Lower Costs and Enhance Value in Your Network

Reduce healthcare plan costs while delivering greater value to members by proactively structuring your network to maximize efficiency, accountability, and outcomes.

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The Problem

How are out of network costs affecting your healthcare plan today? Isn’t it time to make your network work for your business and your members?

Preventable issues like a suboptimal network structure or low-performing providers have a monumental impact on plan cost.

The problem is that optimizing network design requires deep insight into how your network is performing today. Unfortunately, most employers lack critical knowledge about member needs, network performance, and costs, which is needed to identify and make meaningful improvements.

The Solution

The sources of network inefficiency are complex and multi-faceted. 4C Health Solutions empowers employers to identify and embrace opportunities for meaningful network improvements by understanding the many strengths and weaknesses of their current network design:

Verify & Quantify Out of Network Spend

4C enables employers to verify that every out of network claim corresponds to out of network care, and quantify total out of network spend.

Educate Members & Reduce Out of Network Usage

By providing employers the insights needed to educate members on the cost of out of network care, 4C supports the overall reduction of out of network usage.

Identify High & Low Performers

By scoring providers by popularity and performance, 4C empowers employers to eliminate low-performing providers and bring in those with superior accountability and outcomes.

Proactively Structure Network Design

4C provides employers critical visibility into how their providers and rates stack up to other businesses and industry benchmarks, allowing them to better optimize their network design.

fraud by the numbers

By the Numbers

treatment bills

Out of network treatment bills are 118% to 1,382% higher than the federal Medicare system is billed.

America’s Health Insurance Plans

out of network

One study found that when insureds went to an in-network hospital, they received an out of network bill 22% of the time.

Health Affairs

narrow plans

Self-insured and third-party networks are narrowing, with 70% of plans on healthcare exchanges classified as narrow.

McKinsey & Company

“Only in healthcare do companies turn over responsibility for managing hundreds of millions of dollars to third parties. 4C returns transparency and control to those with the most at stake – employers and employees.”

– Ken Lockard, Chairman of Lockard Companies and 4C Board Member

infographic totaling fraud damages

Infographic

Totaling the Damages
An Employer’s Guide to Breaking through Healthcare’s Biggest Cost Drivers

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From Our Blog

 

March 20, 2019

The Informed Customer is Always Right

Recent News

 

4c health new web launch

March 15, 2019

4C Health Solutions: Employer-Centered Focus on Health Care Costs Drives New Website

Twitter

"Employers continued to see moderate health benefit cost growth of 3.6% in 2018, but projections of a 4.4% hike this year would be above the consumer price index and employees' earnings growth, a new Mercer survey warns." #healthcare #employer #insights https://t.co/lCcJUtLsFj

4C Health Solutions is excited to announce the launch of its newly redesigned website. #healthcare #costs #transparency #insights #employers https://t.co/fUf32fMPoN

“Patients are becoming wiser consumers, and much more empowered consumers..." #healthcare #artificialintelligence #costs #insights https://t.co/KtzsjARvXu

Shielded payment and quality-related data reflect the misaligned incentives of the current healthcare payment ecosystem, forcing those paying for healthcare to accept the ever-rising costs. #healthcare #costs #transparency https://t.co/Bp9ekGnAtb

It’s more than your right to see your claims data, it’s your fiduciary responsibility under ERISA law. But assuring compliance in today’s complex claims ecosystem can seem an insurmountable feat—that is, until now. #transparency #costs #healthcare #ERISA https://t.co/TeN4kFdZab