Despite provider assumptions that managed care contracts will yield incremental increases in patient volume, there are no guarantees that volume increases will be realized. Providers can improve the likelihood that incremental volume increases will be achieved, however, by including certain provisions in managed care contracts related to volume-based discounts, limitations on network size and composition, access to physicians, provider directory listings, patient financial incentives, service scope/carve-outs, and participation in all service products offered by the managed care organization. Negotiating such provisions may be difficult, but providers and managed care organizations that reach agreement on these provisions gain mutual understanding and frequently can form more successful relationships.