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Northwell Health selects Northwell Direct's provider network for employee benefit plan

The move, the health system says, is intended to control costs without compromising access to care.

Jeff Lagasse, Editor

Photo: John Fedele/Getty Images

Northwell Health has selected Northwell Direct to supply the provider network for the health system's 2022 healthcare benefits for about 75,000 employees and dependents, eschewing the traditional approach of teaming with a private insurer.

Northwell Direct, Northwell Health's affiliated, direct-to-employer company, is a for-profit entity that delivers solutions for a variety of businesses. This marks the first time the state's largest private employer has chosen direct network contracting, a health benefits approach that enables businesses to offer their workforce access to care without engaging with a traditional insurance company.

The move, said Northwell Health, is intended to control costs without compromising access to care by tapping into Northwell Direct's selective network, which was constructed specifically to meet the needs of employers with employees and dependents in the tristate area.

Northwell Direct will also make care management programs available to plan participants. Such programs can navigate participants through their healthcare needs, potentially helping to prevent gaps in care in order to avoid potentially dangerous and expensive exacerbations, the system said.

WHAT'S THE IMPACT?

Since Northwell Direct launched in 2020, it has provided a number of healthcare programs and services to large national and regional employers. It works with JetBlue Airways to provide a comprehensive set of COVID-19 solutions for the airline's local workforce, and with Whole Foods Market, providing team members in the tristate area a primary care network that delivers holistic and lifestyle-based care. 

Other off-the-shelf and customizable services provided by the company include on-site and near-site health clinics, clinical concierge services, occupational health and workforce safety solutions, and a range of other options.

Its provider network comprises nearly 20,000 physicians in the New York metropolitan area, including ones in Long Island, Queens, Staten Island, Brooklyn, the Bronx, Manhattan, New Jersey and Westchester. 

Northwell Health has chosen Brighton Health Plan Solutions as its third-party administrator to handle the processing of claims and customer service for its employee health plan. A wraparound network is available for employees or dependents who need to access care out of state, which may be important for a family member attending college outside New York and New Jersey, for instance.

THE LARGER TREND

Northwell Health was at the epicenter of the pandemic in New York State. It cared for 200,000 COVID-19 patients over a 15-month period ending in August. At the height of its inpatient care for COVID-19 patients, in April 2020, Northwell had 3,500 patients in the hospital on a daily basis, according to CEO Michael Dowling

From March 11 to June 1, 2020, 4,516 probable COVID-19-associated deaths were known to have occurred among New York City residents, according to the Centers for Disease Control and Prevention.
 

Twitter: @JELagasse
Email the writer: jeff.lagasse@himssmedia.com