How to Write a Joint Operating Committee Charter for a Direct Contract

Most direct contracts promise a “joint operating committee.”

Fewer define what that actually means.

Without a clear charter, JOC meetings turn into status updates, not decision forums. Problems linger, pet projects dominate, and no one is quite sure what “good” looks like.

A short, concrete charter fixes most of that.

Who should be in the room

Aim for a small, cross-functional group from each side:

From the employer:

• Benefits or total rewards lead
• Finance representative
• Operations or HRBP for key markets

From the provider or platform:

• Contract owner / network lead
• Clinical representative
• Operations lead (access, scheduling, revenue cycle)

Optional: navigation vendor, TPA rep, or analytics support as needed.

Keep it to 6–10 people. Bigger groups talk more and decide less.

How often you should meet

For a new program:

• Monthly during the first 6–12 months
• Quarterly once things are stable

You can always call ad-hoc sessions for specific issues, but a predictable cadence keeps the program moving.

What the JOC is for

Spell this out in the charter:

• Reviewing performance against financial and experience goals
• Identifying and resolving operational issues
• Approving modest scope changes and pilots within the existing framework
• Preparing joint communication back to executives and boards

Equally important: what the JOC is not for.

• Renegotiating base rates every quarter
• Micromanaging individual cases
• Serving as a vendor sales call

The core agenda

Most good JOC meetings follow a simple pattern:

1. Metrics review (15–20 minutes)

   • Steerage
   • Unit cost vs. baseline
   • Total savings
   • Member experience
   • Operational incidents

2. Issue log (20–30 minutes)

   • New issues since last meeting
   • Status of prior items
   • Owners and timelines

3. Opportunities and decisions (15–20 minutes)

   • Small scope changes or process improvements
   • Early discussion of potential expansions

4. External communication (5–10 minutes)

   • Key messages to internal leadership
   • Any joint messaging to members or clinicians

Write this agenda into the charter so meetings do not devolve into anecdotes.

Decision rights and escalation

Ambiguity here is where programs stall.

Define:

• What the JOC can decide on its own (e.g., minor benefit tweaks, operational fixes, narrow expansions).
• What requires executive escalation (e.g., major pricing changes, adding entirely new service lines).
• How disagreements will be handled—tie-breakers, arbitration paths, or executive sponsors.

If you do not make this explicit, every hard decision becomes a political test case.

Documentation and follow-through

Finally, decide how you will:

• Capture minutes and decisions.
• Maintain a shared issue log.
• Track action items with owners and due dates.

This does not need to be a fancy system—a shared spreadsheet or simple project board is enough.

What matters is that both sides can see the same list and agree on what was decided.

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Direct contracts do not run themselves once the ink is dry.

A well-written joint operating committee charter turns “we’ll meet regularly” into a structure that can actually manage the work.