Direct contract intelligence
Direct contracting is how employers are taking back control of healthcare costs. We track every deal, explain every concept, and publish the data that makes it possible.
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Every Friday, the deals that got signed, the contracts that got published, and what it means for employers cutting out the middleman.
Latest intelligence
Multi-year direct contracting agreements can lock in savings and stability—but the wrong provisions turn long-term deals into expensive traps. Here's what belongs in fixed terms, what needs escape valves, and how to structure flexibility without giving up leverage.
Read the analysisMost value-based care arrangements fail because the incentive math is wrong or the metrics are unmeasurable. Here's how self-insured employers structure outcomes-based payments inside direct contracts that hold providers accountable and deliver real savings.
Read the analysisSelf-insured employers pursuing direct contracts with health systems carry ERISA fiduciary obligations that most never formally address. Here's what those obligations actually require and where employers routinely fall short.
Read the analysisWhat is direct contracting?
In plain English, direct contracting means a self-insured employer negotiates rates and care pathways directly with a health system, physician group, surgery center, or platform instead of outsourcing every pricing decision to an insurance carrier. The employer gets cleaner economics, the provider gets a clearer reimbursement arrangement, and employees get a narrower but more intentional network. The upside is lower unit cost, faster payment, and stronger steerage. The tradeoff is that someone has to actually manage the contract, the navigation, and the quality controls.
Learn more →The Direct Contract Tracker
The public market still treats most direct contracts like anecdotes. We’re building a living database instead, with deal terms, employer context, and what the arrangement actually changes.
Seed deals live at launch
Largest member base in tracker
Best public PMPM reduction cited
Participating self-insured employers via Ascension Employer Network · Indiana
Ascension's employer network serves more than 4,400 employees and roughly 9,000 members through a discounted employer-facing network built around Ascension St. Vincent facilities, employed physicians, and selected contracted providers.
Participating employers in the Ascension cardiovascular care program · Indiana
Ascension carved out a heart care program for employer plans, covering cardiologists, diagnostic testing, and inpatient and outpatient services at the Heart Center of Indiana under a defined Medicare-based pricing structure.
Building Service 32BJ Health Fund · New York, NY
A large union health fund partnered directly with Northwell to steer members into a defined network with clearer rates, better navigation, and a stated goal of lowering total cost of care.
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