Innovative Healthcare Solutions, Tailored To Your Needs
A.I. enhanced member engagement app that includes TIC compliance, call center navigation, service provider integration, direct contracting, and Rx advocacy— seamlessly delivered through one app at no PEPM cost.
Enhance the healthcare experience by streamlining communication and improving access to care for both members and providers.
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THE PROBLEM
Enlighten
Hospital services in the U.S. are often heavily marked up, causing financial strain on patients and contributing to widespread medical debt. The lack of pricing transparency makes it difficult for patients to anticipate and understand their medical expenses.
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- Reduce the frequency & severity of medical claims
- Care costs can lead to some people delaying needed treatment
- Prescription drugs costs prevents some patients from filling prescriptions
- Out-of-pocket cost of a prescription can result in higher mortality among Medicare patients
ENLIGHTEN
Reduce the frequency & severity of medical claims
- Hospitals typically mark up the cost of common procedures by an average of 300%
- Average markups for imaging are estimated at approximately 500%
- The cost of an ER visit can be marked up by 300% compared to similar services in outpatient settings
ENLIGHTEN
Care costs can lead some to put off needed treatment
- Avoiding Care Due to Cost: About 38% of Americans reported delaying or skipping medical care in 2022 due to high costs. (Source)
- Financial Hardship: Medical expenses drive over 60% of personal bankruptcies in the U.S. (Source)
- Increased Severity & Costs: Patients who delay care often face higher costs later, with untreated conditions leading to more severe health issues and expensive emergency interventions. (Source)
ENLIGHTEN
Prescription drugs costs prevents some patients from filling prescriptions
- Medication Nonadherence: About 1 in 4 Americans (24%) say they or a family member have skipped doses or not filled a prescription due to cost. (Source)
- Chronic Disease Impact: Nonadherence to medications for chronic conditions (e.g., diabetes, hypertension) leads to $300 billion in avoidable healthcare costs annually. (Source)
- Cost vs. Compliance: A $10 increase in prescription co-pays results in a 33% drop in adherence among patients with chronic illnesses. (Source)
ENLIGHTEN
Out-of-pocket cost of a prescription can result in higher mortality among Medicare patients
- Higher Mortality Rates: Medicare patients with high out-of-pocket drug costs are 23% more likely to die within a year than those with affordable access. (Source)
- Coverage Gaps & Risk: The Medicare “donut hole” leads to 14% of seniors stopping essential medications, increasing hospitalizations and complications. (Source)
- Financial Burden & Health Outcomes: Seniors facing high prescription costs are 50% more likely to cut back on food or other essentials, further worsening health risks. (Source)
Growing Trends
In the wake of the ACA, for-profit care companies have shifted their focus to maximizing returns for shareholders, often sidelining the needs of employers, clients, and employees. In this post-ACA landscape, profit growth is skyrocketing at a pace rivaling Apple’s meteoric ascent to become the world’s most valuable company.
Post ACA
Apple
Since the ACA passed, the S&P 500 Healthcare Index has risen 186%, outpacing the S&P 500 (141%) and Dow Jones (139%).
Misaligned Incentives
Problem: Shareholders over Employers, Clients, and Employees.
| 2010 | 2023 | |
| Anthem | $51 | $520 |
| Cigna | $31 | $272 |
| CVS/Aetna | $27 | $98 |
| United | $32 | $500 |
WHAT WE DO
About Transperra
Transperra can best be described as “High Tech, High Touch” – we’re healthcare industry experts passionate about supporting employers by enhancing their competitive position, reducing healthcare spending, and improving the lives of their employees and their families.
Digital Member App
White label user friendly app with option to integrate Transperra transparency price solution.
Transperra Technology
Transparency tools built by healthcare experts to obtain the right information at the right time.
Customized Value Based Networks
Leveraging Transperra data, we support TPAs, Utilization Review and other plan partners identify quality providers with reasonable prices generating plan and member savings.
TPA Bolt On Solutions
One Platform- One Place- One size does not fit all- A fully integrated solutions hub for bolt on TPA back-office solutions and value add offerings without all the costs and hassle.
Advanced Claims Cost Management
Data-driven solutions that empower TPAs and plan sponsors to proactively manage claims expenses, reduce waste, and optimize cost efficiency without compromising care quality.
Seamless Provider Connectivity
A unified platform that streamlines communication between TPAs, utilization review teams, and direct primary care providers, ensuring HIPAA-compliant data sharing for better decision-making and improved patient outcomes.
OUR MISSION
Revolutionizing Healthcare Access for Employers and Members
Our advanced platform streamlines healthcare benefit offerings, providing comprehensive services that are both cost-effective and simple to manage. We give you the tools to deliver superior care with efficiency.
By streamlining communication and care coordination, we help eliminate out-of-pocket costs for members and significantly reduce the total cost of care without the fees and paperwork. With a focus on technology and dedicated nurse call center support, we create sustainable, predictable, and user-friendly health plans that save thousands on medical claims and Rx costs. Experience a healthier tomorrow with Transperra.
Empower
Hospital services in the U.S. are often heavily marked up, causing financial strain on individuals and families contributing to widespread medical debt. The lack of pricing transparency makes it difficult for patients to anticipate and understand their medical expenses.
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WHAT OUR CLIENTS SAY
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