Celeste inherited a Joint Operating Committee that met twice a year, whenever both sides could find a shared hour, with no standing agenda and whoever happened to be free from each side sitting in. A claims processing issue had been quietly compounding for four months by the time it finally made it onto a JOC agenda, because there simply hadn't been a forum to raise it sooner. By the time the two sides addressed it, the backlog had grown large enough that fixing it took a formal escalation instead of the routine conversation it should have been.
The JOC existed on paper. It just wasn't doing the job a JOC is supposed to do.
Why the meeting exists and why it quietly stops working
A Joint Operating Committee is built to be a working session, not a checkbox, a standing forum where the operational and relational complexity of a contract gets managed in real time instead of piling up until it becomes a crisis. When it's running well, it's where credentialing issues, care management questions, and claims problems get resolved months before they'd otherwise surface in a formal dispute.
The external problem is that JOCs are easy to schedule and easy to let drift, since nothing forces the structure to stay sharp once the initial contract excitement fades. But the internal problem is what actually causes the drift. It's treating the meeting as a formality that happened rather than a working session that produced something, the way Celeste's predecessor did. A JOC without a standing cadence, real leadership in the room, and a tracking system for what gets decided isn't managing the relationship. It's just occupying a slot on a calendar.
I've led these meetings for decades, and the difference between a JOC that prevents problems and one that just documents them always comes down to the same handful of structural choices.
Seven (7) practices that make a JOC actually work
Set a real cadence and hold it. Quarterly is the floor, not the target, and consistent timing is what keeps rapport and operational awareness current instead of stale.
Get real leadership in the room, from both sides. Executive presence turns a status update into a decision-making session, because issues that need authority to resolve actually get resolved instead of tabled for someone else to escalate later.
Work toward genuine goal alignment. Payer and provider incentives don't naturally point the same direction, and naming that directly is what turns a JOC from two sides trading complaints into a shared effort at solving them.
Circulate a detailed agenda well before the meeting, with clear objectives, discussion points, and what each side needs to prepare. A JOC without an agenda turns into whichever issue is loudest that quarter instead of the issues that actually matter most.
Keep communication open between meetings, not just during them. Monthly executive check-ins build the kind of trust that makes the quarterly JOC itself more productive, since neither side is walking in cold.
Track every action item with a real follow-up system. Documenting a decision isn't the same as resolving it, and accountability only exists if progress actually gets monitored between sessions.
And keep compliance in view throughout. Every discussion and decision needs to hold up against legal and regulatory standards, with counsel or a compliance officer looped in whenever a decision touches that line.
What changes when the JOC actually functions
Skip this structure, and problems compound quietly for months at a time, the way Celeste's claims backlog did, surfacing only once they're big enough to force a formal escalation instead of a routine fix.
Celeste rebuilt the JOC around all seven practices over the following two quarters. Executive leadership from both sides started attending consistently, a standing agenda went out two weeks ahead of every meeting, and a shared tracker kept every action item visible between sessions. The next claims issue that came up got flagged in a monthly check-in and resolved before it ever needed to appear on a formal agenda at all.
Pull your organization's current JOC cadence, agenda practice, and leadership attendance, and compare it against these seven items. Fix whichever one is weakest before your next scheduled meeting.
A JOC that's running well rarely makes headlines inside your own organization, because it's quietly solving problems before they become the kind of thing anyone needs to escalate.
Call to Action: If your JOC structure has changed how quickly your organization resolves issues with a payer, tell me what worked in the comments. I'll reply to every one.
Send this to whoever runs your organization's JOC meetings before the next one gets scheduled.
About the Author: Kevin W. Barron, MBA, FHFMA, FACHE is a nationally recognized healthcare contracting and payer relations executive with over 30 years of experience in healthcare finance. He is an author, speaker, and mentor to emerging leaders in healthcare finance. Follow Kevin on LinkedIn or subscribe to his weekly newsletter at https://www.KevinWatsonBarron.com
Disclaimer: This article is provided for general informational and educational purposes only. It reflects my personal views and observations based on professional experience in healthcare finance, managed care, payer relations, and revenue cycle operations. It should not be interpreted as legal, financial, regulatory, actuarial, or reimbursement advice. The content is not intended to represent the official position of my employer, any payer, provider, professional association, or other organization with which I may be affiliated. Readers should consult their own legal, financial, compliance, actuarial, or operational advisors before making decisions based on the issues discussed. Any references to payers, providers, regulations, market trends, or reimbursement practices are intended for discussion and education only and should not be construed as a statement about any specific contract, negotiation, patient matter, or confidential business arrangement.