The Nexus Connection
Episode 25: Why/When/Will Stop Loss Carriers Finally Care About Direct Pay and High-Performance Networks
Stop loss carriers do not buy buzzwords. They buy proof. This episode shows how a direct pay strategy and high-performance network data can actually improve plan design, reduce unnecessary claims, and create a credible case for savings. The Nexus Connection Host, Brian Garcia talks with Kevin Murphy of Direct Pay Designs and Scott Smith of Logro Network about what makes a provider truly high performing, how care navigation changes member behavior, and why employers and underwriters need real evidence — not just marketing claims. If you work in self-funded or level-funded plans, brokerage, or stop loss underwriting, this conversation breaks down how direct primary care, bundled surgeries, cash-pay options, and provider quality scoring can work together to lower cost without lowering quality. You’ll learn: Why direct pay is becoming the “front door” of healthcare How provider quality data helps identify better care options Why this is not reference-based pricing How better steerage can lead to major savings opportunities What underwriters actually want to see before approving decrements A practical, data-driven look at the future of healthcare navigation, plan design, and stop loss strategy. #DirectPayDesigns #LogroNetwork #StopLoss #directpay #directprimarycare #SelfFundedBenefits #Levelfunded #HealthPlanInnovation
