Direct Pay Designs is a modular healthcare solution that combines cash-pay care models with traditional insurance strategies to reduce costs and improve access to care. Brokers can start with one component and expand over time.

Traditional plans rely heavily on insurance networks and fee-for-service pricing. Direct Pay Designs uses direct contracting, virtual care, and transparent pricing to lower costs and simplify the member experience.

Best-fit groups typically:

- Are self-funded or open to alternative funding models

- Have 25+ employees

- Are experiencing rising healthcare costs

- Are open to innovation at renewal

Many groups see ~20–30% savings, depending on plan design, utilization, and implementation. Savings vary by group.

Yes, depending on the structure.

- CareCore can operate alongside existing plans

- CareFlex wraps around insurance

- CareComplete combines direct care + insurance into one integrated solution

Members access care through our care navigation team

Care navigation helps guide members to the right care at the right time, reducing unnecessary ER visits and improving outcomes.

Most groups can go live in 30–60 days, depending on complexity and plan structure.

Brokers receive:

- Plan design support

- Sales enablement materials

- Implementation guidance

- Ongoing strategy support

No — the model is designed to be simple and modular, making it easier to explain than traditional complex plans.

Yes, that’s a core feature.

You can start with one component (e.g., CareCore) and add additional solutions over time.

Insurance is still used for:

- Catastrophic coverage

- Stop-loss protection

- Larger claims

Direct Pay Designs helps reduce reliance on insurance for everyday care.

We handle:

- Vendor coordination

- Implementation

- Rollout strategy

- Claims optimization

So brokers and employers don’t have to manage multiple moving parts.

Start with a 20-minute broker intro to:

- Review your book of business

- Identify best-fit groups

- Map a simple rollout strategy