Quantify Health will lower the cost of healthcare for employers by over $300 per employee per year 

 

Also works for health plans, stop-loss carriers, captives, work comp 

E.g., for a company with 5,000 employees, we will save $1.5M/ year

 

Shared-savings model where the employer/ payer keeps 70% of the savings and we get 30% – no other costs involved

Last year we delivered $140 million+ in savings (avg. 23% savings)

Contact us below to get started or email us at info@quantifyhealth.co

The Problem

  • Quantify Health addresses overcharging by providers in two key areas: High Cost Claims and Implants

  • High Cost Claims:

  • High Cost Claims (hospital claims with a payable of over $100,000) are the number 1 strategic healthcare priority for self-funded employers according to a Mercer survey

  • Hospitals are overcharging through several techniques, e.g., charging for 48 hours of ventilator usage in a 24 hour period, continuing to charge at the higher trauma ICU rate even after the patient has been moved to regular ICU, etc.

  • Medical Implants:

  • Medical Implants (e.g. artificial knees and hips, plates, screws, rods, pins, stents, pacemakers, etc.) typically represent half the cost of an average surgery

  • Hospitals and  surgery centers are overcharging through different techniques, e.g., by supplying a doctored invoice with inflated pricing, charging for more implants than were used, etc.

The Quantify Health Solution

  • Our proprietary process identifies overcharging from the provider and works with the third-party administrator (TPA) and provider to correct it and charge only the appropriate amount

  • We have different solutions for High Cost Claims and Implants, but they work in a similar way

  • This happens “pre-pay”, i.e., we identify the overbill before it’s paid out – so the employer/ payer only pays the correct amount

  • Contingent-based shared savings mode, where we charge you 30% of the actual realized savings based on the difference between the original allowed amount and the repriced amount

  • Last year we delivered total savings of over $140 million (average savings per claim of 23%)

  • Our solution works for self-funded employers, health plans, TPAs, stop-loss/ reinsurance carriers, captives, and worker’s comp carriers 

Financial Impact

  • Quantify Health will save the employer/ payer/ resinsurer over $300 per US employee per year

  • These are direct savings to the bottom lines of self-funded employers, health plans, reinsurers, and captives - and for TPAs can provide additional impact to their self-funded employer clients

Getting Started

  • Getting started is very straightforward and takes just a few minutes to set up

  • We first start with an opportunity analysis - we will request the last 12 months of claims data (no PHI), and we'll come back with a free opportunity analysis

  • After that, we simply sign a BAA and contract (can be canceled at any time with a 30 day notice)

  • Beyond that, it's a fully automated process for the employer – we work directly with the TPA and the providers to correct the overcharges​ on a pre-payment basis
 

Press Mentions

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"…Lowering healthcare costs is critical for companies – the key is to do so in a model that doesn't require capex or other upfront costs, while also not affecting the quality of employee healthcare.

Quantify Health does just that – lowering healthcare and workers' compensation costs for employers... without any upfront or fixed costs and without negatively affecting healthcare or benefits quality."

Contact
Contact us below to get started

3 Columbus Circle

15th Floor

New York, NY 10019

info@quantifyhealth.co

© 2020 by Quantify Health

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