While PPO networks remain a core part of how self-funded employers provide access to care, a growing share of MedBen clients have added direct-to-employer contracting and other alternative reimbursement strategies — 42% of clients in 2025, up from just 17% in 2018. The same trend is showing up nationally: a recent Pulse of the Purchaser survey found employers with direct contracts rose from 18.7% in 2023 to 27.6% in 2025.
Under a direct contract, MedBen negotiates and locks in rates with local providers. The arrangement provides:
- Members with access to high-quality local care at fixed copays, without deductibles, coinsurance or balance billing for covered services from contracted providers.
- Employers with predictable pricing established in advance.
- Providers with opportunities for greater patient volume, without having to collect deductibles and coinsurance.
MedBen tailors these arrangements to the workforce. A PPO wrap can extend network access for employees who travel or live outside the contracted area, while reference-based pricing and fair market pricing wraps offer additional reimbursement options. Or where employees are concentrated in several markets, MedBen can establish direct contracts with multiple health systems.
Across MedBen clients using alternative reimbursement strategies, claim costs averaged 17.3% lower in 2025 than those of clients using a PPO alone. For information about direct contracting and how it works — alone or combined — for your plan, contact your broker or MedBen Marketing.