10 leading health systems join Transcarent's direct contracting ecosystem

Photo: Courtesy Intermountain

Ten leading health systems have joined Transcarent's first National Independent Provider Ecosystem, setting the foundation for increased direct contracting.

Direct contracting between employers and health systems has historically been a challenge to do at scale, according to Transcarent's announcement.

Transcarent directly contracts rates upfront with the health systems and guarantees same-day payment.

Employers receive competitive pricing previously only reserved for narrow networks while maintaining access and choice for members, said Transcarent, a consumer-directed healthcare platform for self-insured employers. 

Employee members get access to the health systems' collective clinical experience.

The 10 health systems joining the National Independent Provider Ecosystem are:

• Advocate Health
• Atrium Health
• Baylor Scott & White Health
• Corewell Health
• Hackensack Meridian Health
• Intermountain Healthcare
• Mass General Brigham
• Memorial Hermann Health System
• Mount Sinai Health System
• Virginia Mason Franciscan Health

WHY THIS MATTERS

For the first time at a national level, members can access virtual care that works in tandem with complex care services delivered locally at hospitals, Transcarent said.

Employees get access to virtual care in 60 seconds, faster access to in-person care and predictable, affordable costs with full transparency, the company said.

Other member benefits include concierge-level experience across digital and in-person care, including scheduling and pre/post care; and integrated wraparound support such as expert opinions, virtual physical therapy, orthopedic consultations and a pharmacy marketplace.

"To be clear, we're not talking about the lowest costs; we're talking about the highest quality of care enabled by better processes," said Transcarent CMO Dr. Randy Hawkins.

THE LARGER TREND

Direct contracts for covered care services simplify the healthcare experience for employers, providers and health consumers, Transcarent said in the announcement. 

The company was founded in 2020 in Denver. CEO Glen Tullman said in 2021 that Transcarent was looking to overhaul the employer-self-insured business by offering a new way to navigate members to high-quality, low-cost care.

"Everyone agrees that healthcare in America is too confusing, complex, and costly. Our goal is to make it easy to access high-quality care and to do that, we've partnered with the people who deliver that care ... the best health systems across the country," Tullman said by statement. "Our close collaboration with these 10 leading health systems will allow us to better design care pathways, provide higher-quality care, and faster access. By aligning with health systems who can guarantee both quality of care and competitive pricing, we can reduce administrative burden, and just as important, demonstrate true measurable value for the people who pay for care – employers and their employees. We'll also more closely integrate the digital experience with the hands-on care that we know only health professionals can provide. It's not an either/or; it's both."

ON THE RECORD

"Mass General Brigham is excited to work with Transcarent on this new solution," said Niyum Gandhi, CFO and treasurer at Mass General Brigham, by statement. "We have a strong alignment with Transcarent in providing high-quality care for patients and offering new and innovative solutions to access care. As an organization with a strong commitment to the affordability of healthcare, we are also excited that this solution allows us to take accountability for total cost of care, helping us keep costs down for our patients. We feel that this new model complements our existing value-based care approach and will be a promising choice to improve value opportunities for employers, and ultimately the people who choose us for their care."

"Hackensack Meridian Health is committed to enhancing the patient experience and transforming the way healthcare is delivered," said Robert C. Garrett, CEO of Hackensack Meridian Health. "Transcarent is an innovative, one-stop-shop solution that brings high-quality options together. If employers and their team members in the communities we serve begin their healthcare journey through the Transcarent app or through one of Hackensack Meridian Health's facilities, every patient will receive high-quality, affordable, coordinated care when and where they need it."
 

Twitter: @SusanJMorse
Email the writer: SMorse@himss.org