Cutting out the Middlemen by Direct Contracting

 

Health insurance costs continue to rise and increase in complexity. As a result, non-traditional solutions are catching attention. One such solution is direct contracting. Direct contracting can help to reduce costs while also improving the quality of care. Employers typically save between 10% and 20% in comparison to more traditional health plans.

Direct contracting is an option that matches self-funded businesses with integrated health systems and/or providers. It allows the employer and the provider to work together, effectively cutting out the “middle man.”

Benefits include

  • transparent pricing structures,
  • improved relationships between employer and employees,
  • better alignment between community members and providers,
  • objectives for patient satisfaction, and
  • improved access to care, alleviating many significant barriers.

There are various types of contracts available. These include a fee for service, service level agreements, and risk-based, which uses a form of global payment.

Direct contracting can be challenging to set up and requires a third-party administrator (TPA) to do so. Here at ECCHIC, we are experts at working with employers and providers to set up, support, and administer a direct deal.

Factors to consider:

  • Employer size and location.
  • Providers who are willing to direct contracts.
  • Employers willing to utilize direct contracts.
  • Eligibility.
  • Claims processing.
  • Customer Service.
  • Payments to providers.

A plan will fail if it does not truly benefit all parties involved. At ECCHIC, we have a deep understanding of what employers, employees, and providers expect with a direct contract plan. Each and every day, we prove our value through our attempts to find effective, executive solutions to the rising cost of medical benefits. Cutting out middlemen has proven to be an effective tool.

Contact us today to see if direct contracting is right for you!