If you are managing a self-funded plan, know that 55% of physicians are health system employees.

The goal of the health system, like any business is to provide all services inside the castle walls. I don't blame them. I'd do the same thing.

What employers call shopping, they call leakage. They work hard at minimizing leakage. Essentially building a moat. If your employees choose a doctor inside the walls, and there's a 55% chance they will, they will most likely get that MRI or surgery inside the system at a significantly higher cost than an independent provider.

Your strategy must include an understanding of that reality.

RBP or direct contracting are good strategies given that reality. You might also consider DPC. DPC's all operate on the other side of the drawbridge.