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Difficult conversations

PIP, performance review, contract renegotiation, hard news. Walk in clear-headed with the script and the off-ramps.

briefing.pdf · Cedar Point Hospital · Contract renegotiation
Cascade Locums
Provider-first staffing
Cedar Point Hospital · Contract renegotiation
Meeting Prep · May 8, 2026 · 9:00 AM CT · 60 min · Confidential
$420K
Annual spend
11mo
Tenure
Yes
At risk
14d
Decision window

Account snapshot — what we know

  • Situation: Cedar Point CFO is pushing for an 8% bill-rate cut at renewal. They cite an MSP-benchmark report showing we're above market.
  • What's true: Our blended bill rate is 8% above their MSP's benchmark. Our fill rate is 94% vs their MSP's 71%.
  • What they don't see: Their travel-nurse spend dropped 18% the quarter we ramped — we're absorbing demand their MSP can't.
  • Champion temperature: VP Med Staff (Reyes) is on our side privately but won't push back on CFO publicly. He'll need air cover from CMO.
  • Risk if we walk: 11 months of clean placement data, 3 locum-to-perm pipeline candidates we'd lose, $420K ARR.
  • Risk if we capitulate: Sets a precedent for two other hospitals on the same MSP comparing notes. Margin compression in 60 days.

Cascade Locums product fit

  • Hold current bill rateDISCUSS

    Walk-away position is 'no cut.' Open to a 12-month rate hold + 3-month bridge if they pull the cut. This is the negotiation room.

  • ✓
    5% volume rebate at year-endIN SCOPE

    We can offer this. CFO sees a number that goes down on his report. Costs us less than a rate cut and is volume-conditional.

  • ✓
    Quarterly fill-rate SLAIN SCOPE

    We commit to ≥90% fill on EM reqs at current rates. Reyes wants this in writing — gives him cover to push back internally.

  • Exclusivity clauseOUT OF SCOPE

    They'll ask for it. Decline politely. Exclusivity caps our upside and hands them all the leverage.

Known objection & intel

'You're 8% above the MSP benchmark — that's not sustainable for us.'
CFO will lead with this. It's the only number on his report. We don't argue the number — we redirect to the numbers he isn't seeing.
Key counter-points when it comes up
  • •Fill rate beats benchmark by 23 points: 94% vs 71%. The MSP's cheaper rate doesn't help when half the shifts go uncovered.
  • •Travel-nurse spend dropped 18%: Quarter we ramped. We're absorbing demand their MSP misses; they're saving more than they're paying us extra.
  • •Time-to-credentialed: 11 days vs 26 days: MSP's median credentialing time is more than double ours. CFO's report doesn't price this — but Reyes does.

Meeting attendees — May 8, 2026

RC
Robert ChaseDECISION MAKERIN MEETING
Chief Financial Officer
rchase@cedarpoint.org
  • •Owns the rate-cut push. Driven by the MSP report; will quote it twice.
  • •Numbers-only. Don't get into clinical or relationship arguments — give him a different number.
  • •His real fear: explaining the MSP report to his board if he doesn't act on it. Help him write a different story.
TR
Dr. Tom ReyesCHAMPIONIN MEETING
VP, Medical Staff
treyes@cedarpoint.org
  • •Privately on our side. Will not push back on CFO publicly.
  • •Wants the SLA in writing — it's his cover to defend the rate hold.
  • •Pre-meeting: send him the fill-rate / travel-nurse data. He'll bring it up so we don't have to.
LP
Dr. Linda ParkKEY INFLUENCERNOT IN MEETING
Chief Medical Officer
  • •Skip-level. CFO will float the rate cut to her after this meeting.
  • •We don't talk to her directly. Reyes is our path to her.
  • •If we walk away cleanly, expect her to call within a week. Don't burn the bridge today.

Key questions to uncover — May 8, 2026

Cost-driver framing
  • •Help me understand which line item on the MSP report is driving this — is it our rate, or the total spend trend?
  • •When you compare our fill rate to the MSP's, how does the cost-per-filled-shift compare?
  • •Are you tracking the travel-nurse spend separately? It dropped 18% the quarter we ramped — that's our impact.
Value-proof asks
  • •Would a quarterly fill-rate SLA — say 90% — give you something to take back to the board?
  • •If we lock the rate for 12 months and add a 5% volume rebate at year-end, does that solve your benchmark optics?
  • •Reyes has the SLA draft. Can we walk through it with him before we close this conversation?
Walk-away triggers
  • •If they push past 5% rate cut without movement on volume rebate / SLA — pause, schedule follow-up.
  • •If they ask for exclusivity in exchange — decline politely; offer to revisit at next renewal.
  • •If CFO threatens 'we'll just go back to the MSP' — let it sit. Their travel-nurse spend will tell the story in 60 days.
Prepared by Cascade Locums · Confidential · May 8, 2026
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