Last fall, the announcement that Walmart employees could go directly to top medical centers like the Mayo Clinic in Rochester, Minn., and Cleveland Clinic in Ohio for surgeries made national headlines and insurance industry leaders' heads turn. Cyndy Nayer, value-based design consultant, says she thinks more employers will begin to make similar agreements directly with hospitals and hospital groups, circumventing insurers in the process. "It's the first of many, and there will be more," she says of the Walmart contracts.

While insurers may be left in the dust with this model, the broker and consultant certainly should not be. "Now we're starting to see very cool broker maneuvers where they're finding the right [hospital] network locally and finding smaller companies to buy into that network," Nayer says.

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