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Catilize Health is the standalone professional benefit administrator of the Medical Expense Reimbursement Plan aka SIHRA or Spousal MERP. Employers and employees benefit because SIHRA reduces financial inequity, dramatically lowers risk and measurably increases the bottom line. Catilize Health delivers niched benefits administration with a massively transformative purpose which enables Employer Plan Sponsors to effectively level the playing field of economic disparity so prevalent in today’s health plan designs.
EquityHealth helps Employers and Employees understand ALL their options for pursuing high-value healthcare services and driving out waste, overtreatment, overspending, avoidable risk, and all forms of surprise medical bills. EquityHealth then removes impediments to pursuing their self-interests. EquityHealth believes Value = Quality/Cost x Appropriateness.
1. A healthcare supply chain audit of claims at the Employer level to understand where every dollar has gone.
2. A smart-phone deployed Transparent Medical Marketplace where Employees can see available Costs and Employers can steer high-value choices.
3. Smart-phone deployed Employee Education and Empowerment tools that provide just in time steerage to help Employees and their families understand the system and how to make it work for them.
finHealth seeks to be your trusted advisor in safeguarding your healthcare dollars. Whether you are a self-insured plan that bears the ultimate cost of healthcare expenditures, a large medical provider/third party administrator who wants to bill customers with full integrity, or a health system that is embracing a role as an accountable care organization, finHealth stands ready to support you with world class solutions and expertise. We look to achieve this lofty goal through education, benchmarking, data transparency and proprietary algorithms.
EmpiRx Health is the industry’s only value-based PBM. We take a clinical-first approach to improving health outcomes while delivering deep and sustainable savings for our client s. And we do it in a high-touch, people-focused way like no one else can.
PRECISION, PERFORMANCE, DELIVERED.
At EmpiRx Health, we measure performance based on value, not volume. And to us, value is a combination of financial, clinical and service performance.
•. We’re the only PBM with a pay-for-performance model. If we don’t meet our savings guarantee, we pay the difference, dollar-fo r-dollar.
• The industry’s only Rx-driven population health solution with a client-tailored clinical strategy that lowers costs and improves health.
• Our pharmacists are an extension of the patient’s care team, partnering with physicians to drive clinically appropriate solutions.
• We deliver a white-glove service experience to clients and members, a concierge-level amenity that sets us apart.
Texas Medical Management is a Free Market Medicine solution in Texas for surgical procedures, which offers competitive, transparent prices on surgical procedures across a broad range of specialties, both outpatient and inpatient. Texas Medical Management’s mission is to deliver the highest quality care at transparent, competitive prices.
MedEncentive is a mobile-enabled healthcare cost containment service (SaaS). Our customers are governments, self-insured employers, managed care plans, Medicare, Medicaid, health systems that offer health coverage, and any organization that underwrites health insurance. What we do is control healthcare costs and generate a proven return on investment for our customers. In fact, we can now offer an unprecedented financial guarantee of a ROI to all types of health plans – private or public – in any health delivery system.
To prove our program’s effectiveness, we are committed to subjecting it to the rigors of publicly conducted studies that can be scrutinized universally against the highest standards of validity. How we control costs is with a web-based patented process that offers customer-sponsored financial rewards to both doctors and patients with each office visit (or rewardable event) for accessing MedEncentive’s website to hold each other accountable for incorporating something called information therapy. The process motivates adherence to best clinical practices and healthy behaviors by creating important checks and balances between doctors and patients, called mutual accountability. The MedEncentive program is easy to implement and maintain, loved by patients, and effective with even relatively low physician participation.
Cecelia Health positively transforms the lives of people living with diabetes and other chronic diseases. Their technology-enabled personalized coaching solution optimizes patient health outcomes at high ROI for their customers and healthcare partners via a tailored mix of expert clinician and digital health interactions. With over one million remote patient interactions, Cecelia Health has been a pioneer in delivering telehealth and chronic disease management solutions.
Quantum Health is an award-winning consumer healthcare navigation company that delivers an unparalleled consumer experience based on empathy and trust, enabling employers to achieve industry-leading satisfaction rates and independently validated claim savings. Launched in 1999, Quantum Health’s model is based on years of consumer research and the insights learned from guiding millions of consumers and their providers through their healthcare journey.
