This is probably an idea that is searching for an acronym.  It is certainly not new;  it is just being rediscovered by employers.  Once the employees elect and select an on-site physician, the question of referrals arises and someone wonders about being selective.  Some of the pioneers in the field, like QuadGrapihics, have been doing the math (and the contracting) for over a decade.  "Narrow Networking" or "Value-based contracting" has long been one of the central features of mature, employer-managed healthcare programs ensuring access, cost savings, and quality as employers contract with specific hospitals, specialists, and other providers (hand-picked because of their ability to work closely with the on-site clinic primary care component) to keep costs down and drive quality. 

 

But, how did Lowe's figure this out?  Well, they did the same thing that the number crunchers do for their on-site clinic bosses/clients.  They studied the data.   Lowe's recently announced that it has reached agreement with the Cleveland Clinic to be the primary provider for heart procedures for all Lowe's employees (employees will have a choice, but will have reduced out-of-pocket costs and travel expenses paid if they use the Cleveland Clinic).  In exchange for this funneling of volume, the Cleveland Clinic has agreed to reduce unnecessary procedure volume and drive up the stats on outcomes for the procedures that they do perform.