Start before surgery
Evaluations, imaging, therapy, and non-surgical care help members understand their options early. Bundled surgery is there when it is the right clinical choice.
Manage specialty care costs
A small share of members.
A big opportunity for your plan.
High-cost specialty episodes can shape an entire plan year. HealthMe connects members to independent specialists and upfront bundled prices—so your plan can spend less while helping people get the care they need.
- Surgical
- Chronic
- Primary
Under 2%% of members
30–40%% of spend
Under 2% of members drive 30–40% of plan spend.
Illustrative plan mix. Category proportions are schematic; your plan’s experience will differ.
Built for this moment
Change the path. Change the cost.
Your specialty-care strategy starts at the first visit. Connect members with physician-owned practices, make the price clear, and help them follow through on the right next step.
Choose the care setting deliberately
Independent specialists and ambulatory surgery centers offer alternatives to hospital-owned venues. Compare the full episode, the services included, and the upfront price.
Make the benefit easy to use
A lower price only matters when members can access it. HealthMe pairs the network with education, referrals, and care navigation to turn an available benefit into completed care.
The difference a venue can make
Same procedure.
A very different price.
Independent, physician-owned practices and surgery centers can deliver specialty care at a lower bundled price. Here’s what that looks like across one total knee replacement episode.
Knee replacement · procedure price by venue
Hospital outpatient
Typical, modeled
Typical, modeled
$62,000
HealthMe bundle
At an ASC
At an ASC
$25,500
Across the full episode
$39,490less in this example.
From the first evaluation through post-op therapy: about 60% lower than the modeled hospital outpatient total.
Estimate your plan’s opportunity| Episode of care | HealthMe | Hospital outpatient (typical) |
|---|---|---|
| Knee evaluation | $270 | $650 |
| MRI of the knee | $450 | $1,800 |
| Knee replacement | $25,500 | $62,000 |
| Post-op PT, 6 visits | $540 | $1,800 |
| Total | $26,760 | $66,250 |
HealthMe prices are plan-paid bundle amounts. Hospital outpatient figures are modeled comparisons, not quotes. Actual prices and savings vary by market, services included, and plan; we review the opportunity using each employer’s claims experience.
Putting it into practice
Find the opportunity in your own claims.
Your population, local provider options, and current claims tell the story. We review that information with your team, compare relevant care episodes, and build a program around the opportunities your members can actually use.
What comes together
- Map member locations to available specialty care
- Compare historical episodes with defined bundle prices
- Align eligibility, benefits, and payment with your TPA
- Launch with member education and navigation support
Employer
“HealthMe built a direct contract network for our employees and has saved us hundreds of thousands of dollars. Just as important, when our people need care, someone actually helps them find the right specialist, book the visit, and walk in knowing they won’t have any out-of-pocket costs.”
Kristina EwingDirector of Health & Wellbeing, Shoestring Valley HoldingsA few more details
Your questions, answered.
Is this only a surgery savings program?
No. HealthMe supports the specialty care journey, including evaluations, imaging, therapy, non-surgical care, and surgery when appropriate.
Can we keep our existing TPA?
HealthMe works with your benefits partners on the required eligibility, claims, and payment processes. Network and operational fit are reviewed during implementation.
Will members have no out-of-pocket cost?
Member responsibility depends on the employer’s benefit design and applicable plan terms. HealthMe works with your team to communicate the program and the member’s expected costs.
A better way forward
See what a different care path could save.
Let’s review your population, claims experience, and local provider options.