As doctors who spend each day speaking with patients experiencing pain, we know the effects that living with pain can cause. Research has shown that many would benefit from a form of physical therapy, but too many either:
– Can’t leave work for regular visits to a clinic
– Find the high cost of multiple co-pays prohibitive
– Are limited by their insurance plan
We knew there had to be a better way—a convenient alternative that is designed around individual needs, guided by orthopaedic principles and best practices, and highly affordable. When we couldn’t find a service that met these needs, we created one.
SimpleTherapy now offers video-based, head-to-toe exercise therapy programs that target the joint, muscle, tendon, and/or ligament that are causing you distress. We listen to what you tell us about your pain and suggest a customized exercise therapy program drawn from the hundreds of videos available in our library. We activate each of your subsequent custom sessions based upon your own feedback. Our video exercise therapy is designed so that it fits your life — on your own time, in the comfort of your own home, or anywhere you’d like.
We also understand that our product is not for everyone. SimpleTherapy does not provide medical advice, diagnosis or treatment. SimpleTherapy is not a replacement for a physical therapist or a doctor. We want the best for you, so please send us an email if you have any questions or concerns. We are committed to providing you with the highest quality exercise therapy and helping you on your journey for better health.
Arche Healthcare is the leading population health management (PHM) provider for diabetic foot health. Our state-of-the art, patient-centered diagnostic and engagement tools, combined with a standardized risk stratification process, allow for timely interventions that reduce diabetes-related lower extremity wounds and amputations by up to 50%.
Arche Healthcare’s PHM strategy, together with its programs and tools, are trusted by leading clinicians and informed by the latest evidence-based research on diabetic foot health and validated by the Care Innovations™ Validation Institute. As the creator of the Comprehensive Diabetic Foot Exam (CDFE), we partner with forward-thinking health plans, national health retailers, retail pharmacy, healthcare providers, skilled nursing facilities, and other healthcare organizations across the country to address a costly and debilitating healthcare event.
Wiser employees make healthier decisions. Quizzify’s mission is to create health-literate employees. Many workplace wellness programs employ misguided health challenges, ineffective health risk assessments, and expose private health information which may harm, rather than benefit, employees.
Quizzify creates a health-literate workforce through entertaining, trivia-style quizzes which educate employees about health and healthcare. Monthly quizzes are made available to employees through a simple admin dashboard. Employees take the quizzes, earn points, gain knowledge, and begin to make healthier decisions almost immediately.
Sword Health is the world’s fastest growing virtual musculoskeletal (MSK) care provider, on a mission to free two billion people from chronic and post-surgical pain. The company’s clinical-grade virtual therapy platform pairs expert physical therapists with FDA-listed wearable technology to deliver a personalized treatment plan that is more effective, easier and less expensive than traditional physical therapy. Sword Health believes in the power of people to recover at home, without resorting to imaging, surgeries or opioids. Since launching in 2015, Sword Health has worked with insurers, health systems and employers in the U.S, Europe and Australia to make quality physical therapy more accessible to everyone.
UberDoc gives consumers access to physicians via an online platform. UberDoc makes it easy for people to get care by offering priority in-person or telehealth appointments by not requiring referrals, and by having a flat rate price for visits. UberDoc physicians offer primary and specialty care, such as dermatology, pain management, and vascular surgery. See table for complete list.
Founded in 2000, Allergychoices, Inc. started as the nation’s first dedicated education, advocacy, and networking resource for patients and providers who were interested in treating the cause of allergic disease using sublingual immunotherapy.
Today, we are a leading healthcare services company that is disrupting the status quo in allergy care:
· Helping providers offer more patients the option to modify their allergic disease instead of managing symptoms.
· Connecting allergy sufferers to options to treat the cause of allergic diseases safely, effectively, and affordably.
· Partnering with employer groups to identify and address allergy-related health by driving down costs and improving productivity, outcomes, and quality of life in their workforce.
We do this through services and expertise based on the fact that no two patients are alike, and their treatment should reflect this.
Using the La Crosse Method™ Practice Protocol, developed by our founder, Dr. David Morris (1929-2017), and his physician partners at Allergy Associates of La Crosse in Wisconsin, thousands of providers across the U.S. have helped more than a quarter million allergy sufferers take the next steps to live healthier, happier lives.
