How to Brief Your Board on Direct Contracting in 10 Slides

Boards do not need another benefits webinar.

They need a clean capital story: what problem you are solving, how direct contracting changes the economics, and what downside protection exists if it does not go perfectly.

If you treat direct contracting as a trend you are chasing, the board will stall you. If you treat it as a defined capital decision, the conversation gets much easier.

This is a simple 10-slide structure that gets most boards to a real decision.

Slide 1: The problem in your own numbers

Start with your claims, not with national trend slides.

Show a single view of the last 3–5 years:

• Total allowed amount by year
• PEPM trend versus revenue or EBITDA
• 3–5 cost drivers (service lines, markets, or facilities) that explain most of the increase

The goal is not to impress anyone with analytics. The goal is to make it obvious that you already own the downside risk and that the current trajectory is incompatible with the board’s financial targets.

Slide 2: What you have already tried

Most boards assume “we’ve done everything we can” when it comes to healthcare cost.

Make that explicit:

• Carrier changes and network moves
• Plan design changes (deductibles, coinsurance, HSAs)
• Care management, navigation, and point solutions

Then show, on one chart, how much each lever actually bent the trend.

If the answer is “not much,” say it plainly. This is the setup for why a different contract structure is on the table at all.

Slide 3: What direct contracting actually is

In one slide, in your words:

“Direct contracting means we contract directly with specific providers for defined services, with clearer pricing, faster payment, and stronger steerage, while keeping our stop-loss in place.”

Anchor the model:

• You are not building a full replacement network on day one.
• You are not taking new clinical risk beyond what you already carry as a self-funded plan.
• You are changing how a narrow slice of claims is priced and steered.

Avoid vendor logos. Focus on the relationship between employer, provider, and members.

Slide 4: Where it would apply in your plan

Pick one or two concrete areas where a direct contract would live:

• Joint replacement episodes with a regional health system
• Imaging in a specific metro where your current rates are clearly above market
• A narrow set of surgeries routed through a center-of-excellence program

Show:

• Current annual spend for that slice
• Current unit cost variance versus a benchmark (Medicare, internal best-in-class, or a public reference)

You are making the pilot feel bounded and real, not theoretical.

Slide 5: Before / after economics

This is the heart of the briefing.

Lay out a simple table:

• Current average allowed per case
• Proposed direct contract rate per case (or index to Medicare)
• Expected steerage range (e.g., 40–70% of eligible cases)
• Modeled savings at low / base / high steerage

Then add the cost to run the model: navigation fees, incentives, or platform charges.

If you cannot show that the economics are materially different, you are not ready for the board yet.

Slide 6: Guardrails and downside protection

Boards worry about blowback more than basis points.

Address that head-on:

• Stop-loss: Confirm that current stop-loss coverage remains in force.
• Member choice: Clarify that members retain access to the legacy PPO for exceptions.
• Clinical quality: Note any quality thresholds or outcomes guarantees in the contract.
• Exit ramp: Show the specific clause that lets you unwind after the pilot window.

The message: you are running a bounded experiment, not gambling with the entire plan.

Slide 7: Operational plan and ownership

Show who is actually going to run this:

• Internal owner (benefits + finance)
• Navigation or TPA partners
• Provider counterpart (contracting + operations)

Outline the major milestones:

1. Contract finalization
2. Member communications
3. Go-live
4. 30 / 60 / 90-day reviews

Boards want to know that someone is on point and that the work does not disappear after approval.

Slide 8: Member experience

Most board questions come from lived experience with bad network changes.

Make the member upside explicit:

• Lower or waived cost sharing for using the direct pathway
• Simpler scheduling and fewer surprise bills
• Clear communications and one phone number for questions

You are not just tightening a network. You are trading some provider optionality for better economics and a clearer member experience.

Slide 9: Success metrics and thresholds

Define in advance how you will decide whether to expand, renew, or exit.

At minimum:

• Steerage percentage
• Savings versus baseline
• Member experience scores
• Operational issues (escalations, appeals)

Give the board a simple rubric:

• Green: Expand and renew
• Yellow: Adjust scope or partner
• Red: Unwind and capture lessons learned

Slide 10: The ask

End with a single, concrete ask:

“Approve a 90-day pilot for [service line] with [partner], with an expected savings range of X–Y% on $Z in annual spend, under the guardrails described above.”

You are not asking the board to sign off on a vague “innovation initiative.”

You are asking them to approve a bounded, reversible test of a contract structure that better matches the risk you already carry.

When you treat direct contracting as a capital decision instead of a trend, the board conversation starts to look like the rest of the business—not an exception to it.