Solving the Direct-to-Employer Model for Self-Funded Health Plans

direct-to-employer model
Direct-to-Employer Partners

CSuite Solutions (CSUITE) in partnership with Key Benefit Administrators (KBA) recently announced the availability of a new provider-sponsored, self-funded healthcare program that was created just for healthcare systems and hospitals to level the playing field with the payors. CSUITE is a healthcare consultancy comprised of former health system provider Presidents and CEOs who are well-known amongst their peers in the industry.

With the “death stars” of Amazon/Berkshire Hathaway/JP Morgan, CVS/Aetna and United/Optum moving quickly to disrupt the provider space, it is now more important than ever for providers to have effective tools to fight back. We are one of very few offerings that allows healthcare systems to sell their own provider-branded and sponsored health plans to employers with as few as 10 employees or as many as 100,000 plus. This program is NOT insurance and does NOT require a healthcare system to become an insurance company and take on claims risk which we know has been a disaster for a number of very large providers.

It does allow health systems and hospitals to work directly with employers WITHOUT an insurance intermediary using KBA’s best-practices legacy of 30 years of successful self-funded healthcare plans to greatly reduce the cost of healthcare for the employers. You can read more about this innovative program at directtoemployer.com.

We have 4 active installations at this time and will have excellent customer testimonials to share by the 4th quarter of this year. Direct-to-employer programs are a hot topic in the industry right now but none that provide the tools and proven outcomes that we do. This program is the answer for all providers who are feeling under siege right now.

If you are interested in learning more about the DTE solution for your health system, area employers and community, visit our contact page to connect with us.


See article excerpt below from Becker’s Hospital Review – May 4, 2018

4 executive insights on the challenges of direct-to-employer models

As hospitals and health systems shift toward value-based reimbursement and look to remain profitable while adapting to what healthcare consumers want, direct-to-employer models are on the rise.

Employers are increasingly frustrated with a lack of transparency into health plans’ premium rates and coverage policies. Furthermore, employees are becoming less satisfied with how services are offered through their health benefit plans. To improve care quality and reduce administrative costs, some employers are fostering direct relationships with medical providers.

Through direct-to-employer contracting strategies, hospitals and health systems can secure direct reimbursements through gain sharing and give medical providers a stronger voice in developing protocols for managing patient cases and care regimens, all while helping employers cut healthcare costs.

However, as medical providers navigate the best ways to put these strategies into action, they face a number of challenges, particularly when exploring price transparency, developing payment models that serve diverse patient populations and jumping over various administrative hurdles.

Twenty-three hospital and health system leaders from across the U.S. shared four insights on what healthcare organizations should consider when implementing direct-to-employer models during an executive roundtable discussion April 11at the Becker’s Hospital Review 9th Annual Meeting in Chicago.

CLICK HERE to read the full article on Becker’s Hospital Review.



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