Cost Plus Wellness Adds Six Direct Contracts — Including Legent Health Surgery Centers

Cost Plus Wellness has added another wave of public direct-to-employer healthcare contracts, including a potentially important expansion into ambulatory surgery centers.

Six contracts dated September 30 and October 1 are now visible in the Cost Plus Wellness library:

• Legent Health (C060) — ambulatory surgical centers in Texas and Florida; fee for service.
• DermFlo (C061) — telehealth / virtual-first practice in California and Texas; fee for service.
• ARK Physical Therapy (C067) — physical therapy in Texas; fee for service.
• Allison McDade (C068) — telehealth / virtual-first practice in California and Texas; fee for service.
• Anchor Restorative Medicine (C070) — primary care and women's health in Texas; fee for service.
• Ember Modern Medicine (C077) — family medicine in South Carolina; subscription.

The additions continue the expansion of a model that lets self-funded employers contract directly with providers using publicly available terms and pricing.

Legent is the one to watch

The most notable addition is Legent Health.

Cost Plus Wellness categorizes the agreement as an ambulatory surgical center contract covering Texas and Florida.

That matters because the economics of direct contracting become increasingly consequential as the model moves beyond office-based primary and specialty care into higher-cost procedures and facilities.

Surgery is also a category where employers have increasingly experimented with centers of excellence, bundled payments, reference-based pricing and other alternatives to conventional carrier-network pricing.

A reusable direct contract creates another option.

Instead of every employer independently negotiating an agreement, Cost Plus Wellness publishes a contract framework that eligible self-funded employers can potentially adopt.

The network is broadening by service line

The other five contracts demonstrate how quickly the model can spread horizontally.

The October additions span virtual-first care, physical therapy, women's health, primary care and family medicine.

Ember Modern Medicine is particularly useful as a contrast to the fee-for-service additions because its contract uses a subscription model.

That gives employers another example of how direct contracting does not have to use a single reimbursement methodology.

Cost Plus Wellness says most of its contracts use fee-for-service pricing, frequently tied to Medicare, while other arrangements can use subscriptions, case rates or custom schedules where appropriate.

Why the public-contract model matters

The interesting part of Cost Plus Wellness is not simply the number of providers.

It is the attempt to turn direct contracting into reusable infrastructure.

Cost Plus Wellness says its contracts are public, include pricing, and are intended for self-funded employers and certain level-funded plans whose vendors can support the model.

Providers opt in to individual employers.

Under the standard operating model, the plan pays the negotiated rate and the provider does not pursue the patient for payment.

Cost Plus Wellness also says Mark Cuban Companies uses its direct-contract providers as a preferred tier in its own self-funded health plan, alongside a PPO wrap network.

That structure illustrates how direct contracts can coexist with conventional networks rather than requiring an employer to replace its entire plan at once.

Another new contract appeared this week

DirectContract also added Indiana Direct Primary Care (C076) to the tracker.

That contract is dated September 28 and uses a subscription model for internal/family medicine across multiple states.

Combined with the six September 30–October 1 additions, it represents seven newly captured Cost Plus Wellness contracts since the older 68-contract snapshot.

What we don't know yet

The published contracts establish pricing and terms, but they do not by themselves establish employer adoption or realized savings.

Those are separate questions.

DirectContract will continue watching for:

• employers actually executing the new contracts;
• covered lives;
• utilization;
• realized savings versus incumbent network prices;
• expansion of the Legent arrangement;
• additional hospital and ASC contracts; and
• new TPAs supporting the Cost Plus Wellness model.

The distinction matters.

A growing contract library is evidence of expanding direct-contracting infrastructure. Employer utilization and claims results will determine how consequential that infrastructure ultimately becomes.

Browse these arrangements and other employer-provider agreements in the Direct Contract Deal Tracker.

Sources

• Cost Plus Wellness — Direct contracts
• Cost Plus Wellness — Contracts library
• Cost Plus Wellness — How MCC implemented direct contracts
• Cost Plus Wellness — FAQ