Healthcare is a multi-trillion dollar industry. And yet, it hasn’t seen a productivity gain in the last 20 years1, leading to a steady increase in costs for employees and employers alike.

Healthcare Costs Continue to Rise,with No End in Sight.

COSTBREAKDOWN

$28,1662

Between 2017 and 2026, the average annual rate of national health spending is expected to grow by 5.5%—reaching $5.7 trillion by 2026.3 That’s three times the rate of inflation.4

56% of healthcare costs are paid by employers, totaling

$15,788 for the average American family of four.2

Paid byEmployer

44% of healthcare costs are paid by the employee, with the average American family of four paying $7,674 via employee payroll deduction and $4,704 from out-of-pocket expenses.2

Paid byEmployee

$174 billion in anticipated costs

for U.S. health system /employers by 2020.9

Up to 10% of the U.S.’s total annual healthcare spending is lost to fraud, totaling over $200 billion each year.5 While government agencies seek to reclaim these fraudulent payments, more often than not, funds remain lost and underlying problems remain unaddressed.

Master the Businessof Healthcare with 4C.

4C Health Solutions empowers self-insured employers with unmatched clarity and actionable tools to regain control of plan spending and value.

EliminateFraud, Waste & Abuse

Estimates state that 33%-50% of healthcare spending adds no value.1 Still, employer health benefit costs will rise 5% for the sixth consecutive year in 2019.4 When you factor in out of network treatment bills, which can be 118% to 1,382% higher than what the federal Medicare system is billed,7 these cost margins skyrocket.

ReduceNetwork Costs

To break the pattern of fraud, waste, and abuse in healthcare, employers require complete insight and control over claims data— co-adjudication, pre-payment.

Insight is Power

The farther a disease advances, the greater its negative impact on member quality of life and plan costs. By effectively supporting employee disease management, employers can not only save thousands per employee, but also improve the health and wellness of their entire population.

EnhanceDisease Management

Employee health and performance are two sides of the same coin. By supporting the overall health and wellness of workers and their families, employers improve employee quality of life—all while elevating productivity and reducing costs.

Improve Wellness

To reduce network costs, employers require real-time data that enables them to proactively structure their healthcare plans and gain negotiating power.

Insight is Power

To combat the costs of chronic diseases, many of which can be controlled or prevented, employers can leverage data to enact disease management programs tailored to their network needs.

Insight is Power

By Leveraging insights gathered from claims data, employers can enact programs that address the timely health needs uncovered within their populations.

Insight is Power

Out of Network Costs, by the Numbers8

Average In Network Cost Potential Out of Network Bill

Muscle and Skin Graft

Spinal Fusion

Gallbladder Removal

Breast Lesion Removal

$150,500

$115,625

$1,781

$5,593

$44,000$1,892

$18,500$688

Diabetes

90% of the U.S.’s $3.3 trillion in annual healthcare spending is for chronic or mental health conditions.9

Heart Disease & Stroke

Cancer

Affects29 million

Americans.9

86 million U.S. adults have prediabetes.9

$245 billion in annual expenses

for the U.S. healthcare system / employers.9

810,000deaths in the

U.S. each year.9

$190 billion in annual expenses

for the U.S. healthsystem / employers.9

$126 billion lost in on-the-job

productivity.9

1.7 million Americans diagnosed

each year.9

600,000deaths in theU.S. annually.9

93% of business leaders state employee health has a significant impact on productivity.10

4Control™4Clarity ™

More choices.View your health plan data like never before with a multi- dimensional view that spans all major cost drivers.

More power.Take control of your data stream to proactively address issues and opportunities in your plan —co-adjudication, pre-payment.

More savings.Understand your true healthcare costs and outcomes, and compare results with other employers and benchmarks.

More confidence.Install safeguards that allow you to uphold your responsibilities under ERISA and mitigate legal risk.

4Cost™ 4Compliance™

Chase, Dave. “10 Healthcare Industry Tricks Used to Redistribute Profits Away From Employers.” Forbes, June 2018, https://bit.ly/2QKGB5g

Paavola, Alia. “$28k: The average price a family of 4 will spend on healthcare in 2018.” Becker’s Hospital Review, June 2018, https://bit.ly/2JmCMTF

Landi, Heather. “CMS Actuaries: Economic, Demographic Factors Driving Healthcare Spending Growth.” Healthcare Informatics, Feb. 2018, https://bit.ly/2Dir2hx

Miller, Stephen. “For 2019, Employers Adjust Health Benefits as Costs Near $15,000 per Employee.” Society for Human Resource Management, Aug. 2018, http://bit.ly/2Q0k6IN

Hitchcock, Erin. “The Role of Big Data in Preventing Healthcare Fraud, Waste and Abuse.” Datameer, Feb. 2018, https://bit.ly/2Q1zXHg

Geyman, John. “Growing Bureaucracy and Fraud in US Health Care.” Huffington Post, Dec. 2015, https://bit.ly/2qGsrH9

Center For Policy And Research. “Charges Billed by Out-of-Network Providers: Implications for Affordability.” America’s Health Insurance Plans, Sept. 2015, https://bit.ly/2AfSivf

Rosenthal, Elisabeth. “After Surgery, Surprise $117,000 Medical Bill From Doctor He Didn’t Know.” New York Times, Sept. 2014, https://nyti.ms/2JPzAgf

Center for Disease Control and Prevention. “Health and Economic Costs of Chronic Diseases.” CDC, Oct. 2018, https://bit.ly/2O3vR45

Health, Productivity, and Performance Study Committee. “Exploring the Value Proposition for Workforce Health.” Health Enhancement Research Organization, Feb. 2015, https://bit.ly/2kY4G8N

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$15 billion is the amount of money the federal

government reclaimed in cases involving fraud since 2009.6

$270 billion is lost to healthcare fraud every year.6

Because Healthcare is Your Business.

Get Started

Connect with 4C Health Solutions today.

Physical ActivityA lack of exercise can lead to lasting health complications—

costing $117 billion in annual spending.9

Tooth Decay$300 million in dental treatment costs could be saved by proactively applying dental sealants to children who don’t have them.9

ObesityObesity and its related conditions cost the U.S.

healthcare system $147 billion a year.9

Smoking$160 billion in direct medical costs can be saved by helping smokers quit and preventing children from starting.9

Solving the Trillion Dollar Problem.

Why is healthcare one of a business’s top expenses? And more importantly, what can employers do about it?

Let’s explore what greater clarity and control can do for today's self-insured employers.

Healthcare’s Big

BreakthroughDo you know how much waste exists in you healthcare plan?

Which of your healthcare costs are necessary—and which are avoidable?

Do you have the insights needed to proactively reduce costs and enhance member value?

With 4C Health Solutions, self-insured companies can finally answer the big questions about their healthcare plans, and unlock big business benefits through total plan optimization.