Employer Direct Healthcare

Bundled case rates allow for predictability and manageability.

For self-funded employers, planned medical procedures are typically the most expensive part of your health plan, representing 20-30% of your total healthcare spend. So why is it you don't know how much those procedures cost? The short answer is the current healthcare system doesn't allow for price transparency... at least it didn't, until now.

EDHC consolidates all the costs for an episode-of-care (physician, facility, anesthesia, imaging, etc.) into a single, bundled price, so you'll know the total cost of each procedure before you pay for it. This results in simplified billing, reduced administrative overhead and increased manageability for your business.

Save up to 30%-50% per procedure and 6%-10% on your overall health plan.

In today's healthcare system, medical providers and facilities are frustrated by insurance company red tape and delays, so we take a different approach. At Employer Direct Healthcare we pay our providers up front and bring them patients they wouldn’t have otherwise seen, so they are pleased to accept our bundled case rates at price points much lower than conventional PPOs and major insurers, which results in dramatic savings. With EDHC, you'll pay up to 30%–50% less than your current in-network negotiated rates for surgical procedures, and you can save 6%-10% on your overall healthcare spend.

Provider excellence equals better outcomes.

Your plan members have access to an elite network of medical providers and facilities, all committed to helping patients return to work healthier, happier and sooner.

A healthy workforce is good for your bottom line, and you want your plan members feeling good and back at work as soon as possible. Naturally, you’d like them to have their medical procedures performed by the best providers available, especially if savings can be realized without sacrificing quality.

EDHC medical providers and facilities deliver personalized, high quality care throughout the United States. Our medical providers are specialists and specialty centers, which are measured by clinical outcome data and high-volume capacity, which directly correlates to excellence. As specialty facilities, these providers are organized for efficiency and effectiveness, offering a higher level of personalized care and courtesy that patients and their companions want.

Member services provide a better patient experience.

Your plan members aren’t in the business of planning medical procedures. We do it every day, and we’re available to help members plan for a smoother process and a speedier recovery. EDHC Care Coordinators are available to help your plan members with:

• Assistance in finding the right provider for the plan member’s individual needs
• Transfer of medical records
• Scheduling the procedure
• Scheduling travel and accommodations
• Assistance transitioning back into local care

What's more, our member services don't stop when the procedure is completed. EDHC has created an internal quality and member satisfaction metric and data system that is designed to ensure the most positive and all-inclusive member patient possible.

Many procedures are available through EDHC.

Employer Direct Healthcare has an extensive network of top-quality medical providers and facilities across the country, offering many procedures to choose from, such as:

• Major heart (valve replacement, coronary bypass)
• Orthopedic (knee & hip replacement, shoulder & knee arthroscopy, ACL repair)
• Spine (fusion, laminectomy, pain management)
• Colonoscopy & endoscopy
• Outpatient procedures
• And more

Contact us for a complete list of providers and procedures.

We provide employee education materials.

When you add EDHC to your health plan, you'll want to share the good news with your employees about the quality, choice and savings that are available to them through Employer Direct Healthcare. So we provide a complete employee education campaign that makes it easy for you to roll out the new benefit. 

Then, we know from experience that once one employee has received their procedure with EDHC, others will follow suit because it's a positive experience with substantial cost savings for plan members. This is good news for you, too, because your platform cost for the entire year is usually covered in the savings you'll see with just two or three procedures.

A flexible plan design makes it easy to add EDHC to your health plan.

EDHC is a supplemental program that may be added to the health plan of any health self-insured employer, or by the plan carrier, if fully insured, to give plan members access to top quality providers in every geographic region of the U.S.

Your EDHC plan design is flexible, giving you the ability to choose procedures, locations, and other options that make your plan unique to your needs. And because your savings are so significant, you’ll have the option of sharing those savings with plan members through:

• Waived co-pays, deductibles and coinsurance Value based benefit design encourages members to save on out-of-pocket expenses associated with their procedure when they utilize high quality, cost-effective EDHC providers.
• Covered travel expenses for plan member and companion are included in the procedural cost and accounted for in cost savings projections.
• Additional cash benefit in the form of a pre-paid EDHC Reward Card™ helps to cover incidental expenses and incentivize the plan member for following post-surgery protocols in support of better outcomes.

Lastly, we provide a complete member information campaign, designed to inform your employees about the quality and savings available to them with EDHC and how to benefit from them. We make it easy for benefit managers to communicate with plan members, using a variety of employee education resources resources.