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