Cost Containment Strategies

Plan Design Changes

  • Non-Linear Employee Contributions
  • Pre-Authorization for Certain Procedures
  • Second Opinion Requirements from Identified Centers of Excellence
  • Tie Dialysis Treatments to Medicare
  • Incentive In-Home Dialysis
  • Step Therapy for Hepatitis C Drugs/Super Statins
  • Transplant Carve Out
  • Stop Loss Carve Out
  • Health Benefits Captives

Employee Wellness Strategies

  • Health Risk Assessment
  • Biometric Screenings
  • Tobacco Cessation Programs
  • Customized Wellness Plan
  • COBRA Advocacy

Rx Savings Programs

  • Pharmacy Tourism
  • Manufacturer Drug Coupon Program Programs
  • Foundations
  • Rx Carve Outs
  • Diabetic Population Management
  • Diabetic Testing Supplies
  • Genetic Steerage

Primary Care

  • Telemedicine Programs
  • Urgent Care Clinics
  • Shared Employer Clinics
  • Direct Primary Care Programs
  • Onsite Clinics

Patient Advocacy

  • Centers of Excellence
  • Managing the Person vs. Managing the Claim
  • Coordinated Case Management

High-Performance Networks

  • Metro Care Program
  • Direct Provider Contracting
  • Reference-Based Pricing
  • West MI Partners
  • Southeast MI Partners
  • Physicians Choice PPO


  • Cost Estimator
  • Rewards Program
  • Decision/Advice/Guidance Tools
  • Customized Benefit Mobile App

Fully Insured Strategies

  • Advanced HRA & HSA Concepts
  • High-Performance & Narrow Networks
  • Contribution Analysis
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