Direct Contracting Support

Benefit from specialized expertise to develop and implement direct contracting strategies for better outcomes and lower total costs. Our comprehensive approach addresses all aspects of direct contracting, from assessing your unique needs to selecting partners and negotiating terms.

Service Details:

• Comprehensive Assessment and Strategy Development:
  • Evaluate employee and employer priorities and goals.
  • Assess quality and value of potential regional partners using public data.
  • Select key metrics for quality, access, experience and cost performance, including payment rates and methods.
  • Review data availability, existing contract terms and identify necessary implementation partners (e.g., independent TPAs, data vendors, actuaries).
  • Consider regional regulatory requirements and necessary benefit incentive changes.

• Partner Selection and Contracting Process:
  • Determine suitable payment models and rates.
  • Draft contract standards and terms based on best practices among leading employers and purchasers.
  • Conduct RFPs, data analyses and qualitative assessments to select optimal provider partners.
  • Offer contract review and negotiation support.

• Implementation and Performance Monitoring:
  • Develop an internal and employee communication plan.
  • Establish a system for performance monitoring and transparent reporting.
  • Conduct ongoing meetings with providers to monitor performance and adapt arrangements as needed.