The Northwell Direct / Brighton Health Plan Solutions Story

When Northwell Health, the second-largest employer in New York and the state’s largest health system, decided the rising cost of traditional health insurance was unsustainable, they decided the future lay with a direct-to-provider solution. By eliminating traditional insurance carriers and providing the extensive experience and high standard of care of their world-class physicians and facilities direct to employer groups, they could offer quality, customizable plans at a lower cost.

Northwell Direct, Northwell Health’s employee health plan, is administered by Brighton Health Plan Solutions. It removes traditional insurers from the equation completely, lowers employer healthcare costs by 20%, and provides high-quality healthcare. Nick Stefanizzi, CEO of Northwell Direct, says direct-to-provider contracting ensures employee access to quality tailored programs. “Judgments are made based on the patient’s clinical needs and what’s going to get them the best outcome, and not around how we are going to get the highest return on the dollar for our shareholders.”

According to a recent blog post in the Society for Human Resource Management, employers’ group health plan premiums increased, on average, between 4.7% and 5.2% in 2022, even after taking into account cost-management initiatives. In other words, companies are heading back to pre-pandemic levels of rising costs. “The employers that are going to win the war for talent,” Stefanizzi says, “are those being seen as making investments in the health, safety and resilience of their workforce.”

This commitment to innovation is one reason Northwell Direct now provides direct-to-provider contracting to high-profile companies like Whole Foods and Jet Blue. Another reason is Northwell Direct’s extensive healthcare network. With 20,000 providers, 4,450 primary and specialty care practices, 33 ambulatory surgery centers, 118 urgent care centers, and 50 leading hospitals, Northwell Direct can provide a comprehensive level of care in Long Island, New York, and New Jersey. Brighton Health Plan Solutions, with more than 30 years’ experience as a third party administrator (TPA), provides ongoing, customizable TPA services and award-winning support technology to facilitate this direct-to-provider contracting.

Michelle Zettergren, Brighton’s Chief Sales and Marketing Officer, speaks of the value of Brighton’s efficient claims processing and customer service, which creates both goodwill and transparency, especially because traditional insurance companies generally make important data unavailable, leaving both employers and employees in the dark. “With Northwell Direct,” Zettergren says, “the patient is hearing directly from the providers and the level of adherence is going to be so much higher, as well as employee satisfaction, and it improves the outcome overall.”


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