HD570 Unit 9 Partnership Negotiation Plan Example

Learning of Births in Days, Not Five Weeks: A Unit 9 Partnership Negotiation Plan With a Composite Hospital

[Student Name]

Purdue University Global

HD570: Health Education Leadership and Management

Unit 9 Partnership Negotiation Plan

[Instructor Name]

[Date]

Ashcombe Health Plan, Corliss Regional Medical Center and all figures are composite; the negotiation, privacy and postpartum sources cited are real.

The Problem

The postpartum measure gives credit only for a visit made in a set window, roughly the second through twelfth week after birth. Ashcombe usually learns of a birth when the hospital's claim arrives, about 35 days later. Outreach then has about seven weeks left, and many mothers have already missed the early weeks when support matters most (Tully et al., 2017). A daily notice from Corliss, listing plan members who delivered the day before, would let outreach start in the first week.

Our Interests

Earlier knowledge of births, for the postpartum measure. A simple, secure file, not a complex integration. A relationship with Corliss that could extend to other notices later.

Corliss's Likely Interests

From conversations with Corliss's case management director and the hospital's public statements, Corliss is likely to care about: protecting patient privacy and avoiding legal risk; limiting work for its information technology team, which has a long queue; its own postpartum readmission rate, which affects its standing with payers; and being seen as a good partner by the plan that covers a large share of its births.

Negotiation guidance stresses focusing on interests rather than positions (Fisher et al., 2011). Corliss's position may be "we cannot share patient data." Its interest is avoiding risk and work.

Options That Serve Both

Privacy. Federal privacy rules allow disclosures between covered entities for certain treatment, payment and operations purposes, care coordination for patients they share among them (Uses and Disclosures to Carry Out Treatment, Payment, or Health Care Operations, 2024). The plan will offer a data use agreement drafted by its counsel, limited to member name, identifier, delivery date and discharge date.

Work. The plan will accept a daily file in any format Corliss already produces, such as an extract of its admission and discharge feed, delivered to a secure server. No custom build.

Benefit to Corliss. The plan will share back, monthly, which of Corliss's delivering members completed a postpartum visit, data the hospital cannot easily get. Health educators will also call members flagged by Corliss's case managers as high risk within 48 hours of discharge, which could help the hospital's readmission rate.

The request is easier to grant if the hospital can see what it gains, so the plan arrives offering monthly visit data and fast follow-up calls rather than asking only for a file.

Our Alternatives

If Corliss declines, the plan's best alternative is to use pharmacy and lab claims, which arrive faster than hospital claims, to identify some births earlier. This would cut the delay to about three weeks for some members. Knowing this alternative sets the limit of what the plan should give up to get the agreement.

Walk-Away Point

The plan will not accept a notice delayed by more than seven days, since that would add little to the pharmacy alternative. It will not pay for a custom build above $10,000. It will not agree to share member data with Corliss beyond what is needed for the monthly report.

Preparing the Team

Before the first meeting, the team will hold a one-hour rehearsal. The privacy officer will play Corliss's privacy officer and raise the strongest objections. The analyst will prepare a one-page summary of how many Corliss deliveries are plan members each month, about 147, and how many of those currently miss the postpartum window. The manager will practice the opening and the responses until they can be said without notes.

Measuring Success

If an agreement is reached, the plan will track, each month, the share of Corliss deliveries received within two days, the median days from delivery to first outreach contact and the postpartum visit rate among Corliss deliveries compared with other hospitals.

Who Negotiates

The health education manager leads, with the plan's privacy officer and a quality improvement analyst. Corliss's case management director is the likely counterpart, with its privacy officer and an information technology lead.

Opening and Responses

Opening: "We'd like to find a way to learn of our members' births within days, so our health educators can help them get postpartum visits. We know your IT team is stretched, so we're asking for something you may already produce, and we'd like to share our visit data back to you."

If Corliss raises privacy: offer the draft agreement and invite its counsel to review it. If Corliss raises IT capacity: ask what files already exist and accept the simplest. If Corliss asks for payment: explore a small pilot payment within the walk-away limit.

Timeline

First meeting in September, with a follow-up meeting two weeks later to answer questions raised in the first. Data use agreement drafted by October. Pilot file for one month in December. Full start in January, reviewed after three months.

References

Fisher, R., Ury, W., & Patton, B. (2011). Getting to yes: Negotiating agreement without giving in (3rd ed.). Penguin Books.

Tully, K. P., Stuebe, A. M., & Verbiest, S. B. (2017). The fourth trimester: A critical transition period with unmet maternal health needs. American Journal of Obstetrics and Gynecology, 217(1), 37-41. https://doi.org/10.1016/j.ajog.2017.03.032

Uses and Disclosures to Carry Out Treatment, Payment, or Health Care Operations, 45 C.F.R. § 164.506 (2024). https://www.ecfr.gov/current/title-45/subtitle-A/subchapter-C/part-164/subpart-E/section-164.506