Internationally recognized as a pioneer in sublingual immunotherapy, Dr. Morris began publishing papers in medical literature on sublingual immunotherapy in 1969.
In 2018, outcomes from the Protocol received validation by population health scientists and biostatisticians at the Validation Institute.
Tria Health develops and maintains a partnership of trust with patients and their health care providers. Tria Health delivers a telehealth solution that is patient-centered, pharmacist-led and technology-enabled. Tria’s chronic condition management program provides telephonic patient consultations and achieves optimal health outcomes and improved financial outcomes.
Vera Whole Health is at the vanguard of a health revolution and a national leader in advanced primary care. Vera Whole Health\\’s model is uniquely designed to help people achieve optimum social, psychological, and physical well-being — an outcome that’s neither probable nor affordable within the current sick-care system.
The Leapfrog Group is a nonprofit watchdog organization that serves as a voice for health care purchasers, using their collective influence to foster positive change in U.S. health care. Leapfrog is the nation’s premier advocate of hospital transparency—collecting, analyzing and disseminating hospital data to inform value-based purchasing.
AIMM builds medical management programs to the unique specifications of each individual group. By understanding the client’s culture, population, goals, objectives, and budget, AIMM formulates a medical management strategy that is the best possible fit for them, and will generate the results they need to achieve. Tweaking and modifying the program as services progress ensures optimal success. All AIMM services are centered on the concepts of being patient-centric, comprehensive, holistic, and fully integrated. AIMM understands that the most effective, most well received, medical management programs are “Patient Centric”. Therefore, AIMM\\’s programs focus on identification of patients who could benefit from the individualized attention and assistance of a professional Nurse in controlling their health condition(s).
U.S. Preventive Medicine is leading a global preventive health movement focused on saving lives and money by keeping people healthy and better managing chronic conditions before they progress. The company has developed The Preventive Plan®, an innovative health management program that is based on the clinical science of preventive medicine: primary (wellness and health promotion to keep healthy people healthy), secondary (screening for earlier detection/diagnosis) and tertiary (early evidence-based treatment to reduce complications and disability). The Preventive Plan, which is available to consumers and employer groups, identifies each individual\\’s top health risks and designs a customized plan of action to reduce those risks, supported by health coaching, robust online tools and plan-wide challenges with incentives.
Virta Health is the first clinically-proven treatment to safely and sustainably reverse type 2 diabetes and other chronic metabolic diseases without the use of medications or surgery. Virta Health\\’s innovations in nutritional biochemistry, data science and digital tools combined with clinical expertise are shifting the diabetes treatment paradigm from management to reversal. Virta Health\\’s mission is to reverse type 2 diabetes in 100 million people by 2025.
At Apta Health, we have created the last healthcare program you will ever need.
In the current healthcare system, consumers struggle to navigate a mire of perplexing options. From providers who overcharge, to frustrating hidden fees, to unhealthy workforces driving up costs, the system is broken and confusing. As insurance premiums continue to skyrocket and uncertainty clouds the future, mid-sized companies are increasingly looking to contain their rising employee healthcare bills.
Apta Health has the solution. As the first fully-integrated, mid-market care coordination model, our mission is to build a better healthcare system from the ground up. Our team of experts has perfectly packaged the best-of-the-best benefit program to revolutionize your group healthcare plan without the burden of traditional year-over-year premium increases. We help employers bend the trend of rising healthcare costs through:
1. expert guidance
2. industry leading care coordination
3. proven cost containment options
In fact, our clients see an immediate reduction in their total costs within their first year with Apta Health, and an average 20% cost reduction by year three.
Welltok is a data-driven, enterprise SaaS company that delivers the healthcare industry’s leading consumer activation platform. Welltok’s solutions empower leading health plans, employers, providers and public entities to connect consumers with personalized health improvement resources, making it easy and rewarding for consumers to complete actions that optimize their health and wellbeing.
BizMed provides a platform to integrate and facilitate the administration of quality improvement initiatives for office-based practice. Based on the Patient Centered Medical Home (PCMH) operational framework, BizMed supports focused quality initiatives for improving care and population health, while reducing overall costs. For interested practices, the BizMed set of tools and services facilitates formal PCMH recognition from the National Committee for Quality Assurance (NCQA) with minimal administrative effort.
