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Using Direct Contracts to Improve Your Insurance Program

Written by Jennifer Stuart—Employee Benefits Advisor

November 11, 2024 · 2 min minute read

Blog Using Direct Contracts to Improve Your Insurance Program

Upfront pricing helps employers establish payment models with providers, such as direct contracting, that would lower spending and reduce the administrative role, and associated costs, of insurance intermediaries. A growing number of healthcare providers are ready to engage in direct-contracting arrangements as these types of contracts guarantee steerage of business and revenue diversification.

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Direct provider contracts in healthcare can benefit both providers and patients, and can also help employers control costs and improve access to care: 

  • Improved patient experience: Direct contracting can lead to a more positive care environment, where providers focus on wellness and patients have stronger relationships with their providers. 
  • Lower costs: Direct contracting can lead to lower, more consistent costs without compromising quality. 
  • Improved access to care: Direct contracting can lead to improved access to top-level care. 
  • Better price transparency: Direct contracting can lead to improved price transparency. 
  • Faster cash flow: Direct contracting can lead to faster cash flow for providers. 
  • Eliminates middleman processes: Direct contracting can eliminate complex “middleman” processes. 
  • Aligned incentives: Direct contracting can lead to aligned incentives for all parties. 
  • Improved patient outcomes: Direct contracting can lead to improved patient outcomes. 
  • Higher member satisfaction: Direct contracting can lead to higher member satisfaction. 
  • Differentiation: Direct contracting can help providers differentiate themselves in a competitive market. 
  • Steppingstone to larger-scale arrangements: Direct contracting can be a steppingstone to larger-scale value-based arrangements.  

Direct-contracting arrangements embody the belief that “health care is local” and can serve to build valuable bonds between healthcare providers and local employers and their patients. It’s important to be aware that direct contracting is complex and requires navigating and coordinating relationships between the employer, the provider, and the third-party administrator (TPA) to facilitate claims payments and audits. In addition, network adequacy and capacity must be carefully assessed to ensure that employees have convenient, reasonably timely access to care. Employers and providers negotiating direct-contract arrangements will also need to ensure compliance with an array of legal issues.

Have questions? Contact:

Jennifer Stuart

Jennifer Stuart

Employee Benefits Advisor

Call: (903) 716-5916
Book an Appointment»

Years of experience

19

Growing up, my mom owned a TPA (third party administrator) that processed health, dental, disability, and workers comp claims for self-funded insurance plans. As a child, I would work there stuffing envelopes and filing papers. So, you could say I grew up in the insurance industry.

I graduated from Hendrix College in Conway, Arkansas with a B.S. in Business and Marketing, and got my life and health insurance license a year later. My first “official” insurance job was with a dental insurance carrier, before I moved to the agency side.

Since then, I've been an account manager, account executive, advisor, and department manager. My area of focus is self-funded accounts and pharmacy benefits. These plans are where you can make the most impact for an employer and their staff.

I love working with our team at Leavitt Risk Services because Leavitt Group offers a powerful combination of a national presence with a local broker's personal touch.

My clients stay with me long-term because I know my stuff and I care. I’m dedicated to making each client’s experience a positive one—from the renewal and open enrollment process to year-round servicing. I go to bat for their employees in difficult situations, and I am constantly gaining new knowledge to communicate more effectively, help plans perform better, and create long-term sustainability. I even have clients who improve their employee-facing benefits because the plans have performed so well. That's a rare occurrence in health insurance.

I was born in Oklahoma City and grew up in Northwest Arkansas—the land of Wal-Mart. My husband and I have two children and we just moved to Georgetown, Texas. We enjoy spending time outdoors, traveling, reading, artwork, and being with family.

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