“One SME is contract management at our organization” is a statement we’ve heard countless times. This go-to person has an encyclopedic knowledge of their organization’s contract universe, they can name the most favorable terms, the contract with the highest amendment count, and provide precise page counts if you ask them nicely.
These contracting connoisseurs are not enabled by good technology; quite the opposite is true: their impressive expertise stems from their mastery of the content at hand. This makes them nigh impossible to replace.
So what do you do when this VIP retires? Goes on vacation? Family leave? How can we better enable both our favorite contracting SME and their entire organization to successfully carry on contracting no matter the workforce?
Let’s take a moment to evaluate the situation by tackling some managed care contracting succession planning.
Contract Chaos, A History
Healthcare, like many businesses, is partially dictated by legal contracts that outline the relationship, responsibilities, and rights of the involved parties. In managed care, these contracts are between payers and providers, specify how the provider will participate in the payer’s network, and cover the typical legalese that accompanies any contractual relationship. Keeping these healthcare contracts organized is futile since most span a long and winding paper trail (sometimes actual paper, usually electronic) that documents the many complex changes of a payer-provider relationship over time. From adding or removing health plans and providers to adjusting nuanced variables in reimbursement calculations, redlines and contract terms are buried in shared drives, desktop files, and rusty cabinets. Basically: it’s a process these organizations can't avoid if they want to stay in business and it’s total chaos.
The content of contracts is viewed as sensitive and easy to misinterpret so making sense of an organization's contractual relationships falls to a trusted and specialized few. They do their best to represent the complexity of their contract universe with the tools at their disposal, but it only gets them so far. These contract experts, like our friend Connie whom you’ll meet in a second, become the contractual source of truth. This creates a pretty obvious and serious risk for an organization: when this single contracting SME leaves, what does an entire organization do?
Meet Connie, Our Contracting SME In Need Of Succession Planning
Let’s play this out: Imagine our contracting SME, Connie, has worked in Managed Care Contracting at a multi-hospital health system for thirty years. When she first started, it was a two-hospital system with one medical group and a single file cabinet of their contract documents. She led their contract digitization efforts and served as the point person for all things contracts over years of acquisitions. If anyone has a question about a contract, Connie knows the answer, making their reliance on her stronger every year.
Connie has recently started thinking about the future. It may be many years off, but she’s already looking forward to retirement and even considering finally dusting off that tuba in the garage. As Connie considers retirement, she asks herself: who would fill my shoes? She starts to think through all the complex data and processes that only she knows with certainty. What would it take for her to document her method and expertise, one that’s been honed and specialized over several decades at this health system? Connie realizes she has a problem and some decisions to make. Should she quickly identify a capable colleague and start training them? How long would it take her to transition her work? Where to begin? For anyone in Connie’s position, the answer is a complicated combination of attempting to transition work but likely, not doing it effectively. With proper succession planning, Connie could easily begin planning for retirement while keeping existing projects rolling. It all starts with the right contracting software.
What if the paper trail of contract documents became a digital oasis?
Connie did the foundational work to enable this oasis decades ago when she digitized thousands of paper documents. However, this “digital filing cabinet” is not the ideal outcome since it introduced a host of new challenges. Connie’s organization has defined a folder structure and file naming conventions. Unfortunately, not everyone follows her guidelines making folder and file names inconsistent. They’ve also changed over the years as they’ve expanded into new product lines and acquired additional facilities, resulting in stale and outdated names. Connie has managed to master this web of folders and files, but others aren’t able or willing to do so. Others couldn’t even if they tried.
The first step in planning for SME Success is to digitally organize these documents. Managed care contracts aren't sorted simply by alphabetizing them—they are complex, making them suitable for converting into metadata. Digitized and metadata organized, anyone within the organization could filter by payer name, document type, and effective date and immediately see the relevant file. What used to require opening seven scattered contract documents or filtering three columns across three different Excel files now occurs in one place in a matter of seconds. This centralized database eliminates dependence on detailed folder and file naming conventions and disparate, often conflicting contract data reports. Your contracting SME and the entire organization are free to take some well-deserved time off and your contracts remain secure.
But we’re not done! This has solved our immediate problems, but what about condensing work across email, shared drives, project management systems, and other software?
What if everything wasn’t everywhere all at once?
Connie’s attention is split across many systems and activities as she works via email to conduct negotiations with payers, responds to messages from teammates, manages reminders in her calendar, digs through folders to read specific documents, and filters columns across Excel files. She uses at least a dozen different tools throughout the day and most aren’t integrated. She’s sometimes encoding the same information in many different places. It’s exhausting and frustrating, and she knows there must be a better way to organize and manage all of this information.
In an ideal world, contract documents and their underlying data would live in one place—a one-stop shop for Connie to conduct all her key daily activities and for anyone else in the organization to step in and do their part without her immediate involvement. Contracting SMEs would be empowered to structure this information to meet their needs and those of the broader organization. With an organized ecosystem, our SME can translate the nuances and complexities of every contract, eliminating duplicative data entry and the frustration that comes with it. Connie could harness her deep understanding of their contractual arrangements and start generating new insights; identifying areas of improvement or standardization.
Now, the organization in question is bulletproof. No longer dependent on a single person, suddenly innovation and scaling become available. Succession planning efforts compound across the organization making anything from acquisition to major leadership change seamless thanks to an indisruptable contracting ecosystem. But have we covered every angle? Can we leave poor Connie to her work-life balance and right to contemplate retirement? Almost!
What if access to contract data was buffet-style?
Connie has and never will be a fan of buffets, but she does dream of “all-you-can-eat” style reporting across her organization. If each contract were a plate of food and the ingredients contract data elements, Connie currently acts as server and chef, accepting countless requests for contract data, cooking up custom reports, and delivering them back to her “customer.” She doesn’t maintain a menu and her customers aren’t shy about asking for substitutions so there’s always a long wait for a meal. By eliminating the restaurant-style process of requests and instead empowering her colleagues to self-serve reports from the “buffet” of data available, she can free up her time to structure and maintain the “buffet” of data while her colleagues get instant reporting. Every member of the organization may not have access to everything, but they have what they need and can quickly and easily generate effective reports whether they’ve been at the organization for a day or a decade.
With everyone at the organization referring to a shared source of truth, Connie can feel confident that the right information is being disseminated and shared. She can focus on keeping contract information accurate, fresh, and accessible to her organization. She cemented her legacy as the contracting SME who made contracting organized and accessible to her entire, multi-hospital health system. Succession planning has concluded, leaving the organization risk-free and humming along. Shouts of “Our hero!”, “Our queen!”, and “Where would we be without you!?” ring throughout the office. Connie’s final years at the organization are spent identifying discrepancies and introducing standard, favorable terms in even the most problematic contractual relationships. Connie has transformed static and laborious document storage into dynamic, forward-thinking contract data management. Her retirement party is a true celebration of her contributions: establishing and evangelizing a contract management mecca that could support her colleagues in the many years to come. Thanks, Connie.
Free The SME
The key to creating this happily ever after at your organization is to free your organization’s contracting SME from the tower in which they are locked. Although contracts can feel low-tech and unsophisticated, they are a highly strategic asset that must be understood and appreciated before they can be optimized. You never know when your SME will be ready to switch careers, have a family emergency, call it quits, or sail off into retirement. You must focus on succession planning early and ensure your contracting SME is given the support they need to define and construct a lasting system. Invest in resources and technology to make sure your Connie gets their flowers in a sendoff fit for a Contract King or Queen!