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CEO
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Founded
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Website

Problem Tech Solves

Tech Brief

Health care is more confusing, more costly and more complex than ever before. Employers are recognizing that it’s not enough to offer solutions. Payers have a strong financial incentive to maintain the status quo. They merely offer incremental improvements or navigation to and through a faulty system. Members need unbiased information and trusted guidance along with easy, equitable access to high quality care—elements that create a meaningful experience for Members that meet their needs—at an affordable cost. Transcarent in a sense is saying, how can we take the health consumer and have her or have him go directly to the care and avoid the middle, because the middle is always where the friction is and where the cost is. We developed a new health and care experience that makes it easy to get the high-quality, affordable health and care that everyone and their families deserve – where and when they want it, on their terms. Transcarent puts health consumers back in charge by directly connecting them with an integrated ecosystem of high-value providers and health solutions, providing transparent information, and offering trusted guidance – in as little as 60 seconds, 24/7/365, from the palm of their hand regardless of location, often at no cost to Members and at a lower cost to their employer. Transcarent takes accountability for results – offering at-risk pricing models (unheard of in the digital healthcare industry) and transparent impact reporting to align incentives towards measurably better experience, better health, equitable access, and lower costs.

Tech Differentiators

Transcarent is a fully integrated health and care experience offering that coordinated information from employers, health plans, providers, and partners in a carefully curated ecosystem, not point solutions that don’t communicate. Transcarent is addressing the 20 years of unmet promises by insurers and navigators to resolve the increasingly confusing, complex and costly healthcare system with a new, different, and better health and care experience delivered with easy-to-use technology within one digital tool for Members and one dedicated partner for self-insured employers. Our app is a digital front door to access Transcarent’s full benefits, all a person’s company health benefits information and health plan documents, access to everyday care, complex care, behavioral health, care at home, personalized pharmacy, and specialists, as well as human health guides (not bots and without an IVR) via chat, message, video, or app-initiated phone call. Our solution is interaction enabled via technology, managed by systems and algorithms, with a human instantly available to help you at any point in your care journey - a dedicated Health Guide who builds a longitudinal relationship that sees people through their family’s health and care, someone who truly listens, understands the challenges and can become a trusted partner who goes with you on the journey rather than the industry norm of being a cross between a traffic director and switchboard operator - accessible by the touch of a button any time from anywhere and giving the same care for all incomes, education levels and zip-codes!

Validation

In 2021, MorningStar Actuarial Consulting, a leading actuarial and consulting firm summarized two national databases representing over 53 million lives and $253 billion in paid medical claims (excluding pharmacy-based prescription drug claims) to ascertain the claim experience under a traditional health plan setting. MorningStar Actuarial Consulting analyzed Transcarent costs compared to the national average (population level) cost benchmarks. The data analyzed represented all Transcarent claims data from over 1 million Members, all surgical categories, all geographic areas and all facility types, including inpatient hospital, outpatient hospital, specialty hospital or ambulatory surgical centers over a two-year period. Transcarent serves over 1 million Members with more than 160 Centers of Excellence and Ambulatory Surgery Centers, more than 300 pre-negotiated surgical bundles across eight surgical categories, and provide documented improvements in quality of care, resulting in 80% lower complications. Transcarent’s Surgery Care consistently reports Net Promoter Scores (NPS®) above 90, proof that if you focus on quality care and a better experience for the patient, you can also drive lower costs for everyone. Key Study Insights Include: ●Transcarent’s model provided an average overall net savings of 49.5% per procedure ●Savings were reported in two key areas — bundled case rates and shifts to the appropriate site of care ●Per surgery savings varied from 40.3% for orthopedic surgery to 76.9% for spinal surgery ●This savings analysis did not include the positive effect of fewer complications, decreased presenteeism, lower absenteeism or faster return to work

Why Us