Why Healthcare's Future is Direct | amNewYork

"For decades, the standard response to rising costs has been to shift costs to workers by raising deductibles, raising premiums, cutting services or shrinking access. The primary payers of American healthcare, employers and workers, now face a staggering $18,500 per employee cost. As a result, the traditional commercial insurance model, defined by murkiness and overreliance on third-party intermediaries, is no longer just inefficient. It is broken."

"But there are solutions starting to emerge from a new kind of market-driven approach that keep quality at the center. They are solutions that prioritize cost efficiency over cost shifting, transparency over complexity, directness over bureaucracy. The goal of the system should be high quality and good access. But too often the friction that exists between healthcare financing and delivery gets in the way."

"This pressure is creating a new opportunity: a shift toward direct contracting. The solution is simple. Those who pay for care (employers and union health funds) deal directly with those who provide it (health systems). There is a living case study for this model here in the New York metro area. In a historic move, the 32BJ Health Fund, representing 100,000 building service workers locally, and Northwell Direct have implemented a direct-to-purchaser solution that bypasses the traditional insurance model."

"The model is now fully operational for 32BJ members, giving members expanded access to an extensive network of 39,000 providers at lower cost, including thousands of Northwell Health providers available at a $0 copay. The result is that the 32BJ Health Fund expects to save $46 million (20%) in the first year alone. It is a total reimagining of how health"

American healthcare is lifesaving yet increasingly unaffordable for many people. Rising costs have often been handled by shifting expenses to workers through higher deductibles and premiums, reduced services, and limited access. Employers and workers now face about $18,500 per employee in healthcare costs. The commercial insurance model relies heavily on third-party intermediaries and has become inefficient and unsustainable. A market-driven alternative emphasizes cost efficiency, transparency, and direct contracting. In this approach, payers such as employers and union health funds contract directly with health systems. A New York metro example pairs the 32BJ Health Fund with Northwell Direct, bypassing traditional insurance. The program expands provider access to 39,000 providers, includes thousands of Northwell providers with a $0 copay, and is expected to save $46 million, or 20%, in the first year.

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