Catalyst for Payment Reform

Michelle Zettergren on direct contracting, COEs, and employer compliance with new ERISA regulations

Michelle Zettergren on direct contracting, COEs, and employer compliance with new ERISA regulations

Suzanne Delbanco speaks with Michelle Zettergren, President of Labor and Public Sector markets and Chief Sales and Marketing Officer for Brighton Health Plan Solutions, a health enablement company that serves as third-party administrator to self-funded employers and other health care purchasers. Michelle heads marketing, customer retention, and business intelligence units for the company, bringing over 30 years in the health insurance industry.

Michelle Zettergren explores the barriers and benefits of employers contracting directly with a health system, and why she’s seen direct contracting solutions earn high Net Promoter Scores among enrollees. Michelle also points to Centers of Excellence for high-cost procedures, like total joint replacement surgeries, as a proven way for employers to contain health care costs and secure high-quality care. Finally, Michelle shares what Brighton Health Plan Solutions is doing to help employer clients prepare for new ERISA regulations set to take effect in 2022 and 2023.

Featured quote: 

“What’s great about [direct contracting] relationships is they allow for an employer to work directly with a health system in developing a solution that’s specific to their employee base. They can design programs that address their specific needs, such as addressing diabetes issues within their employee population or behavioral health. In return, the health system expects employers to develop benefit plans and contribution strategies that steer their employees to that health system…

…Among employers, we’ve seen some hesitancy to commit to one health system, but what we find is most employees struggle with navigating the traditional health system, and many don’t have an established relationship with a primary care physician, so they like the level of assistance associated with these integrated models and most prefer them.”

–Michelle Zettergren, Brighton Health Plan Solutions.

Want to learn more about direct contracting? Visit CPR’s Direct Contracting Get Started Brief today!

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