Direct Contracting for High-Value Care
The Challenge
The organization’s workforce was being treated by a single dominant health system that dictated pricing and terms. This lack of competition was driving costs higher while quality metrics remained stagnant, leaving the company with few options for cost containment.
The IMPACT
The rising cost of care was making it difficult to maintain competitive wages for the workforce. Leadership felt they were subsidizing the health system’s expansion rather than receiving the best value for their healthcare investment.
The Strategy
JA negotiated a direct contract with an alternative high-performing provider group, bypassing the traditional network entirely. This arrangement established fixed, transparent pricing for common procedures and included a direct referral path for employees.
THE OUtcome
The direct contract provided the company with immediate cost relief and improved the quality of care for the employees. By taking a proactive stance on provider relationships, the organization gained a level of control over their health spend that was previously impossible.
Things Employers Should Consider
Direct contracting is the ultimate expression of an employer’s power in the healthcare market. It requires a partner with the expertise to navigate complex provider negotiations and build a custom network that serves your specific needs. Employers who embrace this model find that they can achieve significantly better outcomes by working directly with those who provide the care.