BizMed proudly serves hundreds of physicians in independent practice, medical groups, health systems, accountable care organizations (ACO), health plans and safety net providers across the United States.
Evolving over the last 30 years, Nova aims to manage trend to reduce health care spend and improve health plan performance. Headquartered in Buffalo, NY, Nova is a wholly-owned affiliate of Independent Health.
Nova works with flexibility to provide the solutions clients need in the way clients need them including medical, dental, vision, COBRA, reimbursement account administration, and private-labeled partnerships. Nova provides clients with unique cost management and customized health plan strategies through personalized service.
To view Wildflower’s e-book for Value-Based OB Care, please visit: www.valuebasedobcare.com
Wildflower connects women and families to better care by breaking down silos among providers, payer and best-in-class partners. It delivers personalized experiences that simplify the healthcare journey for families with a combination of human touch and digital tools. Wildflower’s model fuels the transition from fee-for-service to value based care.
Wildflower eliminates excess costs, improves patient satisfaction and outcomes across the continuum of family health. Empowering women. Collapsing silos. Rewarding value. This is a smarter way to care.
Curant Health is a Medication Care Management® (MCM) organization headquartered in Atlanta, Georgia. Curant Health’s comprehensive product offering inclusive of Advisory, Engagement & Evidence solutions has been validated in numerous clinical trials to improve the lives of complex care, poly-chronic patients nationwide while reducing their overall healthcare spend. Specially trained pharmacists, nurses and patient care coordinators are the foundation of the innovative program. Consistent, dedicated interaction with licensed Curant Health clinicians supports the quality of life of employees who have chronic conditions.
ARC Fertility is the most established national network of carefully selected Centers of Excellence, founded in 1997 and led by globally recognized physicians who put the patient first. Its success providing evidence-based, cost-effective, and affordable care to consumers has been used to create a comprehensive, innovative, administratively easy, employer fertility benefit with superior employee clinical, emotional, and financial experience. The comprehensive digital platform and apps, personalized information and emotional support, and excellent medical care ensures a high-value product for all employees and a seamless fertility journey for those on that path. ARC Fertility’s customized plan design with no PEPM and managed bundled packages result in validated better outcomes and lower cost that make fertility benefits affordable for all employers. Employers are enabled to meet their DEI and talent retention and recruitment goals and to build a family-friendly culture.
Carrot Fertility is the leading global fertility benefits provider for employers, built to support employees through their entire fertility healthcare journey. Companies use Carrot to customize a fertility benefit that provides employees financial, medical, and emotional support as they pursue parenthood, reducing healthcare costs and resulting in better clinical outcomes. Carrot\\’s clinically-managed program includes egg freezing, in vitro fertilization (IVF), donor and gestational carrier services, and adoption; Carrot Rx, a premium pharmacy experience, at significant savings; Carrot Pregnancy; and the Carrot Card®, a flexible fertility benefits debit card employees can use to pay for their care. Carrot supports companies in more than 50 countries across North America, Asia, Europe, South America, and the Middle East.
Edison Healthcare believes that distance and cost should never get in the way of receiving the best possible medical care. Edison client’s and their employees have access to Edison’s Smart Care Network, a handpicked network of America’s best medical centers. Edison believes the best healthcare outcomes for the most complex and costly diagnoses will come at the hands of the best surgeons, physicians and medical teams who work for the best medical centers in America. That is what Edison Healthcare does, it delivers extraordinary outcomes from phenomenal medical centers.
Proactive MD provides a total healthcare and population health management solution for employers by partnering with them to offer Advanced Primary Care Health Centers for employees. The Proactive MD model is designed to elevate the standard of primary care, going above and beyond the typical boundaries of healthcare to meet each employee’s unique mental, emotional, social, and physical needs. Proactive MD’s care model is built on the foundation of strong Physician-patient relationships and onsite Patient Advocates, empowered by advanced population health insights, who personally guide and advise employees through the full healthcare system. Coupled with reduced-rate access to the nation’s leading specialists for complex and catastrophic diagnoses, the Proactive MD model removes obstacles to care, reduces risk, and dramatically improves the quality of care for employees while simultaneously lowering healthcare costs for employers.
