Direct Contracting for Healthcare: Risks vs. Rewards
From time to time, we are asked, “What are the risks of direct contracting for healthcare?” It may sound trivial to say that there aren’t any – but yes, that’s exactly what we’re saying. As healthcare consultants to so many companies that have benefited from it, we here at GM&A truly believe the risks of direct contracting are virtually non-existent when compared to taking part in traditional health plans, such as PPOs.
Why are Direct Contracting Health Plans Better?
Remember, direct contracting involves entering into direct relationships with providers, without all the bureaucracy and middlemen of traditional healthcare. That means lower costs for employers, in addition to better, faster and more affordable healthcare for their employees.
Without direct contracting, you miss out on the cost reduction benefits and better care for everyone who is in your network – the healthcare network your company has created especially for its employees and their families. So the truth is, the real risk is not taking advantage of direct contracting.
Direct Contracting vs. PPO Plans
Some will say that if you go the traditional health plan route, you’ll get more services. First, that’s not necessarily true. We have seen some very critical care services – including life-saving surgeries, transplants and neo-natal care – provided in a superior manner for our direct contracting clients. Patients who have been unable to affordably receive these services via the former company health plan are now receiving them in the manner they deserve, and naturally, they couldn’t be happier. Second, it doesn’t matter how many services you get with a traditional PPO plan; your costs will be inherently more because you haven’t made competition work in the marketplace.
All in all, direct contracting is just the more sensible way to provide a company health plan. To learn more, contact GM&A to request a complimentary company health plan consultation. We will be glad to answer your questions.