51H - Direct Contracting: How and Why Health Systems Can Build Successful Employer Partnerships

Tuesday, March 21

2:00–3:00 p.m.

With healthcare costs rising every year, an increasing number of employers are looking to establish direct contracting relationships with health systems to lower their healthcare spending and get more value for their healthcare dollars. In fact, nearly a quarter of all employer healthcare purchasers are considering contracting directly with integrated health systems, according to the Business Group on Health. This session will discuss the benefits of developing a direct contracting program and best practices for how to establish and execute a competitive direct-to-employer offering.

Northwell Direct is the new direct contracting option from Northwell Health. By removing the health insurance carrier from the healthcare equation, Northwell Direct can deliver high-value health benefits to area employers at rates that are 20% lower than best-in-market rates. Brighton Health Plan Solutions, which has deep experience working with both health systems and employers on direct contracting arrangements, supported Northwell in establishing its direct contracting program and is now serving as a preferred third-party administrator partner for participating employers.

Presenters will outline the operational and financial benefits of direct contracting arrangements, including the impact of dedicated patient volumes and how these structures better enable health systems to deliver on quality metrics to earn performance-based reimbursement. They will share their first year of results showing improvements in care coordination and patient experience. In addition, they will walk through the business and administrative processes required to establish and run these contracts, giving participants a roadmap of next steps for embarking on their own successful direct contracting strategies.

Learning Objectives

• Explain how well-designed direct contracting arrangements deliver greater value to health systems and employer groups.
• Describe the administrative prerequisites and steps health systems must take when establishing direct contracting arrangements, as well as potential pitfalls to avoid.