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Self-insured employers have already made the strategic decision to take control of their healthcare spending—a decision that positions them ahead of their fully insured peers. However, the complexity of the self-funded marketplace means that even well-intentioned plan designs can harbor hidden inefficiencies that erode the cost advantages self-funding should deliver.
We conduct audits that expose hidden cost drivers. Our analysis examines TPA fees against industry benchmarks, dissects PBM contract language to identify spread pricing and rebate retention, evaluates network discounts against reference-based pricing alternatives, and identifies duplicate or unnecessary coverage layers.
Following the audit, we redesign the plan architecture. This might involve renegotiating vendor contracts with transparent fee structures, introducing direct primary care to reduce emergency department utilization, implementing reference-based pricing for major procedures, or integrating transparent pharmacy benefits that eliminate hidden markups.
Self-funded employers typically see 15-30% reductions in total healthcare spend within the first 18-24 months, coupled with improved employee satisfaction as barriers to care decrease and out-of-pocket costs decline.
If your current health plan feels more like an unavoidable expense than a strategic asset, let's explore what's possible when incentives align, data becomes transparent, and fiduciary responsibility drives decision-making.
We begin every engagement with conversation, not quotation—because meaningful change starts with understanding where you are and where you want to go.
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