When assessing your managed care relationships, look not only at reimbursement, but the so-called "red tape" issues as well. Ask your staff this question for each of your payers: "What would you like to have changed with regard to this payer that in turn would make your life easier each day working with that payer."
For example, simplifying paperwork, making authorizations easier to obtain, and removing charge bundling are just a few of these issues. I am sure your staff can think of many more.
When negotiating or renegotiating managed care relationships, medical practices obviously have a tendency to zero in on getting better reimbursement. While this should be the main objective of any negotiation, don't forget to negotiate the "red tape" issues that can help your practice become more efficient and effective when dealing with managed care plans and their enrollees.
While payers don't like to give up more money, they do have a tendency to work with you on the "red tape" issues.