CCDCareCostDownSurgical Spend Management

Resources

Download the knee replacement savings brief.

A practical PDF for self-funded employers, CFOs, HR benefits leaders, brokers, TPAs, and plan administrators evaluating whether high-cost elective surgery claims may justify a governed overseas COE pathway.

The brief uses an illustrative knee replacement scenario to show domestic allowed amount, China pathway cost, travel and support costs, estimated net plan savings, and annual opportunity.

Program view

Surgical spend pathway

Pilot ready

Savings

30-50%

Governance

Clinical review

Reporting

Case-level

Knee replacementEligible review$42k domestic benchmark
Orthopedic bundleCOE pathwayNet savings modeled
Member supportVoluntaryNavigator assigned

Employer reporting snapshot

12

Eligible cases

3

Clinical exclusions

Modeled

Pilot savings

Featured download

What one eligible knee replacement can mean for plan savings.

Use this PDF to frame an employer, advisor, or TPA conversation around savings logic, clinical governance, member suitability, and annual opportunity.

Knee Replacement Savings Brief

A CFO-ready example showing how one eligible knee replacement could create meaningful plan savings through a clinically governed China COE pathway.

Why users will find it valuable

  • Shows a simple employer-facing savings calculation.
  • Uses knee replacement as a concrete, familiar example.
  • Separates medical cost, travel, coordination, and member support.
  • Explains why this is a governed pathway, not unmanaged medical tourism.

Illustrative knee replacement scenario

Domestic allowed amount$42,000
China COE pathway medical cost$18,000
Travel + coordination + member support$5,000
Total overseas pathway cost$23,000
Estimated net plan savings$19,000
10 eligible cases per year$190,000

Illustrative only. Actual savings depend on procedure category, plan design, allowed amounts, member eligibility, travel suitability, clinical review, facility selection, and implementation costs. Savings are estimates, not guarantees.

Additional resources

More evaluation tools for employer surgical spend management.

Use these buyer-facing briefs to evaluate governance, advisor conversations, and pilot readiness before requesting a formal briefing.

Employer Buyer's Guide

A practical guide to evaluating voluntary overseas Center of Excellence pathways for self-funded employers.

Surgical Savings Model Brief

A framework for evaluating claims opportunity, participation assumptions, program cost, and net savings.

Clinical Governance Checklist

Questions to ask before launching a global elective surgery pathway.

Broker Client Conversation Guide

A client-ready discussion guide for advisors evaluating surgical spend alternatives with employer groups.

These resources are for employer-sponsored benefit evaluation and advisor discussions. They are not direct-to-consumer medical advice and should not be used to submit patient information or PHI.

Need a decision-ready briefing instead?

We can walk your team through savings, governance, member experience, and pilot fit.