AnalysisApril 26, 20267 min
Where TPAs Fit in Direct Contracting (and Where They Don’t)
Direct contracting does not replace TPAs; it changes what 'good' looks like for administration, data, and member experience.
Read the analysisIntelligence
Analysis for employers cutting out the middleman.
Reverse-chronological coverage of deals, platform launches, benefit design shifts, and the operating mechanics behind direct contracting.
AnalysisApril 26, 20266 min
Why Provider Cash Flow Is the Hidden Lever in Direct Contracting Negotiations
For many providers, predictable cash flow is as valuable as a higher rate. Employers who understand that can trade timing for price.
Read the analysisAnalysisApril 26, 20268 min
Direct Contracting Failure Patterns: How Good Ideas Go Sideways
Most failed direct contracts do not blow up on pricing; they erode quietly through weak steerage, vague data rights, and misaligned partners.
Read the analysisAnalysisApril 24, 20268 min
Why 2026 Is the Tipping Point for Direct Contracting
The 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 analysisAnalysisApril 24, 20267 min
Cost Plus Wellness Explained: Inside Mark Cuban’s Open-Source Contract Platform
Cost 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 analysisAnalysisApril 23, 20267 min
Post-Mortem: What to Do When a Direct Contract Fails
Not every direct contract works. The difference between a useful failure and a political disaster is how you handle the post-mortem.
Read the analysisAnalysisApril 22, 20268 min
Measuring Direct Contract ROI After Year One
Year-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 analysisAnalysisApril 20, 20268 min
Aligning PBM Strategy With Direct Contracting
Direct 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 analysisAnalysisApril 19, 20267 min
Using Direct Contracts for High-Cost Outliers Instead of the Whole Network
You 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 analysisAnalysisApril 16, 20267 min
Getting Providers Comfortable With Downside Risk in Direct Contracts
Most 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 analysisAnalysisApril 14, 20268 min
Direct Contracting Platform RFP Checklist
If 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 analysisAnalysisApril 12, 20267 min
Building a Direct Contracting Dashboard That Actually Matters
Most 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 analysisAnalysisApril 8, 20267 min
Direct Contracting in Concentrated vs. Fragmented Markets
A 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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