How Tier 1 Direct Contracting Works

Most Michigan employers use the same carrier networks they've always used. It's what you know, and it's what your broker brings to the table every year.

But those networks keep getting more expensive and less stable. Providers drop out. Rates go up. And you're left dealing with it.

Here's what most employers don't know: healthcare systems across West Michigan have been building direct contracting relationships that cost less and work better.

You just haven't been told about them.

What's Happening with Traditional Networks

Carrier networks used to keep costs somewhat in check. Not anymore. Networks are getting narrower. Rates keep climbing. And carriers have less pull with healthcare providers than they used to.

What that means for you:

• Costs that jump without warning at renewal time

• Employees paying more in deductibles and copays

• Zero visibility into why rates keep going up

  
  

Southwest Michigan's major health systems have been setting up direct contracts because it's better for everyone involved. But most employers never hear about it from their brokers.

What Direct Contracting Actually Is

It's straightforward. Instead of using whatever network your carrier offers, your plan contracts directly with healthcare providers. You agree on prices for services, and those prices don't change.

Companies like Nomi Health have these relationships with Michigan systems like Bronson and Trinity. Here's what it looks like:

You know what things cost. Procedures and visits have set prices that don't change year to year.

Employees pay less. Lower costs mean you can offer zero deductibles and copays at contracted providers.

Employees go to good providers. Not a huge confusing network, but specific providers with clear pricing and quality care.

Your claims stay predictable. No surprise out-of-network bills that wreck your renewal.

Why This Matters

Traditional networks aren't doing what you need them to do anymore. Direct contracting gives you something different:

• Costs you can actually predict

• Better benefits without raising premiums

• Real control over how your plan works

  
  

The healthcare systems here are already doing this. You just need a plan that takes advantage of it.

What Your Employees See

Someone needs an MRI. They get sent to a contracted provider where the price is already set and they pay nothing. Done.

Someone else needs surgery. They go to a quality facility with rates already agreed on. No surprise bills. No network headaches.

That's what happens when your plan works directly with providers instead of going through a carrier's network.

Is It Worth Looking Into?

Switching to direct contracting means designing your plan differently. You're building something that actually fits your people instead of taking whatever the carrier offers.

For Southwest Michigan employers, this isn't some future possibility. It's available right now. The systems are here. The relationships exist.

Message us with any questions.