How direct-to-employer contracting can benefit primary care physicians in private practice

Medical Economics August 30, 2023
Troy Williams, Anisha Sood

When done correctly, doctors become the ‘quarterback’ leading a patient care team.

Amid discussions of different health care payment models over the years, various references to “direct-to-employer” health care or “direct contracting” may leave some confused.

The most common form of direct-to-employer contracting is a relationship that simply replaces an insurance carrier with an independent administrator to process claims. The independent administrator handles business processes after a fee schedule is negotiated between an employer plan sponsor and a health system, or network of health care providers.

Direct contracting may also exist in centers of excellence such as ambulatory surgery centers, or through direct primary care or concierge medicine. Some of these models are insurance-related models and some are cash pay...

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