Healthlock Precare Navigation Case Study
The Transparency in Coverage Rule and No Surprises Act opened the door to price transparency, but Precare turns compliance into strategy. By leveraging HealthLock’s Precare platform, employers reduce healthcare costs while giving employees the insights they need to choose high-quality, cost-effective care.
The Challenge: The growing Burden of Healthcare Costs
The Problem
A 3,250-employee self-funded organization was hit with healthcare costs rising more than 15% per year. The CFO needed to get ahead of the financial impact on both the company’s budget and its employees.
The challenge was to gain clear insight into healthcare spending and identify actionable ways to reduce costs while preserving quality of care.
Employer Goals
  1. Reduce healthcare costs while enhancing patients' ability to choose the best care
  1. Provide an intuitive shopping experience that rewards economically sound choices
  1. Ensure compliance with federal mandates to avoid $100/employee per day fines
About Healthlock: Industry Pioneer
The Precare solution was the only platform showcased to the federal Health Policy Team during the creation of the Transparency in Coverage Rule. Its innovative approach set the benchmark for today’s national transparency standards.
Clarity Over Complexity
Demystifying healthcare expenses with clear, actionable insights
Empowerment
Providing transparent data so consumers control their healthcare decisions
Customer-Centric Innovation
Every feature designed with the end-user in mind
Trust as a Cornerstone
Maintaining highest standards of accuracy and reliability
The Price Problem: How Price, Not Utilization, Drives U.S. Healthcare Spending
As healthcare economist Uwe Reinhardt noted, the main reason medical costs are higher in the U.S. than other industrialized countries is higher prices. Healthlock's data shows that differences in prices paid for the same exact service between in-network providers can vary by 5x to 20x.
These providers were often less than 1 mile apart, revealing massive wasteful spending within the group's annual healthcare spend.
Step 1: Claims Hindsight Analysis
Working alongside the group's benefit consultant, historical medical claims were uploaded to Healthlock's Advisor Dashboard and analyzed through Healthlock's proprietary claims data engine.
63% Overspending Discovered
This group overspent by 63% due to high-cost providers
The Claims Hindsight Analysis runs a line-by-line claims comparison, cross-referencing the group's actual experience against the largest commercial claims database in the country. This revealed every instance of waste, defined as the amount spent on care in excess of what could be spent for the same care at the most cost-effective facility at the same or higher quality of care within the same geographic area.
Step 2: Consumer Incentive Calculator™
Driving down healthcare costs requires more than price transparency, it requires increased healthcare consumerism. Healthlock assessed the group's plan designs to determine if they would drive employee engagement to mitigate wasteful spending.
1
High-Deductible Health Plan with HSA
Score: 47
Employer-funded HSA with MyMedicalRewards incentives
2
High-Deductible Health Plan with HRA
Score: 23
HRA allowance with MyMedicalRewards incentives
3
PPO Health Plan
Score: 9
Traditional PPO with MyMedicalRewards incentives
The Healthlock Solution: Educate, Empower, Engage
Educate
Healthlock's Customer Success team engaged with leadership, providing access to the Employer Dashboard and MyMedicalMetrics™ to monitor healthcare utilization and spend.
Empower
Training ensured employees could access MyMedicalShopper™ and leverage tools to their fullest extent.
Engage
MyMedicalRewards™ incentives deposited reward dollars into HSAs, HRAs, or eGift cards for smart healthcare consumerism.
MyMedicalRewards™: Incentives in Action
Healthlock's patented rewards system drives engagement and consumerism throughout the plan year, extending beyond the consumer's deductible and out-of-pocket maximum.
Shopping Rewards
Employees earn rewards for choosing high-value providers using customizable price percentile benchmarking. Activity Rewards included enrolling, connecting health plans, and downloading the mobile app.
Engagement Rewards
Activity rewards drive platform adoption and usage, creating a catalyst for increased engagement with the healthcare transparency tools.
Engagement Growth Through Best Practices
Following Healthlock's engagement best practices, the group saw dramatic increases in employee participation throughout the year.
1
After Q1
31% Engagement
Initial rollout with Activity and Shopping Rewards
2
After Q2
52% Engagement
Ongoing engagement and communication with employees
3
After Q3
71% Engagement
Retrospective Shopping feature reviewed EOBs line-by-line, identifying missed savings opportunities
Results: Transformative Savings Achieved
84%
Annual Employee Enrollment Rate
34%
Employee Shopping Rate
Over first year
$3.1M
Total Savings Realized
20%
Claims Hindsight Analysis Realized
$2,800
Average Shopper Annual Savings
22%
Average Active Shopper annual savings
Top Shopping Success Story: Cataract Surgery with IOL saved one employee $11,659, earning them a $3,518 reward.
Contact Sales: sales@Healthlock.com | Healthlock.com