• Ep 10. Navigating hospital/physician direct to employer contracting, truly value-based care

  • Mar 14 2025
  • Length: 52 mins
  • Podcast

Ep 10. Navigating hospital/physician direct to employer contracting, truly value-based care

  • Summary

  • As the cost of healthcare continues to rise, more employers are turning to direct employer contracting and self-insured models to take control of their healthcare costs. But how do these models compare to fully insured arrangements? And what are the key considerations for health systems, PBMs, and employers looking to engage in value-based care?

    In this episode of Value Health Voices, Dr. Anthony Paravati and Dr. Amar Rewari sit down with Ned Laubacher, CEO of Health Spectrum Advisors and an expert in direct-to-employer contracting, to break down:
    ✅ The shift toward self-insured models and employer-driven health benefits
    ✅ The role of quality metrics and shared savings in employer-provider contracts
    ✅ How data transparency is transforming healthcare finance and cost control
    ✅ The impact of legislation on employer health plans
    ✅ Common pitfalls in direct contracting and how to avoid them

    💡 Key Takeaways:
    🔹 Self-insured employers have more control over healthcare costs and provider networks
    🔹 Direct contracts with health systems help improve cost transparency and health outcomes
    🔹 Employers must take a proactive role in healthcare policy to navigate complex regulations
    🔹 PBMs and cost-plus drug models are playing an increasing role in employer-led health plans
    🔹 Analytics & data-driven decision-making are the future of value-based care

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