Self-Funded

Why Self-Funded Employers Are Abandoning National Networks


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"If we can do it for Whole Foods, which is a very large organization, why can't we do this for other employers?"


Is the era of relying on national, opaque "BUCA" networks finally coming to an end?


My guests this week are Blake Allison, CEO of Employers Health Network (EHN), and Philip Eaves, from Ascension. Together, they break down the exact blueprint they used to build a direct-to-employer, high-performance network for Whole Foods - and how they are scaling that exact same model for self-funded employers across the country.


In this episode, we explore the hospital system's perspective on direct contracting. Phil explains why massive health systems like Ascension are eager to bypass traditional carriers to work directly with employers, citing faster payments, zero collection risk, and the ability to proactively manage patient care. 


We also discuss how to successfully integrate Direct Primary Care (DPC) into a localized network, the lessons commercial plans must learn from Medicare Accountable Care Organizations (ACOs), and why the future of healthcare relies on "re-localizing" how we buy medical services.


If you are an employer, benefits consultant, or healthcare provider who is fed up with the transactional, nickel-and-dime nature of traditional insurance carriers, this conversation proves that a better, more collaborative model already exists.


Thank you to our 2026 sponsors!


ParetoHealth: ParetoHealth empowers midsize employers with a long-term solution to reduce volatility and lower overall health benefits costs. Visit https://www.paretohealth.com/fully-insured-vs-self-funding-with-paretohealth-spencer-podcast/?utm_source=youtube&utm_medium=referral&utm_campaign=SelfFundedwSpencer to learn more.


Samaritan Fund: A program that connects those who need help to the support they need. We are proud to offer the Samaritan Fund Program. Visit SamaritanFundProgram.com to learn more.


Vālenz Health: We're Vālenz Health, your partner in improving health literacy, reducing plan spend, and delivering high-value healthcare. Visit ValenzHealth.com to learn more.

Imagine360: Imagine360 helps self-funded employers save on healthcare with smarter health plans. Cut expenses by 20-30% with custom solutions. Contact us today at Imagine360.com.



Chapters:


(00:00:00) Intro: Whole Foods and the Move Away from BUCAs  

(00:07:29) The Whole Foods Case Study: Building a Direct Network 

(00:12:15) Why Health Systems Want Direct Employer Contracts 

(00:17:15) The Evolution from RBP to High-Performance Networks 

(00:19:21) Integrating Direct Primary Care and Care Management 

(00:23:41) The Challenges of Scaling Direct Contracts Nationally 

(00:28:15) Re-Localizing Healthcare: Buying Care in Your Community 

(00:33:36) Overcoming the Negative Stigma of "Networks" 

(00:36:55) Applying Medicare ACO Lessons to Commercial Populations 

(00:42:31) Defining True Value-Based Care and Downside Risk 

(00:45:51) The Ideal Employer Profile for Direct Contracting 

(00:50:52) Lowering Costs with Local, Community-Based Care 

(01:05:17) Future Predictions: Site Neutrality and Price Transparency 

(01:11:25) Closing Thoughts: Providers Are Open for Business




Key Links for Social:


@SelfFunded on YouTube for video versions of the podcast and much more - https://www.youtube.com/@SelfFunded


Listen/watch on Spotify - https://open.spotify.com/show/1TjmrMrkIj0qSmlwAIevKA?si=068a389925474f02


Listen on Apple Podcasts - https://podcasts.apple.com/us/podcast/self-funded-with-spencer/id1566182286


Follow Spencer on LinkedIn - https://www.linkedin.com/in/spencer-smith-self-funded/


Follow Spencer on Instagram - https://www.instagram.com/selffundedwithspencer/

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Self-FundedBy Spencer Smith

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