Healthcare is Already Fixed
Thousands of employers are already using some or all of the strategies and programs below to provide better care for their employees while reducing health benefits spending by 20-40%.
How? By focusing on three major goals.
Reducing costs
Organizations that implement the benefit strategies below sustainably outperform the status quo.
Improving quality of care
Keep people healthier and safer. Things like no deductibles on major procedures and unlimited, free primary care.
Better experiences for all
Improve the experience and increase satisfaction for patients, caregivers, families, clinicians, and others.
The components of a high performing plan
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Value-Based Primary Care
Properly incentivized primary care is the front line defense against downstream costs.
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Care Navigation and Guidance
Healthcare is complex, employees need access to trusted, aligned resources to get them the highest quality care.
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Independent, Active Plan Admin & Oversight
We deeply optimize spend in every other area. Why not health benefits? Independent and ongoing oversight is critical.
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Transparent Open Networks
Cost and quality are often inversely correlated in healthcare. Focusing on outcomes and known prices is the path to lower costs.
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Referenced Based Pricing and Hospital Bill Auditing
Hospital charges are paid based on a reference point, usually Medicare, of actual cost. Audits of hospital bills are necessary to prevent errors and overpayments.
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Transparent Pharmacy Benefits
Purchasers need true transparency, the facts & data to control decision making.
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Major Specialties & Outlier Patients
Cardiometabolic, musculoskeletal, and cancer. Catch it early, avoid unnecessary procedures, and get to high-quality providers when needed.
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High-Performance Plan Design & Risk Management
The right foundation of plan design, incentives, documents, and risk management is critical.
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Transparent, Aligned Advisors
The benefits purchasing process should be transparent, based on disclosure, and aligned financial incentives.