Direct to Employer Contracting: New Employer Partnerships

Lacks Enterprises

A recent poll by the Kaiser Family Foundation found that annual premiums are expected to exceed $20,000 for an employer provided family plan in 2019 – paying for health coverage is now as expensive as buying a car. Dissatisfied with the status quo and frustrated by a lack of transparency behind annual rate increases, innovative self-funded employers are starting to meet their healthcare needs through contracting directly with providers.

Affinia Health Network, recognized by a number of third parties as a low cost, high-value network represents a unique solution for the West Michigan business community. Starting in 2020, Lacks Enterprises and Royal Technologies are contracting directly with Affinia to offer about 8,000 members in West Michigan insurance coverage. ASR, a local third party administrator (TPA) will be partnering with Affinia and administering both products.

Royal Technologies

Direct to employer contracting is an integral part of our strategy and represents a significant growth opportunity. Currently, only 20-30% of these members use our system. In 2020, patients will be incentivized to use our network through benefit design and lower contributions. To minimize disruption, members can still choose to go out of network, but will have pay more. In order to keep patient costs down and coordinate their care, it is critical that we keep patients in our network. Concierge like customer service, navigation, and access will increase our system’s “stickiness” factor as new patients are introduced to the Affinia Health way. To further bend the cost curve, this population will be treated much like our risk based Medicare products. Preventative care, robust data, care coordination, and care management will all be prerequisites for success.

If you have additional questions about our direct to employer strategy, please reach out to Kim (Kelly) Bramer or John Luterbach for more information at 616-685-1870.

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