Direct Contracting - providers are paid 130-150% of Medicare
Wincline was founded on the premise of saving employers money and doing what is right for the employer. We also believe in taking care of providers and value the role they provide the employer.
Employers ask us all the time “What does it mean to always pay 130-150% of medicare?”
We always answer simply.
Providers get paid more, employers save more, and employees get better care.
How does everyone win with employer Direct Contracting?
Here’s how it works:
Medicare sets a baseline price for every visit/CPT Code/procedure etc. Because Medicare’s prices must be published, they are fundamentally used as this baseline. When employers direct contract with providers, they enter into an agreement to pay between 130-150% of that medicare baseline cost.
However, what does “pay 130-150%” even mean???
HERE’S AN EXAMPLE
If you are having knee surgery and the amount due is $1,000 based on the medicare baseline for your locality, you pay between $1300 and $1500 for the procedure.
It’s that simple. No negotiating, no sticker shock, and no guessing games. Employers pay the price that is within the baseline range. In other words, direct contracting takes the guess work out of healthcare and puts money back into the employers pocket and increases pay to the provider.
Direct Contracting White Paper
Get everything you need to know about direct contracting in this three page white paper.
Direct Contracting Benefits
Direct contracting eliminates the need to contract with Large Medical Insurance Carriers, more affectionately known as BUCA’s.
Employers eliminate BUCA’s and let us guide them responsibly to seek empowering solutions to manage their organization’s healthcare claim expenses.
Rather than seeing continual rises in your healthcare costs, wouldn’t it be great to see costs stay stagnant or even decrease? Employers see these types of results with direct contracting.
Providers, wouldn’t it be great to get a pay increase and have a consistent income flow? Again, direct contracting helps make this dream a reality.
why every provider should consider direct contracting
Are you a provider that likes earning consistent money and an increase in pay? Building relationships? Taking care of people and getting paid fairly?
If you answered yes to any of those questions, you should take a long, hard look at direct contracting. However, if you just prefer to stick to the status quo, aren’t innovative, or could care less how often and much you get paid, then this type of plan might not be for you.
For more information about this topic or if you are ready to take your company to the next level, please reach out and connect with us.
Our team is full of knowledgeable, savvy, healthcare benefits professionals who work tirelessly to help our clients grow and save. No question is too large or small for our team to dig into. We look forward to working with you.
Direct Contracting Physician Form
Are you a physician that wants to take advantage of this great direct contracting opportunity? We want to hear from you! Fill out this form and one of our team members will connect with you soon.