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Hint Health is rolling out a nationwide network to provide direct contracting between employers and primary care providers, bypassing traditional insurance in the PCP market.
Hint Connect is providing employers a single point of access to hundreds of independent primary care providers, the company said.
It also removes the challenge for DPC practices to find and access large employers.
For physicians in direct primary care, "the challenge is getting to an employer-based that's large enough," said company COO Mark Nolan.
Hint Connect is currently rolling out across Texas in major metro areas and the Rio Grande Valley. Over the next three months, Hint Connect will expand to Colorado, Arizona, Oklahoma and Florida and will soon go nationwide.
WHY THIS MATTERS
Physicians like the simplicity and ability to operate partially or fully outside of the insurance-based system while having someone else take care of the administrative burden, Hint said.
Physicians don't submit claims because care is not based on fee-for-service.
The HintOS platform automates enrollment, eligibility, invoicing, and payment. It offers direct-to-consumer membership management, Hint said.
Employers pay physicians a set monthly fee for each employee to receive primary care. The average cost is around $50 to $75 a month, according to Nolan.
Hint Health comprises 1,700-plus clinics, more than 5,700 employers and nearly a million lives. Its platform helps providers increase membership and saves money for employers, the company said.
THE LARGER TREND
Hint's model does not mirror how self-insured employers operate, Nolan said.
It is also not to be confused with Medicare's Global and Professional Direct Contracting Model, which is getting pushback from some Democratic leaders who fear the Trump-era program will lead to the privatization of Medicare.
The Centers for Medicare and Medicaid Services is soon expected to release revisions or a stop to that model.
Over 200 healthcare organizations have asked Health and Human Services Secretary Xavier Becerra to "fix, don't end" Medicare's direct contracting model, while more than 1,500 physicians have said it should not continue.
Both the CMS and Hint models are value-based rather than fee-for-service, but that's where the similarities end. Whatever CMS decides to do with its model will not affect Hint Connect, according to Nolan.
Hint, which was founded in 2013, predicts interest in direct contracting for PCP physicians will grow.
COVID-19 highlighted the value-based model, according to Nolan. While primary care and other physicians suffered a loss from fee-for-service revenue during the pandemic, DPC physicians continued to earn their monthly fee.
ON THE RECORD
"Primary care is not necessarily something that should be part of insurance," Nolan said.
Twitter: @SusanJMorse
Email the writer: SMorse@himss.org
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February 23, 2022 at 07:02PM
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