Business Details
Your Trusted Partner for Innovative Health Benefits Solutions
At Fix Healthcare, we are dedicated to transforming employer-sponsored healthcare through innovative self-funded health plans. Our mission is to empower employers by offering solutions that control costs while enhancing member experiences. We reject the status quo of a flawed healthcare system, focusing instead on proven strategies like care coordination, reference-based pricing, and virtual primary care. Our platform combines advanced point solutions with concierge-level service, delivering industry-leading cost control and a 76 Net Promoter Score.We specialize in designing plans that integrate seamlessly with existing benefits structures, ensuring transparency in pricing and compliance with evolving regulations. With over two decades of validated medical trend reduction, we provide employers with the tools to reimagine healthcare as a strategic advantage rather than a financial burden.
Services
Self-Funded Health Plans
Care Coordination
Cash Pay Pricing
Reference Based Pricing
Centers of Excellence
Direct Primary Care
Benefits Consulting
Compliance Services
Virtual Primary Care
Pharmacy Plan
Highlights and features
- We deliver 30%+ facility cost reductions through reference-based pricing
- Our care coordinators achieve a 76 Net Promoter Score for member satisfaction
- We provide transparent consultant fees with no back-end bonuses
- Our platform reduces medical trend to 2.5% vs industry 5.8%
- We offer 30 A-rated insurance carrier options at renewal
Services
Self-Funded Health Plans
Our self-funded health plans offer employers direct control over healthcare spending while maintaining quality care. By combining traditional PPO networks with modern point solutions like virtual primary care, we deliver customized benefits that reduce costs through reference-based pricing and cash pay models. This approach has consistently produced 2.5% annual medical trend versus the industry 5.8%, with 30 A-rated carrier options available at renewal.
Care Coordination
Our Care Coordinators replace traditional member services with personalized nurse advocates who guide employees through healthcare decisions. These professionals provide clinical support, navigate treatment options, and connect members with cost-effective care providers. This concierge-level service has achieved a 76 Net Promoter Score, significantly improving member satisfaction while steering patients toward high-value care solutions.
Reference Based Pricing
This innovative pricing model establishes maximum allowable charges based on Medicare rates plus reasonable fees, creating 30%+ savings on facility costs. Employers benefit from predictable expenses while members access quality care at transparent prices. The strategy works particularly well for high-cost procedures, ensuring both cost containment and provider accountability.
Cash Pay Pricing
This optional payment model allows members to pay providers directly at pre-negotiated rates, creating 30% savings for plans and shared benefits for employees. By eliminating traditional insurance billing complexities, it streamlines care delivery while maintaining quality standards. The model works best for routine services and diagnostic testing where price transparency is critical.
Benefits Consulting
We provide comprehensive consulting services covering plan design, compliance, technology integration, and vendor management. Our experts help employers optimize benefit packages through strategic enrollment processes, customized communications, and ancillary coverage solutions. This includes navigating ERISA, ACA, and HIPAA requirements while maintaining alignment with business objectives.
Questions
How does Fix Healthcare reduce healthcare costs for employers?
We combine self-funded plans with reference-based pricing, cash pay models, and care coordination to achieve 30%+ savings while maintaining quality care access.
What makes your care coordination different from traditional member services?
Our nurse advocates provide personalized guidance rather than generic support, achieving a 76 Net Promoter Score through proactive healthcare navigation and clinical expertise.
How do you ensure compliance with healthcare regulations?
We provide comprehensive compliance packages including SPD WRAP documents, Form 5500 filings, and ACA requirements, along with ongoing HR support and updates.
Can we keep our existing benefits structure while using your platform?
Yes, our solution integrates with existing TPAs, networks, and pharmacy plans, allowing you to maintain current components while optimizing insurance through competitive bidding.
What's the difference between your virtual primary care and traditional telemedicine?
Our virtual primary care achieves 60% member engagement vs 3% for standard telemedicine through continuous provider relationships and comprehensive care management.
