For Health Benefits

A provider-employer alliance

For Health Benefits

A provider-employer alliance

Employer direct contracting makes the employer the insurance company. This method cuts out the middle man and gives control of the plan back to the employer and greatly benefits the provider. 

Employer direct contracting - Where the provider wins!

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.

EVERYONE WINS.

Providers get paid more, employers save more, and employees get better care. 

How does everyone win with employer Direct Contracting?

Glad you asked! 

Here is 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, 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 Benefits

Direct contracting eliminates the need to contract with Medical Insurance Carrier more affectionately known as BUCA’s. 

Employers eliminate BUCA’s and let us guide them responsibly to seek empowering solutions fortheir organizations to manage healthcare claim expenses. 

Rather than see the traditional rise in healthcare costs, wouldn’t it be great to see those costs stay stagnant or even decrease? Employers see these types of results with employer 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.

Direct Contracting Partners - Health Rosetta

Health  Rosetta, one of our ally’s in the battle against healthcare greed, tells an excellent story about the benefits of direct contracting. Here is a snippet of the story they tell:

“We described this “solution” to a senior executive of one of the world’s largest banks, a non-US bank. After listening carefully he said, and I paraphrase, “Tom, if I understand correctly, employees get better quality healthcare.” I replied, “Yes”.

He asked, “Employees also save money, correct?”  “Yes.”

The executive then said “And the health plans saves money too, no?” Again, I replied, “Yes”.

His final question was “Then why isn’t every company in the US doing this.” Alas, I did not have a good answer to that question.”

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, are not innovative, could care less how much you get paid or how often, 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 knowledgable, savvy, healthcare benefits professionals who work tirelessly to help our clients grow an save. No question is to large or too small for our team to answer. We look forward to working with you.