Direct-to-employer (D2E) contracting has moved from experiment to imperative. Self-insured employers are actively steering employees toward Centers of Excellence and bundled-price specialty care, and the health systems that show up in those networks are the ones capturing that volume. The ones who don’t are watching it go elsewhere.
That’s the opportunity behind Tendo’s new partnership with Transcarent, the agentic AI-powered health and care platform supporting 21 million members across more than 1,700 employers and health plans.
What is direct-to-employer contracting?
Direct-to-employer contracting is when a health system or provider group negotiates bundled, pre-set prices directly with a self-insured employer or its navigation partner, bypassing the traditional insurance network. Employers use these arrangements — often through Centers of Excellence programs — to steer employees toward high-quality, predictably priced care for planned procedures like joint replacement, spine surgery, or bariatric surgery.
What the Tendo-Transcarent partnership includes
Through this partnership, Tendo’s direct-contracted provider network and Marketplace technology now extend Transcarent’s Centers of Excellence program to more than 2,900 sites nationwide. That includes 145 additional metro and micropolitan areas, plus new clinical categories such as colonoscopy and maternity care.
In practice, providers and health systems in Tendo’s network are now positioned in front of one of the largest D2E populations in the country — without negotiating, onboarding, or managing that relationship themselves. Tendo does that work: curating the network, validating quality, and routing the right member to the right site of care. As Tendo CEO Jennifer Goldsmith said in the announcement, the goal is to make it easier for people to find care suited to their needs while helping employers show measurable value from their benefits strategy.
Three things that matter for your D2E strategy
Reach without the one-by-one sales cycle. Getting in front of a large, well-managed employer population usually means building direct relationships one purchaser at a time. Tendo’s Marketplace gives providers a single connection point into Transcarent’s employer base — 1,700+ employers and health plans, 21 million members — instead of 1,700 separate negotiations.
A quality signal built into the routing. Transcarent’s Centers of Excellence model starts with clinical review to confirm a procedure is necessary before a member is routed to a site of care. The volume flowing through this network is pre-qualified and less likely to churn — a different profile than open referral traffic.
Data that supports your own quality story. Tendo Insights turns claims and clinical data into risk-adjusted quality measures and peer benchmarking — the same kind of data that feeds public quality scores like CMS Stars and U.S. News & World Report. Providers already in Tendo’s network have a stronger, more current way to demonstrate the outcomes that D2E purchasers increasingly ask to see.
Appropriateness, not just access
It’s worth noting what this partnership actually optimizes for. Transcarent’s model doesn’t simply route more people to more sites — it starts by asking whether surgery is necessary at all, then directs patients between complex Centers of Excellence and high-quality, closer-to-home care for routine procedures. Transcarent reports average savings of $17,943 per surgical episode through this approach.
For health systems confident in their outcomes but still working to get in front of employer-directed volume, that’s the part worth paying attention to: a model that rewards demonstrated quality and appropriateness over raw network size.
