Your Health Plan Optimization Specialist

What is DirectCare?

Joining Forces for Employee Health Benefits at a Better Cost

DirectCare is a health plan optimization and risk management company. Serving clients as partners in strategy, innovation, and growth focused on optimizing employer provided health benefits. DirectCare shortens the path to success by leveraging high value relationships and industry expertise to expand the team, capabilities and reach of healthcare organizations from start-up to public companies.

DirectCARE allows employer sponsored health plans to purchase health care services directly from providers. We cut out the middle-man and save the employers 20% to 60% off their health care spend.


We communicate directly to the health providers with fair and reasonable pricing and direct contracts. This is a Major Medial health plan with the medical and pharmacy coverage you expect.


DirectCARE is dedicated to helping members navigate their health care experience. Health plan enrollees never have to question their coverage. 


We Provide

Care Navigation Multi-lingual

Technology and Telephone access to a Care Concierge to answer any questions and provide support including:


Finding a Provider- Confirm network status of providers and coordinate scheduling and transportation.

On-Demand Provider Network- See one  
of 900,000+ contracted providers OR... let us create an on-demand contract for the personal care you seek.


Quality Physician Referrals- Receive primary care and specialist recommendations based on patients needs. Confirm availability,  appointments and acceptance of payment.


Support Direct Contract Options-  Maximize the utilization of the high quality, high value providers.


Verify Benefits and Coverage- Explains and resolves billing issues, denials and balance bills


Out-of-Pocket Assistance Program- Receive member discounts and payment plans for Out of Pocket expenses.

Incentive Management Program 

• Saves money and increases member satisfaction by supporting Center of Value utilization

• Reduces employer’s medical spending by 6% - 12%; Employees save 40% on Out of Pocket; 15%-80% per Episode

• The only program that supports network optimization, direct contracts and variable incentives

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Proactive Population Health Program 

• Identifies avoidable spending –ER, Branded Rx, High Cost Providers

• Improves Rx Compliance and Reduces Population Health Risk

• Monitors Screening compliance and identifies gaps in care

• Offers a proactive outreach program



DirectCARE specializes in Health Plan Optimization & Population Risk Management.  Leveraging advanced analytics and insider expertise we aim to maximize transparency, outcomes, savings, member engagement and patient experience.  

We will engage with vendors, providers, and consultants to help navigate the increasingly complex worlds of healthcare, employee benefits, and finance. 

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Who do we help?

TPAs, Health Plans, & Networks

Hospitals, Providers & ACOs

Employers, Unions, Municipalities

Technology Companies (Fintech / Insuretech)

Patients, Members & Employees

Insurance Advisors, Brokers, & Consultants

We are here to assist

1-800-853-2614 |

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