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"Drop-in" DirectCare & Get Streamlined Access – Direct to Provider.

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Why DirectCare for Purchasers

DirectCare helps purchasers take control of healthcare spending by simplifying direct contracting with independent healthcare providers and ambulatory surgery centers (ASCs). Our approach – from implementation and contracting to ongoing navigation – ensures that employers, unions, and health plans seamlessly access high-quality care at reduced costs. Discover how DirectCare can transform your healthcare strategy while enhancing member satisfaction.

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Higher Value Scores: Quality care at lower costs.

Direct Contracts: No Insurance Chaos.

Transparent Pricing: No PEPM or hidden fees.

Immediate Savings: From day one – no complex setup.

Proactive Support: Care navigation and post-treatment follow-up.

Multi-Specialty Network: Over 2,000 Procedures.

How It Works (Step-by-Step)

Step 1: Data Analysis

We start by analyzing your historical healthcare claims data or using industry benchmarks if data is not available. This helps us identify high-cost surgical procedures and potential savings opportunity.
Outcome: Get a clear, data-driven understanding of your healthcare spend and savings potential.

    1. Data Collection: Securely gather claims data from your current provider or TPA.
    2. Benchmark Comparison: Compare costs using industry standards to identify outliers.
    3. Opportunity Mapping: Identify areas where direct contracts with high-quality providers can reduce costs.
    4. Custom Report: Present findings and cost-saving projections tailored to your organization.

Step 2: Contracting

We simplify the contracting process by connecting you directly with high-quality surgical providers, eliminating insurance barriers.
 Outcome: Access a network of providers with cost-effective, pre-negotiated bundled rates.

    1. Contract Drafting: Prepare direct contracts with bundled pricing and transparent terms.
    2. Provider Selection: Collaborate with top independent physician groups and ambulatory surgical centers.
    3. Pricing Structure: Include pre-negotiated, all-inclusive rates for each procedure.
    4. Compliance Assurance: Ensure all contracts meet legal and compliance requirements.

Step 3: Implementation

We streamline the implementation process to minimize disruption while maximizing efficiency.
Outcome: A smooth, rapid transition to direct contracting with no disruption to current plans.

    1. Integration with Payment Platform: Set up direct payments through our tech platform, avoiding traditional claims processing.
    2. Training & Resources: Educate benefits administrators on how to access and manage new direct contracts.
    3. Employee Communication: Inform employees about the new care pathways and how to access services.
    4. Technology Support: Integrate the DirectCare system with your existing healthcare administration tools.

Step 4: Navigation

DirectCare’s care navigation ensures that your employees access the right provider at the right cost — with zero confusion.
Outcome: Improved patient experience and outcomes, with reduced surgical costs through optimized care pathways.

    1. Dedicated Support Team: Guide patients to high-quality, contracted providers.
    2. Appointment Coordination: Ensure seamless scheduling with minimal delays.
    3. Follow-Up and Care Continuity: Coordinate post-surgery care to maintain outcomes.
    4. Member Education: Proactively communicate the benefits and steps to use DirectCare.

FAQ

DirectCare is a direct contracting model that enables employers and unions to reduce surgical costs by 30-60%. We connect you with high-quality providers through pre-negotiated bundled pricing and streamlined care navigation.

By partnering directly with providers and eliminating insurance middlemen, DirectCare offers bundled pricing for common procedures, reducing costs significantly while maintaining high-quality care.

DirectCare primarily focuses on high-cost, high-volume surgical procedures, particularly within musculoskeletal (MSK) and orthopedic care. This includes surgeries, imaging, and other related treatments.

We partner with top-tier providers and ambulatory surgery centers (ASCs) known for high-quality care and excellent outcomes. Our bundled pricing model ensures transparency and consistency without compromising patient care.

No, DirectCare integrates with your existing plan. We offer a complementary solution that provides cost savings and improved care coordination without disrupting your current setup.

Employees and union members are guided through care navigation, which connects them with the appropriate DirectCare providers, ensuring smooth transitions and efficient care.

We use historical claims data or benchmarks to identify high-cost procedures. This data helps us build a customized savings proposal and targeted strategy for your group.

Implementation typically takes around 60-90 days from initial data analysis to the launch of care navigation. We handle contracting, provider onboarding, and system integration for a seamless transition.

DirectCare provides ongoing reporting, including utilization metrics, savings reports, and patient outcomes. These insights help you monitor performance and maximize cost savings.

With pre-negotiated bundled pricing, payments are made directly to providers, typically within 14 days. This eliminates the need for complex billing and reduces administrative burdens.

Ready to Transform Your Healthcare Spend?

Join DirectCare and see how we optimize your health plan while cutting costs.

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