It may be that the party you are negotiating with is vulnerable, Dr. Baraf said. “What’s happening to their market share? Did they used to be 20% of your business and now they’re only 10% of your business? Are there enough rheumatologists in their network?”
Withdrawing from a contract should be considered if it’s a bad enough contract, he said. “If you’ve got a really terrible contract you should just simply get out of it,” he said. “The threat of withdrawal or a credible threat to withdraw is a very powerful negotiating tool.” But the primary purpose of withdrawal from a contract is not to get a better deal, it’s to get out of a bad contract.
He said withdrawing might prompt a company to come back to you, and if they do, you should have a good idea what you want from them, he said.
He also said it’s important to remember that in a negotiation with an insurer, their representative is a person; it helps to understand their motivations—and the limitations in their authority—and to befriend that person so that you have an ally when they go to their superiors.
He said that rheumatologists might be in demand, but it doesn’t matter much if rheumatologists don’t demand more fair treatment. “The law of supply and demand only works if it’s enforced,” he said.
Thomas Collins is a freelance medical journalist based in Florida.
