Remove Complexity and Barriers to Care with Community Partner Health Programs
How Providers Can Work Directly with Employers to Deliver Quality Care
If you’ve ever wished you could treat patients without the administrative complexity and red tape involved with insurance programs, you may be interested in participating in a community partner health program.
These direct care arrangements enable employers and health providers to negotiate directly. Instead of going through insurance carriers, employers and providers establish contracts on their own, agreeing to prices for care delivery. It’s a simple and innovative approach that results in better care delivery for patients and fewer administrative headaches for providers.
A New Approach to Care Delivery
A doctor determines that a patient needs a procedure, but the patient’s insurer disagrees. Without insurance, the patient can’t afford care.
A patient experiences symptoms for months but doesn’t go to the doctor because of the cost. When the symptoms worsen, the patient finally seeks care, but by then, the prognosis is poor.
Do these scenarios sound familiar?
For most working-aged Americans and the families they support, carrier-based health plans are the norm. In theory, these plans should support well-being by providing access to care, but in reality, patients face high out-of-pocket costs and other administrative red tape, creating barriers to care.
Direct plans remove friction and reduce barriers to care by eliminating carriers from the equation.
How Direct Plans Simplify Care Delivery
There are four parties in the carrier-based model:
- The patients, who need care.
- The healthcare providers, who want to deliver care to patients.
- The employers, who want their workers to receive care.
- The carriers, who are often motivated by profits.
By removing carriers from the system, patients, providers and employers can work together to achieve their aligned goals.
How Do Direct Plans Work?
A direct plan is a simple and innovative approach to healthcare.
- Community healthcare systems and providers negotiate directly with employers.
- This agreement between an employer and health system is formalized in the Direct Corporate Partnership Agreement.
- The Direct Corporate Partnership Agreement covers all services.
- When workers and their families need care, they go to the providers their employer has contracted with.
- The employer is the payer, and there is no carrier in the middle.
Employers and employees like this system because it results in substantial savings. Providers also benefit from the streamlined system that reduces barriers to care.
Removing Administrative Red Tape
The carrier model of coverage can create administrative burdens for healthcare systems. There are often many hoops to jump through, and the administrative tasks can cut into time available for patient care and professional development.
The direct plan model reduces administrative complexity. You no longer have to work with carriers or deal with their requirements.
Becoming a True Community Partner
A healthy community is a strong community.
The employers in your community want a healthy workforce. They invest funds into health programs, not just to comply with regulatory requirements, but to support a resilient and engaged workforce. They are strongly motivated to provide quality care that promotes employee wellbeing and satisfaction while also controlling costs.
When you work directly with the employers in your community, you can form partnerships that align your goals as a healthcare provider with the goals of employers.
How Does It Work?
Read the Wada Farms Case Study
Strengthening Your Practice
Even when the system is obviously broken, it takes courage to break away from the status quo and try something different. By embracing the direct plan model of healthcare, you can differentiate your organization, while:
- Positioning your organization as a caring community partner, attracting new opportunities in the process.
- Becoming the go-to source of care for employers and employees participating in the direct plan model. As this model grows, so will your market share.
- Reinvesting your time. By reducing the administrative burden associated with carrier involvement, you can free up resources, and these resources can be reinvested to grow your organization and expand your services.
Are You Interested in Becoming a Direct Partner Provider?
Here at H2B, we are helping employers and providers work together to build a better healthcare system. We leverage our skills and experience to create a workable Direct Corporate Health Partnership Agreement between you and the employers in your community. We’re already working with high-quality health systems that are dedicated to providing care in their communities. If you’d like to participate, contact us to learn more.