33 %

Commercial insurance will likely account for only 33% of the average hospital payer mix by 2024, down from 38% in 2014. 

Employers are embracing new alternatives

Rising health insurance costs and dissatisfaction with traditional health insurers are motivating employers increasingly to turn to providers for help. Success of some of the biggest employers is inspiring others to chart their own course and contract directly with provider systems.

Employer contracts offer the potential to disrupt the competition and sustain your commercial payer mix — Direct to Employer is a win-win-win.

Potential benefits for:

Health Systems
  • Additional access channel for valuable commercial lives
  • Engages prospective patients far upstream, building “stickiness”
  • New revenue opportunities
  • Ability to defend or increase share of wallet; defense against loss of existing commercial business to competitors willing to contract with employers
  • Avenue for payer contract negotiations beyond price discounts
  • Potential to bypass onerous preauthorization requirements and stringent ED limits
  • Means to get the “first dollar” of the health insurance premium
  • Mechanism to pursue shared risk arrangements
  • Opportunity to pilot value-based care initiatives in small, controlled populations
Employers
  • Reduced health expenditures, or at least a slowing of the rate of increase
  • Increased productivity and employee wellness, reduced absenteeism
  • More control over benefit design
  • Perks to attract and retain employees
Employees and Dependents
  • Lower out-of-pocket health care costs (premiums, deductibles, copays)
  • Expanded access and increased convenience
  • Simplified navigation and billing
  • Improved management of chronic disease
  • Enhanced health outcomes and satisfaction

Contact us to learn more.