The Lifestyle and Condition Coaching solution (LCC) helps members articulate a vision for their health, identify and close gaps in care and achieve short- and long-term health goals. ActiveHealth offers digital engagement platform that incorporates live coaching. They cover 10 lifestyle focus areas, such as tobacco cessation and weight management, plus support for 19 chronic conditions, including diabetes, heart disease and chronic kidney disease.
Read more about the study here: https://go.activehealth.com/lcc
A letter from the Chief Medical Officer: https://www.activehealth.com/news/recent-study-better-outcomes-proven-savings/
Short summary video about the study: Achieve better health outcomes and lower costs
With an unwavering belief that a company’s success starts with its people, Alight Solutions is a leading cloud-based provider of integrated digital human capital and business solutions. Leveraging proprietary AI and data analytics, Alight optimizes business process as a service (BPaaS) to deliver superior outcomes for employees and employers across a comprehensive portfolio of services. Alight allows employees to enrich their health, wealth and work while enabling global organizations to achieve a high-performance culture. Alight’s 15,000 dedicated colleagues serve more than 30 million employees and family members.
Happy Whole Human (HWH) helps people help themselves with an online membership program that confidentially accesses 28 different aspects of a balanced life. The program then supplies innovative Do-It-Yourself tools and tele-coaching to empower members to improve areas that are in need of improvement. HWH validly and accurately measures participants’ change in perceived personal and relationship health status.
Happy Whole Human empowers leaders with a validated turnkey wellness program to cut health care costs, offer a valuable benefit, and improve company culture using ongoing aggregate reports.
In 2005 Med-A-Vision introduced a health insurance model that lowered premiums and out-of-pocket cost maintaining first dollar benefits to employees. Today Med-A-Vision serves over 185 companies and 6,000 people in Maine. Med-A-Vision clients have learned it is more cost efficient to pay small claims than large premiums for lower deductibles. The data collected from the actual employee and dependent claims in 2014 -2015 against $5,000 – $6,000 deductible HSA compatible plans is the bases for this model.
The PredictiMed™ program offers group members a health risk assessment and then provides customized interventions. The interventions apply evidence-based tactics to prevent onset of disease, reduce complications of current disease, and promote primary prevention. The goal is for people at low-risk to remain low-risk, and for people at moderate- or high-risk to shift to lower-risk levels.
Green Imaging is a full service virtual medical imaging network owned and operated by a group of board-certified radiologists. Green Imaging helps patients make the most informed decisions about MRIs, CTs, and other imaging procedures. Unlike other imaging facilities, the cash-pay price Green Imaging provides is the final price you pay. There is no extra charge for the radiologist fee. Green Imaging believes that healthcare costs should be transparent.
Heritage Health Solutions is a leading health care Integrator that works closely with government entities, correctional facilities, and self-funded companies to improve patient care and reduce costs. The company leverages best in class technology coupled with a solution based entrepreneurial team to identify health and cost related issues and develop and implement custom-based solutions. Through their medical and pharmacy networks, they serve more than one million lives, resulting in improved clinical outcomes and a reduction in cost.
Abacus Health Solutions is a pioneer in the behaviorally focused disease management field. Our approach is simple, attack the high cost drivers with precision focused interventions proven to improve health, reduce hospitalizations and lower costs.
Utilizing the latest in healthcare technologies, our programs for diabetes and hypertension are built to foster high rates of adoption, drive members to providers, leverage remote monitoring technologies, and align with healthcare goals of quality and outcomes. Resulting in healthier less costly more productive employees.
ConsumerMedical is a leading clinical advocacy, decision support and expert medical opinion company serving over six million individuals through some of the nation’s largest employers, health plans and private exchanges. The company has been serving patients and payers for 25 years. ConsumerMedical offers a fully integrated suite of solutions, including Medical Decision Support®, Surgery Decision Support®, Expert Medical Opinion, Claims Advocacy and more, helping individuals and families navigate the healthcare system while improving outcomes and reducing costs. ConsumerMedical’s results have been validated continuously by independent actuaries.
