Which situation would likely trigger the need to reassess contract volumes?

The identification of significant underperformance in expected service delivery serves as a critical trigger for reassessing contract volumes. When a healthcare provider or physician practice is not meeting the service delivery metrics that were anticipated in the contract, it becomes essential to evaluate the existing agreements to determine if adjustments are necessary.

This could involve examining the reasons for underperformance, which may include factors such as resource allocation, staffing issues, changes in patient demographics, or shifts in healthcare needs. By reassessing contract volumes in light of these performance issues, the practice can realign its services to better meet patient needs and ensure compliance with contractual obligations. Such a reassessment can lead to renegotiations, adjustments in service delivery expectations, or changes in how services are billed and compensated.

Reassessing contract volumes helps to address the gap between expected and actual performance, fostering an environment where the provider can meet contractual obligations and improve overall service delivery. This proactive approach is vital for maintaining effective relationships with payers and ensuring sustainable practice operations.