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

Location Mark

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