Given the myriad revenue and cost pressures faced by today's organizational providers, it behooves healthcare financial managers to identify opportunities to improve the terms of their managed care agreements when renewal time is near. Selection of a contract renegotiation strategy should be preceded by a focused analysis of situational variables and followed by conscientious performance monitoring. Through careful consideration of the compatibility to their goals, core values, and operational capabilities, healthcare providers and managed care organizations can craft agreements with the potential for sustaining meaningful long-term partnerships.