Intelligence
Reverse-chronological coverage of deals, platform launches, benefit design shifts, and the operating mechanics behind direct contracting.
The first direct contract you sign matters more than the fifth. Here’s a simple way to pick a market and service line where the politics, economics, and operations are most likely to work.
Read the analysisDirect contracting changes the claim pattern, not the fact that you’re self-funded. Here’s how to keep your stop-loss underwriter comfortable while you experiment with new contract structures.
Read the analysisMost self-funded employers underestimate how much their TPA can help—or hurt—a direct contracting strategy. This is how to align roles, incentives, and operations before the first claim hits.
Read the analysisMost boards have never heard a clean, CFO-grade explanation of direct contracting. This is the slide order that gets you through the conversation without hand-waving or vendor jargon.
Read the analysisIf you cannot see steerage, unit cost, leakage, and experience in year one, you are flying a direct contract without instruments.
Read the analysisDirect contracting does not replace TPAs; it changes what 'good' looks like for administration, data, and member experience.
Read the analysisDirect contracts save nothing if members do not use them. This is how employers build steerage that feels like an upgrade instead of a restriction.
Read the analysisDirect contracting is easier in some markets than others. These are the signals that your employer population and provider landscape are ready.
Read the analysisFor many providers, predictable cash flow is as valuable as a higher rate. Employers who understand that can trade timing for price.
Read the analysisMost failed direct contracts do not blow up on pricing; they erode quietly through weak steerage, vague data rights, and misaligned partners.
Read the analysisCFOs don’t buy innovation decks. They buy clear baselines, contract deltas, and reversible tests of capital discipline.
Read the analysisA 90-day pilot is the only credible way for most self-insured employers to test direct contracting economics, steerage, and operations without gambling the whole benefit design.
Read the analysisMost employer teams scan direct contracts for the legal boilerplate and skip the few clauses that actually drive cost. This is how to read the document like a CFO instead of a benefits brochure.
Read the analysisThe ingredients have finally lined up: rising employer costs, more self-funded exposure, public contract infrastructure, and a market that is increasingly tired of paying carriers to sit between the buyer and the provider.
Read the analysisDirect contracting gives self-insured employers a way to negotiate rates, care pathways, and accountability directly with providers instead of outsourcing every pricing decision to an insurer.
Read the analysisA direct contract can lower cost and improve control, but only if the economics, steerage, and operating model are real. These are the five questions finance leaders should ask first.
Read the analysisThe direct contracting market still runs on scattered announcements and case studies. Here are the public deals and platforms that actually matter right now.
Read the analysisCost Plus Wellness is doing something the employer market rarely sees: publishing contract structure openly enough for buyers to compare how direct arrangements are actually being built.
Read the analysisNot every direct contract works. The difference between a useful failure and a political disaster is how you handle the post-mortem.
Read the analysisYear-one results make or break the internal story for direct contracting. Here’s how to calculate ROI in a way your CFO will trust.
Read the analysisCOE programs and direct contracts are often run as separate projects. Done well, they’re two sides of the same steerage strategy.
Read the analysisDirect contracting often ignores pharmacy until a specialty claim blows up the math. PBM strategy and medical direct contracts have to talk to each other.
Read the analysisYou don’t have to ‘go all in’ on direct contracting to get value. Targeting high-cost outliers can be a quieter, more practical first move.
Read the analysisDone badly, direct contracting sounds like a network cut. Done well, it feels like a new benefit path that happens to save money.
Read the analysisThe joint operating committee is where direct contracts either get managed or slowly drift. A clear charter keeps both sides honest.
Read the analysisMost providers say they want value-based contracts until the downside clauses show up. Here’s how to structure risk so both sides can live with it.
Read the analysis‘Bundle’ and ‘case rate’ get used interchangeably in direct contracting conversations. They’re not the same, and the differences matter for risk, reporting, and provider behavior.
Read the analysisIf every direct contracting platform pitch sounds the same, it’s because the questions are too generic. Here’s an RFP checklist that separates infrastructure from marketing.
Read the analysisYou don’t need a 20-person center of excellence to run a serious direct contracting program. You do need clear roles and a realistic view of the work.
Read the analysisMost direct contracting dashboards are noise. Here are the few metrics that actually tell you whether a program is working and what to do next.
Read the analysisWalking into a direct contract negotiation without your own claims view is like buying a building without looking at the rent roll. Here’s the minimum analysis to do first.
Read the analysisMost direct contracting programs underpay the incentive side of steerage. Here’s what it takes to make the preferred pathway feel like a genuine upgrade to members.
Read the analysisReference pricing and direct contracting aren’t competing ideas. A tight reference price can be the backbone of a simple, durable direct contract.
Read the analysisA direct contract in a one-system town behaves very differently from one in a fragmented metro. The same playbook doesn’t work for both.
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