship.  Listen to the things they enjoy when they are not in the office.  Pick up on their family, kids, and real-life routines.  Ask them about those things during all your visits.  They will know you were listening and know that you genuinely care.  It is not always about the numbers.

If you are having guests join your scheduled meeting, please be sure they also know to be early.  Mark it on their calendars, highlight it and then send a reminder the day of the meeting.  Do not just be on time…be early and listen / learn.

2.

Seating position is important – if your meeting takes place in a conference room or around a large table, where you sit for each meeting is important.  Do not get in a habit of sitting across from the provider or office administrator.  There will be times when you will need to sit across from them, but most of the time, you will be sitting on the same side sharing and reviewing information.  Check your agenda before sitting down.  If the meeting is to review data and discuss an actionable solution, you will want to be sitting on the same side with the audience.  If the meeting is to discuss critical opportunities, also known as a “hard talk”, you will want to sit across from the audience.

As a Provider Rep, you are doing just that, “representing the provider”.  You are their counsel.  You are their voice to the DCE.  You are held accountable as much as they are for their performance and engagement.  When you are communicating the game plane, you are on their team, on their side, working together towards the common goal.  When it is time to have the difficult conversations, your position at the table will create the tone for the meeting.

  • Same Side Sitting – creativity, open ideas, game plan discussion, celebrating wins
  • Opposite Side Sitting – Refocus, serious talk, accountability, overcoming loses

Your guests will always sit opposite of the provider and office administrator. During these meetings, educations, or “hard talks” from a Medical Director, the Provider Rep will always sit on the same side as the provider and office administrator. You are their counsel, remember. You will be the one they turn to for direction. This is how credible relationships form and trust builds. Your suggestions become actions and actions become successes.

3.

Have an agenda with actionable takeaways – always have a road map prepared for your meetings, but only share that agenda once the meeting begins.  Never overwhelm your audience with task after task, or large amounts of information.  Focus on three important takeaways that require action to move the needle.  Provide accurate data to review together, set goals together and hold everyone accountable…together.

A communication form is great to have at each meeting.  This allows the Provider Rep to have the three main takeaways listed with a suggested plan of action.  During the meeting, the team can determine the “who”, the “when” and complete the plan of action.  Additional concerns can be added to the communication form for the Provider Rep to follow up.  After the form has been completed (end of meeting), both parties sign off on the meeting’s action items and all receive a copy.

4.

Open with positives and end on positives – this one is easy.  Just like the old saying goes “never go to bed angry”.  Your meetings should never end on negatives, even the “hard talk” meetings.  Open with positives, address the opportunities and then save a win for the end.

At the close of your meeting, share a story you learned from Member Outreach about one of their beneficiaries.  How what they are doing impacted their life and what they are doing is working.  Share an example of how a staff member carried out their job and had passion for the patient, going above and beyond to make someone’s day.  Let the provider and office administrator know how they are doing things successfully and that other offices are learning from their methods.  Again, this builds the relationship you are trying to grow.  You are creating a culture of good habits and instilling pride by positive recognition.

5.

Always do what you say you are going to do – you know the phrase “saving the best for last”?  If you say you are going to do something, simply do it.  If you have the chance to do it beyond your promise, then chose that way every time.  This is the one item that can and will destroy trust and your relationship with the provider will soon crumble.

If it takes an hour to be good, it only takes five more minutes to be great.  Once you commit your word to a provider or office administrator, get it done, do not wait.  When you have completed it, ask yourself (the five minutes part) “how can a make this even better?”.  Just doing something to check it off your list is mediocre.  Are you mediocre?  Do you want your relationship with your office to be mediocre?  Then take five minutes and make an impact.

By creating habits as a Provider Rep, you can increase your credibility with your offices.  Giving your direct contact information and being available any time will help you build trust and reliability.  Representing your offices, fighting for them and with them will build a rock-solid relationship.  Ultimately, by doing what you say you are going to do, and then going the extra step will deem your role (as the Provider Rep) an asset to the participating provider and the DCE.