Direct to Employer Contracting Arrangements: A Response to Rising Premiums and Compromised Care

An increasing number of self-insured employers face rising premiums and real, or perceived, cutbacks in quality of care from their health insurance carriers. In response, providers are stepping into the breach and offering direct-to-employer (DTE) contracting for the delivery of healthcare services.Hospitals, health systems, and clinically integrated networks (CINs) of providers are offering the following services to employers through DTE arrangements.

  1. Narrow network health plans: A health system or a health system’s affiliated CIN offer their private-label health plan to employers and utilize their providers (through the CIN) as the provider network for the employer.
  2. Bundled services: One price for specific services or procedures with a virtual warranty of quality, i.e., any complications will be covered for a period post-procedure.
  3. Onsite clinics: Provider groups bring care to the job site.

Disruptive innovations in the delivery and contracting arenas of healthcare are rapidly being implemented as providers and those who pay for services attempt to meet the challenge of improving quality and lowering costs, i.e., enhancing value to the patients served.

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