Companies bypass middleman with direct health care plans. (Houston companies) (includes related article)

In an effort to take back control of its rising health care costs, Houston Lighting & Power Co. decided to cut out the middleman and in January established a permanent program to contract directly with health care providers.

The idea of customizing a health care provider network for its employees is what appealed to HL&P, says Robert Conte, M.D., HL&P's medical director.

"We like to think of ourselves as being the hub of the wheel, with control over each spoke,' Conte says. "We started from ground zero and considered quality, geographic aspects and cost. Basically, we decided to handle health care benefits like we do other parts of our business."

A handful of Houston companies are contracting directly with physician groups, hospitals and others health care professionals, opting to bypass for-profit health maintenance organizations and other managed care plans. Employers negotiate directly with health care providers, structure their own programs and enlist a third-party administrator to process claims.

Companies less enthusiastic about direct contracting say there are benefits to having …