Resources

Everything we know about direct contracting.

Guides, research, and plain answers on how direct healthcare contracting actually works — written to be read by a person, not just a search engine.

Featured white paper

Unlocking Healthcare Value: A Collaborative Approach Between Providers and Purchasers

Our core research on how direct contracting changes the incentives between purchasers and providers — and what it takes to make it work in practice.

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Guides

Plain-language answers to the questions people actually ask.

Definitions

What is direct healthcare contracting?

The plain-language definition, plus how it plays out day to day between an employer and a provider.

Employers

How do self-funded employers build provider networks?

A walkthrough of selecting providers, sizing coverage, and launching a custom network.

Operations

What is provider network management?

What ongoing network management actually involves, and how it differs on a direct-contract platform.

Claims

What is healthcare reimbursement management?

How claims get matched to contract terms — and why that process is usually invisible to everyone but the payer.

Claims

What is claims repricing?

The mechanics of adjusting a billed charge to a contracted rate, and where it fits in the claims lifecycle.

Providers

How do providers set their own reimbursement rates?

What rate-setting looks like when a provider — not a carrier — controls the terms.

From the blog

Recent writing.

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Why administrative cost is the hidden line item in every health plan

A look at where the money actually goes between premium and care.

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What employers get wrong about "network adequacy"

Broad isn't the same as useful — how to think about network design for your actual population.

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A provider's guide to reading a direct-contract rate sheet

What to look for before agreeing to new terms with a purchaser.

Quick answers

A few frequent questions.

Coverage depends on participating providers in a given market — confirm current geographic availability with the OpenNetworks team.

Timelines depend on network size and provider availability in your market — your OpenNetworks contact can give a specific estimate for your organization.

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