Domestic-only cost management
Traditional network strategies may not create enough price separation for selected high-cost elective cases.
Surgical savings review
Cut avoidable elective surgery costs without sending employees into unmanaged medical tourism.
CareCostDown helps self-funded employers evaluate eligible high-cost surgical cases through a physician-led, clinically governed overseas Center of Excellence pathway, with voluntary member support, savings modeling, and employer-ready reporting.
Concept pathway
Manage high-cost elective surgery spend with a physician-led Center of Excellence pathway.
Plan
Clinical Review
COE Pathway
Reporting
Physician-led review
No PHI in web inquiry
Voluntary member pathway
Employer-ready reporting
Pilot-friendly evaluation
Savings scenario
What one eligible surgery can mean for plan savings
A CFO or broker should be able to see the logic quickly: compare the domestic allowed amount against the governed pathway cost, then scale only eligible cases.
Domestic allowed amount
$42,000
Overseas COE pathway cost
$18,000
Travel + coordination + member support
$5,000
Estimated net plan savings
$19,000
Modeled annual savings opportunity
10 eligible cases per year
$190,000
Savings logic
$42,000 domestic allowed amount minus $23,000 modeled pathway cost equals $19,000 estimated net plan savings per eligible case.
Scale
10 cases
Illustrative only. Actual savings depend on procedure category, plan design, allowed amounts, member eligibility, travel suitability, and program implementation.
The problem
A small number of elective surgeries can create a large plan-cost problem.
Self-funded employers can see annual claims spend move sharply when high-cost elective procedures occur without a suitable alternative pathway. The challenge is not just price. It is limited visibility, limited member support, and the need to avoid unmanaged medical travel risk.
Self-funded employers can absorb large elective surgery claims directly into annual claims spend.
High-cost elective procedures often receive attention only after the allowed amount has already hit the plan.
CFO and benefits teams may have limited visibility into clinically suitable alternatives before members decide where to receive care.
Employers need a governed pathway that avoids the risk of unmanaged medical travel while still creating a serious savings option.
Why now
Why existing options are often insufficient
Employers need more than a lower-price promise. They need a governed, explainable pathway that can be evaluated by finance, benefits, advisors, and operations.
Broad point solutions
Generic navigation or engagement programs often lack a defined surgical pathway, COE criteria, and plan-level savings model.
Employee-led medical travel
Unmanaged travel can create clinical, coordination, privacy, and employer reporting gaps that benefits teams should avoid.
CareCostDown pathway
A productized pathway for elective surgical savings
CareCostDown turns the overseas COE concept into a structured employer program with review, education, coordination, and reporting.
Step 1
Plan-level opportunity review
Review plan context, covered lives, buyer role, and elective surgery savings potential.
Step 2
Eligible procedure screening
Identify which procedure categories may fit the pathway before case-level discussion.
Step 3
Physician-led case review
Use clinical review to determine whether a specific case appears appropriate for the pathway.
Step 4
Member navigation
Provide voluntary education and support so members understand options without pressure.
Step 5
Overseas COE coordination
Coordinate travel, facility pathway, care logistics, and practical member support.
Step 6
Employer reporting
Deliver employer-ready reporting on activity, savings context, and program implementation.
Governed pathway
Not medical tourism. A governed surgical pathway.
The distinction matters. Employers should not push workers into unmanaged travel. The goal is a clinically governed, voluntary, reportable pathway.
Unmanaged medical tourism
Loose, employee-directed travel creates gaps for members, employers, and advisors.
Employee searches on their own
Unclear facility standards
No plan-level savings model
No structured employer reporting
Weak pre/post coordination
CareCostDown pathway
A voluntary, governed pathway is built for clinical review, coordination, savings logic, and reporting.
Physician-led review
Defined COE criteria
Voluntary member education
Travel and care coordination
Employer-ready savings reporting
Clear privacy and PHI boundaries
Who this is for
Designed for the teams responsible for healthcare cost control.
The review is useful when financial, benefits, advisory, or administrative teams need a practical way to evaluate elective surgery savings.
Self-funded employers
Assess whether elective surgical claims deserve a dedicated savings pathway.
CFOs
Evaluate savings potential, claim volatility, and financial rationale before broader rollout.
HR and benefits leaders
Offer a voluntary option with education, support, and privacy boundaries members can understand.
Brokers and consultants
Bring clients a focused strategy for high-cost surgical claims, not a vague point solution.
TPAs and carriers
Review how a defined surgical pathway may fit eligibility, navigation, and reporting workflows.
Review process
How the review works
The goal is to qualify the opportunity quickly, without asking your team to send PHI or build a full implementation plan upfront.
1
Share basic plan context
Submit role, organization, covered lives, and primary interest. No PHI is required.
2
We assess the opportunity
CareCostDown reviews whether elective surgery spend may justify savings modeling or a pilot briefing.
3
You get a recommended next step
The next step may be a savings model, broker discussion, pilot briefing, or TPA workflow review.
4
Move only if there is fit
The review is meant to qualify the opportunity before asking teams to commit time or resources.
Clinical and privacy boundaries
Built for business evaluation without unnecessary patient exposure.
CareCostDown is designed for employer program evaluation and voluntary member support. The website should not be used to submit patient names, diagnosis details, insurance card data, SSN, DOB, medical records, or other PHI.
No patient names, diagnosis, insurance card data, SSN, DOB, medical records, or other PHI through the website.
The pathway is voluntary and does not replace the employee's physician or individual medical advice.
Cases that are not clinically or logistically appropriate for travel should remain outside the pathway.
Employer reporting is designed around business and savings context, not unnecessary patient-level exposure.
FAQ
Common questions
How does the savings review work?
You share basic plan context through the form. CareCostDown reviews whether the organization may have meaningful elective surgery savings potential and recommends the next best step: savings model, pilot briefing, broker discussion, or TPA workflow review.
Do you need claims data to start?
No. A first conversation can begin with covered lives, role, plan context, and target procedure interest. Claims data can make later modeling more precise, but it is not required to start the review.
Is this a replacement for the employee's doctor?
No. CareCostDown does not replace individual medical advice or the employee's relationship with qualified clinical professionals. The pathway is designed for evaluation, education, review, coordination, and voluntary support.
What happens if a case is not appropriate for travel?
The case should not proceed through the overseas pathway. Suitability depends on clinical, travel, procedural, and member-specific considerations. The program is intended to screen for fit before coordination advances.
Can this be piloted before a full rollout?
Yes. Many employers and advisors prefer to start with a defined procedure category, population segment, or pilot briefing before considering broader implementation.
How is member privacy handled?
This website is for business inquiries only and should not receive PHI. Program discussions are structured around clear privacy boundaries, and unnecessary patient-level information should not be submitted through marketing forms.
What procedure categories are most relevant?
The strongest fit is typically selected high-cost elective surgical categories where care can be planned in advance, travel can be evaluated responsibly, and an overseas Center of Excellence pathway may create meaningful savings.
Surgical savings review
Ready to evaluate whether elective surgery can become a serious savings opportunity?
Start with a focused review. We will help determine whether the next step should be a savings model, pilot briefing, broker discussion, or TPA workflow review.