Trending in 2020: Direct Contracting Demands Direct Employee Communications

A direct contracting approach to health care can change a lot for your employees: which doctors they can see, how they’re billed, where they get prescriptions filled, and more. They’ll be worried about costs, limitations in care, and the amount of effort involved.

If you’re rolling out changes that could impact your entire employee population, you should have a plan for how (and what, and when) you’re going to communicate.


According to the National Business Group on Health, the share of large employers contracting directly with health systems and providers in local markets will reach 10% in 2020, and another 21% are considering it in the next two years.


Dave Chase is founder of the growing Health Rosetta health care model, built on value-based direct care. In his book, The CEO’s Guide to Restoring the American Dream, he says, “The need for frequent, clear communication with employees and dependents can’t be overemphasized.”

Focus on the Positive, Tell the Truth, Bust the Myths

You can head off some of their uncertainty with a consistency and four general messages. The plan might look something like this, but every situation is unique.

  • 4 months out. Tell them why you’re making the change, and be honest. Something like: The U.S. health care system is unnecessarily complicated and secretive about costs. There’s a better way to do health care, with better care and lower costs.
  • 3 months out. Tell them what you’re changing, and address common fears with direct contracting (quality and availability of care, catastrophic costs, limited prescriptions, etc.)
  • 6 weeks out. Address their concerns with some myth-busting. By now you’ve heard rumblings of employee fears, so you know what to address. Let them know you understand and bust the myths one by one.
  • 2 weeks out. Tell them how the new plan works. This is the nitty gritty — where they can go for care, how they should pay, who to call for help, the new ID card, and more.

It’s More Than Emails with Bullet Points

To effectively get the messages out, you need to reach your employees in different settings. Face to face in meetings, postcards at home, posters in the office (even in bathroom stalls!), your intranet, and yes…carefully crafted emails.

As HR communicators, we beat a loud drum about using simple words and no geek-speak. Explain the new plan like you’re talking to your Aunt Betty…or your neighbor. Albert Einstein said it best: If you can’t explain it simply, you don’t understand it well enough.

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