IMC (Integrated Musculoskeletal Care) grew from a small clinical practice established in the early 1990’s in Tallahassee, Florida. In 1995 the Florida-based practice hired lead researcher, Chad Gray, who realized the tremendous lack of reliability in the way musculoskeletal disorders were diagnosed, treated, and managed across the healthcare industry. To close this industry gap, Gray enlisted globally recognized, Mark Miller, to assist in comparative effectiveness research, and together they launched IMC utilizing its Outcomes-AccountableTM Standard of Care to broaden the original clinic’s reach and accelerate the overall reduction of MSD incidence, prevalence, and costs in every feasible market. Since inception, IMC has launched major corporate pilot programs and in-house clinician support for brand-name, Fortune 500 partners as well as established a world-class network of education, training, and treatment facilities to improve lives and productivity.
Sera Prognostics delivers pivotal information in early pregnancy to physicians and expectant mothers, designed to enable them to improve maternal and neonatal health and reduce healthcare costs. Sera’s precision medicine PreTRM® test reports to a physician the individualized risk of premature delivery in a pregnancy, enabling earlier proactive interventions in women with higher risk. For more information, please visit the company’s website at www.seraprognostics.com.
Preterm birth is defined as any birth before 37 weeks’ gestation and is the leading cause of illness and death in newborns. The 2020 March of Dimes Report Card shows that of approximately 3.8 million babies born annually in the U.S., more than one in ten is born prematurely. Prematurity is associated with a significantly increased risk of major long-term medical complications, including learning disabilities, cerebral palsy, chronic respiratory illness, intellectual disability, seizures, and vision and hearing loss, and can generate significant costs throughout the lives of affected children. The annual US health care costs to manage complications of prematurity were estimated to be approximately $25 billion for 2016.
The PreTRM® test is the only broadly clinically validated commercially available blood test that provides an early individual risk prediction for spontaneous preterm birth in asymptomatic, singleton pregnancies. The PreTRM® test measures and analyzes proteins in the blood that are highly predictive of preterm birth. The PreTRM® test permits physicians to identify, as early as 19 weeks of pregnancy, which women are at increased risk for premature delivery, enabling more informed clinical decisions based on each woman’s individual risk, so that her care can be personalized to address her risk. The PreTRM® test is ordered by a medical professional. For more information about the PreTRM® test, please visit www.PreTRM.com and the PreTRM® Test YouTube Channel. You can also join the conversation on Facebook and @PreTRM.
BioIQ is a healthcare engagement and quality care gap closure company that is redefining the way payers, employers and consumers navigate and connect with the U.S. healthcare system. BioIQ leverages consumer analytics, real- time omni-channel engagement strategies and an extensive ecosystem of healthcare partners to provide a comprehensive view of individuals throughout their health journey and engage them to make better decisions that lead to healthier outcomes.
Vida Health is a virtual care platform intentionally designed to treat a person’s whole health by treating mental and physical conditions, together. Vida’s clinically validated approach combines an AI-powered, personalized experience with the support and human connection of coaches and therapists. Vida’s app offers video sessions, messaging, and digital content to help people prevent, manage and reverse chronic conditions — like diabetes and hypertension — and the mental conditions that accompany them — like stress, depression and anxiety. Some of America’s largest employers and health plans trust Vida’s whole health offering. Learn more at www.Vida.com.
Everyone should have access to the right medicine, at the right time, at the right cost; and they shouldn’t have to navigate a cumbersome and daunting system to access it.
DisclosedRx’s vision is that truthfulness and innovation will drive greater access to prescription medications for their members at a lower net cost to their client, as well as make them the easiest PBM to partner with.
Airrosti is a nationwide provider-led MSK solution, offering in-person and virtual care. Airrosti has over 17 years of experience and 1 million cases treated. Their licensed providers eliminate muscle and joint pain within 3-4 visits, and 9 out of 10 patients report full injury resolution, allowing patients to return to pain-free activity. Airrosti works with employers and health plans to improve access to MSK therapy patients want, combined with the consistent provider relationship that keeps them engaged. Wellness information, virtual outreach and digital engagement is included at no up-front cost.
Hinge Health is pioneering the world’s most patient-centered Digital Musculoskeletal (MSK) Clinic. Hinge Health reduces MSK pain, opioid use, and surgeries by pairing advanced wearable technology with a comprehensive clinical care team, including Doctor of Physical Therapy, physicians, board-certified health coaches, and more.