Medical Cost Management helps self-funded medical plans teach their employees how to be great consumers of their medical care needs. We guide employees to low cost, quality, in-network providers for routine care, including blood work, imaging and surgery center procedures. The variation of pricing for the same exact routine care costs an employer an unnecessary 20% to 33% of its medical spend for these services.

MCM offers the only transparent solution independent of health insurance providers. Each self-insured employer receives a customized in-network engagement and incentives plan based on its claims data. Concierge and incentive plan compliment the digital “Search and Save” engine.

A large part of our success is with our 5 key employee engagement methods:

1. Our National online price database
2. Cost Concierge Service – trained medical billers assist with searching, saving, and scheduling
3. Customized Savings Cards – with low cost, in-network care facilities and incentives
4. Financial Incentives – pre-set amount by procedure or copay/deductible reimbursed through HRA

We partner with self-funded employers to assist in the effort of fiduciary responsibility sought by CFOs regardless of the size of the group. We contract directly with these employers to become their “second set of eyes” in the claims paying process.

Clients and partners are constantly seeking cost containment strategies to help their clients in the quest to save additional health claim dollars and we specialize in this very niche.

This service provides claims analysis and targeting of In-Network Services for the best provider/cost solution. The plan beneficiary rewarded for making fiscally prudent decisions to help drive down health costs.

Value Proposition: The health plan saves on claims costs related to In-Network services (i.e. bloodwork, imaging, outpatient surgeries) reducing total medical spend by 3% to 10%.

Who Can Benefit? Any self-insured or fully insured health plan.