In this third of a four-part video series, Signify Health senior vice president of Episodes of Care, François de Brantes, speaks with Managed Healthcare Executive about value-based care, the toxic incentives in healthcare, how the Direct Contracting Model differs from Medicare Advantage and more.
Below you'll find a brief excerpt from the transcript of our recent podcast interview with François de Brantes. They have edited for clarity and length.
Is the Direct Contracting Model similar to Medicare Advantage?
The mechanics are similar. The difference is that in Medicare Advantage, Medicare contracts with a Medicare managed care organization, and that Medicare managed care organization can continue to pay 100% of the care for the beneficiaries that enroll in the MA plan fee for service. The chassis of Medicare Advantage plans are a fee-for-service adjudication process.
Now, some of them are fairly innovative in the way that they create the reimbursements with the providers in their network. But a lot of them simply continue to pay a fee for service. So yes, it's like Medicare Advantage in the sense that you're pre-paying an entity a fixed amount for a beneficiary.
The difference is that you're now relying on a provider organization or, you know, some affiliate of a provider organization, to contract with providers, hopefully in a different way.
Optimize Your Healthcare Payments with Optum Financial
April 29th 2025Discover how Optum Financial is revolutionizing healthcare payments in our latest whitepaper. Learn how transitioning to electronic payments can reduce administrative costs, streamline claims processing and enhance security.
Read More
Conversations With Perry and Friends
April 14th 2025Perry Cohen, Pharm.D., a longtime member of the Managed Healthcare Executive editorial advisory board, is host of the Conversations with Perry and Friends podcast. His guest this episode is John Baackes, the former CEO of L.A. Care Health Plan.
Listen
Healthcare hasn't been a priority of the second Trump administration so far, panelists at the Asembia agreed. Medicaid may loom large, though, as the administration and congressional Republicans look for ways to slash government spending as a way of offsetting major tax cuts.
Read More
Breaking Down Health Plans, HSAs, AI With Paul Fronstin of EBRI
November 19th 2024Featured in this latest episode of Tuning In to the C-Suite podcast is Paul Fronstin, director of health benefits research at EBRI, who shed light on the evolving landscape of health benefits with editors of Managed Healthcare Executive.
Listen
What 5 Managed Care Trends Experts Say You’re Not Watching Closely Enough
April 29th 2025Managed Healthcare Executive asked several experts in healthcare and managed care to share the trends they think the industry is overlooking. From rising costs and data challenges to shifts in how care is delivered, these are the issues that could have a major impact — and deserve a closer look.
Read More