The news: A new partnership between health benefits company Transcarent and Cleveland Clinic aims to reduce healthcare costs for employers by providing workers with free or low-cost virtual medical second opinions.
Details on the tie-up: Transcarent is partnering with Cleveland Clinic’s virtual medical second opinion arm, The Clinic—part of a larger telehealth joint venture between the health system and Amwell.
- Transcarent members will gain access to one of Cleveland Clinic’s 3,500 specialists across 550 advanced subspecialties.
- A physician at The Clinic reviews the patient’s original diagnosis and/or treatment plan and provides a personalized second opinion.
- The service will be offered as a Transcarent benefit. In many cases, it will cost patients nothing out of pocket, according to the company.
A win for Transcarent’s employer members: Transcarent’s enterprise customers will want to push virtual second opinions via The Clinic on their staff. That’s because easy and low-cost access to this program could drive employee uptake and save money for businesses.
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72% of second opinions uncover potential modifications to a patient’s original diagnosis or treatment plan, per Cleveland Clinic data. This could include bypassing expensive and unnecessary surgeries in favor of alternative treatments such as physical therapy.
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Misdiagnoses frequently drive up costs for employers, who are already projecting that their medical spend will grow 6% in 2023 versus a 5% increase last year, according to a September 2022 WTW survey.
- Early data from The Clinic reveals that its virtual second opinion program generates $65 million in savings per 100,000 health plan members.
Transcarent’s virtuous circle of savings: The company makes money when its solutions and services deliver savings for employers. For example, if a second opinion arranged by Transcarent results in lower costs for an employer, Transcarent gets a predetermined cut of those savings.
This business model has informed recent offerings and partnerships that Transcarent hopes will lead to more employer customers.
- The startup teamed up with Walmart in late 2021 to offer Transcarent members low-cost prescription medications and other services from the retailer.
- Last April, Transcarent rolled out an oncology care program that gives members access to top oncologists and other resources. Cancer care is now the top health expense for large corporations, per the Business Group on Health.
- And in September, Transcarent launched a pharmacy benefit offering that includes transparent prices and 24/7 clinical support for its members.
This article originally appeared in Insider Intelligence's Digital Health Briefing—a daily recap of top stories reshaping the healthcare industry. Subscribe to have more hard-hitting takeaways delivered to your inbox daily.
