More employers are going
direct-to-provider

In an effort to contain healthcare costs, many employers are creating health plans based on health systems, or hospital systems, near where their employees live and work. By committing to a single health system, employers are achieving 10–25% savings over traditional health insurance. Plus, it’s often coupled with performance goals to drive better health outcomes.

To strike the best deal with the health system, the employer needs to have:

  • Experience in health plan benefit design
  • Expertise in collaborating with health systems
  • A workforce of sufficient size in the same region to make the deal worthwhile to the health system

Many employers do not have this expertise or could benefit from additional guidance from our experts in negotiating competitive fees with health systems. Brighton Health Plan Solutions has extensive experience contracting with providers to build networks – such as the MagnaCare PPO network and integrated delivery networks. Our contracting experts can help employers achieve the best rates with their preferred partner hospitals.

Employers who contract directly with health systems receive rates that are up to 25% lower than insurers’ best-in-market rates

Personalized health plan administration

Beyond helping you create your network, we are a full-service third party administrator (TPA) offering a wide range of services:

  • Health plan design – We build benefits your way.
  • Claims processing and adjudication – We’ll administer your unique benefits, process and reprice your claims, and fully integrate with your vendor partners.
  • Medical Management services – Our in-house clinicians will lower your healthcare costs while improving care for your members.
  • Create® Technology platform – Our award-winning healthcare portals and mobile app simplify plan management and increase member engagement with their health plan.

Pre-built networks based on health systems

For groups that don’t have the critical mass to negotiate a favorable deal with a health system, they can offer their members access to one of the health systems we’ve already negotiated with. Learn more about our integrated delivery networks built around some of the largest hospital systems.

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