DIRECT CONTRACTING
Self-funding offers employers the flexibility and independence to better manage healthcare costs through alternative reimbursement strategies, like direct-to-employer contracting where health systems partner with health plans to lower costs and improve care. EAS Health utilizes Direct Contracting through Transparent Pricing Arrangements, or reference-based pricing that affords employers the opportunity to reimburse according to Medicare pricing.
Medicare reimbursement rates are typically the lowest rate a provider will accept for a service. EAS Health uses Medicare as a baseline and then negotiates with providers a contracted rate that is a percentage above. This new rate is usually significantly lower than the discount provided by a PPO network for the same service. The plan design is often entirely copay based for the member relieving them of the hassles of deductibles and co-insurance.
Direct Contracting Benefits
FOR EMPLOYERS
ACCESSIBILITY
COST REDUCTION
CONTROL
Direct
relationships
with providers
Lower
reimbursement
rates on claims
Helps control
medical
inflation
Direct Contracting Benefits
FOR EMPLOYEES
NO LIMITATIONS
Members
can see any
provider
COST CONTROL
SIMPLE
Copay
based with
no deductibles
Little to no balance
billing with less out
of pocket cost
Direct Contracting Benefits
FOR PROVIDERS
PREDICTABILITY
TIMELY
EFFICENCY
Increased
predictable
reimbursements
Reductions
in accounts
receivables
Faster rated
pay for
providers