Health Plans
A clear path to greater control, savings and member experiences
From new government regulations to overpayments and member experience, health plans are tackling multiple challenges at any given time—and it’s costing them billions. That’s why it’s crucial for plans to curb costs—especially wasteful spending, which accounts for over 20% of total healthcare spend.
Solutions For Health Plans
Designed to address the growing needs—and costs—of health plans and their members.
We’re sharing the industry secrets other vendors won’t. With the goal of creating lasting systemic change and lowering healthcare costs for payers, we go beyond the standard claim review process. We’ll help you identify the root causes of errors to impact true fixes at the source.
- Payment Integrity Consulting
- Audit & Recovery
- Audit Management Technology
SaaS technology and Filing Services that streamline regulatory filing processes for all lines of business. SaaS technology powers the entire regulatory filing workflow through submission.
Our team, of pharmacy experts deliver a unique suite of services helping your health plan leverage your existing PBM contract to grow your ASO business, lower risk and eliminate Rx carve-outs.
Leverage manufacturer copay assistance programs, on Rx and Medical benefit, to help lower drug costs for the health plan and the patient.
A frequently overlooked area that can deliver savings for drugs on the medical benefit. We identify, secure and manage the medical rebates you’re owed.
Regardless of the type of health coverage you offer, people face cost barriers to care. Our guides help members quickly determine eligibility for hospital financial assistance, review bills for accuracy and negotiate lower out-of-pocket costs.
We’re raising the bar for benefits in the workplace. We’re freeing employers and their people from unaffordable healthcare—delivering refreshing experiences and rewarding self-funded plans at a lower cost.
- Targeted savings solutions for Rx & specialty medications
- Dozens of ways for employees to save on healthcare
- Enhanced member benefits & experience
- Average 25% less cost than comparable plans
- Dedicated benefits experts/health advocates
- Streamlined access to financial assistance
With aggressive and innovative PBM contracts and targeted specialty savings solutions we help lower employer Rx spend up to 30%.
- Robust network of strong PBM contracts
- Unlocks negotiating power for groups of all sizes
- Pharmacy savings analysis
- Streamlined RFP process
- We negotiate and define Rx contract terms on your behalf
Best-in-class pharmacy benefit resources, clinical insights and savings through specialized Rx services that deliver the lowest possible pharmacy prices year after year.
- PBM Procurement
- Market Support
- Medical Rebates
- Injectables
- Pharmacy Data & Analytics
- Trend & Clinical Management
- PBM Pharmacy Audits
- Medical Variable Copay
We lower employer benefit spend by making it simple to save. Our one-stop-shop for seamless, human-to-human benefit-cost navigation helps groups and their people:
- Understand their benefits
- Choose high-quality, lower-cost treatment
- Reduce prescription costs
- Resolve billing issues
- Lower high-cost bills
- Easily access hospital financial assistance
While employers look to you for counsel on their benefits—look to us to cut through the noise.
We build, customize and deliver broker solutions that lower health and Rx costs, elevate employee and employer experiences—and keep your clients coming back year after year.
And we’ll take care of all the heavy lifting for you.
Featured
we’re building a better health plan
We’re raising the bar for benefits in the workplace. We’re freeing employers and their people from unaffordable healthcare—delivering refreshing experiences and rewarding self-funded plans at a lower cost.
Let’s Reinvent Healthcare, Together
We help health plans grow their business, while keeping member care, costs and experience at the center. We’re proving that industry stakeholders can do well while doing good at the same time.
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Understanding your needsWe start by understanding your unique challenges
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Customized Strategy DevelopmentOur team recommends tailored solutions that address your specific goals
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Seamless IntegrationWe work closely with you & your team to ensure smooth implementation
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Ongoing CollaborationAs your partner, we maintain regular communication and provide timely updates and insights, ensuring we continue to align with your evolving needs
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Performance Tracking & OptimizationWe monitor, measure and analyze the impact of our solutions - while keeping an eye on the market for new innovations that deliver the best possible results to your members
Let’s talk.
It’s time to maximize your team’s potential, lower costs and elevate your member experience.
Break up with the status quo
We’re igniting real change. From building and accelerating revolutionary healthcare businesses to delivering transformative tech and services to our clients, we’re raising the bar of what healthcare can be.
Ready to join us?
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