Intelligence
Reverse-chronological coverage of deals, platform launches, benefit design shifts, and the operating mechanics behind direct contracting.
Self-insured employers face fragmented federal transparency rules that create real compliance gaps—here's what you must disclose, by when, and where enforcement is tightening.
Read the analysisThe No Surprises Act solved some balance billing problems for self-insured plans but created new exposure—here's what shifted and how to structure your plan to protect employees and your bottom line.
Read the analysisInaccurate provider directories drive out-of-network claims and balance bills that self-insured employers pay twice—once in claims and once in audit costs.
Read the analysisLearn how termination clauses in direct contracts can protect employer interests and ensure smooth transitions.
Read the analysisA detailed analysis of GLP-1 drug spending by self-insured employers and effective coverage strategies.
Read the analysisA comprehensive look at fertility benefits for self-insured employers, focusing on vendor models, cost exposure, and ROI data.
Read the analysisA detailed comparison of Hinge Health, Kaia, and Sword Health for self-insured employers.
Read the analysisA thorough comparison of leading care navigation vendors focusing on model, pricing, and employer outcomes.
Read the analysisExplore effective strategies for managing specialty drug costs driven by a small percentage of members.
Read the analysisA comprehensive look at ERISA fiduciary duty, its implications for self-insured employers, and governance strategies to mitigate risk.
Read the analysisExplore how employers structure bundled payment contracts for orthopedic and spine care and the significant savings these arrangements can yield.
Read the analysisUnderstanding the balance between utilization suppression and catastrophic risk in HDHP design.
Read the analysisExploring how self-insured employers leverage Centers of Excellence contracts for cancer care to reduce costs and enhance patient outcomes.
Read the analysisExplore why musculoskeletal conditions are the largest driver of employer health costs and how direct contracting strategies can effectively reduce these expenses.
Read the analysisExplore the concentrated costs of diabetes management and how to effectively structure vendor contracts for better health outcomes.
Read the analysisSelf-insured employers leverage Cancer Care Centers of Excellence contracts to enhance patient care and cut expenses.
Read the analysisUnderstanding the impact of musculoskeletal issues on employer health costs and effective direct contracting strategies.
Read the analysisExplore the concentrated costs of diabetes management and discover effective interventions and vendor contract structures for self-insured employers.
Read the analysisAnalyzing diabetes management costs, effective interventions, and structuring vendor contracts for self-insured employers.
Read the analysisUnderstanding broker compensation and fiduciary duty is crucial for self-insured employers.
Read the analysisLearn about critical term sheet clauses in direct hospital contracts that can expose employers, and strategies to negotiate better terms.
Read the analysisSelf-insured employers can utilize hospital price transparency data to negotiate better direct contracts and significantly reduce healthcare costs.
Read the analysisCost Plus Wellness posts provider contracts publicly, bans insurer participation, and requires 30-day payment — and ambulatory surgery centers are signing up first.
Read the analysisExplore the real return on investment for employers integrating Direct Primary Care with their health plans.
Read the analysisDirect contracting does not replace TPAs; it changes what 'good' looks like for administration, data, and member experience.
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 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 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 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 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 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 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 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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