Controlling claim costs begins with selecting the right Third-Party Administrator, Pharmacy Benefit Manager and Stop-Loss policy provisions. Then plan design, network access and eligibility requirements should be carefully considered along with proper fiduciary/legal document review.

After a good foundation is laid, we focus on cost-drivers:

  • Care coordination
  • Wellness programs
  • Direct primary care
  • Reference based pricing
  • Renal repricing
  • Imaging networks
  • Telemedicine
  • Transparency tools and reward programs
  • Bundled surgical pricing
  • Specialty Rx management
  • Biometric screenings / gaps in care analytics