Benefits

TRENDING STORY TODAY: ‘Direct care company wants to grab self-funded group biz.’

July, 22 2014

By Anthony Brino

A direct primary care company is targeting employers with a new self-funding model that could spell disruption for the third-party administrator business.

NextCare Holdings, the parent company of an urgent care network in 11 states, has teamed up with the primary care design company Physician Care Direct to offer health plan solutions to employers in Dallas, Texas — promising savings of up to 30 percent if the employers self-fund under a new model.

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“Physician Care Direct is not an insurance company and does not offer insurance products,” the Cary, N.C.-based company explains on its website. What it does offer is an “employer health ownership plan,” a “healthcare purchasing strategy that facilitates purchasing primary care directly from local providers and coordinating additional coverage.”

In Dallas, Physician Care Direct and NextCare will be offering the “employer health ownership plan” solution to small and large employers via NextCare’s PrimaCare Medical Centers, a network of 13 primary care clinics located across Dallas-Fort Worth.

The employer ownership plan model is a variation on self-funding that lets businesses buy personalized primary care from providers like NextCare/PrimaCare and contract with companies like Physician Care Direct to buy specialty and hospital care.

“Small- and medium-sized businesses everywhere are struggling to maintain decent health insurance benefits for their employees,” said NextCare CEO John Julian in a press release. “We believe that this initiative can help companies save money while demonstrating to their employees that their health is a top priority.”

William B.J. Lawson, MD, the co-founder and CEO of Physician Care Direct, added that the model is offering employers a “unique alternative to traditional health insurance that will help them manage their costs while continuing to offer attractive benefits packages to their employees.”

Physician Care Direct is trying to capitalize on employers’ concerns over growing healthcare costs and their employees’ frustration with increasing premiums and deductibles. “We’re changing the way people pay for healthcare by offering a free market solution that keeps healthcare dollars and decisions where they belong — between doctors and patients,” the company said.

The company has been inking partnerships with primary care clinics to start offering direct services to employers, starting last year with Qliance, a primary care network in greater Seattle backed with venture capital from Amazon’s Jeff Bezos, Cambia Health Solutions and others. It has since signed on two other primary care clinics in the Puget Sound region, racking up alliances with 60 providers.

Now, Physicians Care Direct is pitching to hospitals and health systems, urging them to sell their own private-label “employer health ownership plans” to area businesses. “The approach lets hospitals become the center of a community-based solution to improve care coordination and health outcomes,” the company said in a media release.

SOURCE: http://www.healthcarepayernews.com/content/direct-care-company-wants-grab-self-funded-group-biz#.VVt1hEafWpS

Categories: Benefits, Business, Insurance

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