Startup handpicks services so employees can receive free health care

Careledger is aiming to streamline the health care system of self-insured companies, so that their employees can receive free, high quality care.

The US has one of the most expensive and least effective health care systems when compared to other industrialized nations. Though the Affordable Care Act has improved access and equity, for those who don’t qualify as low-income Americans, health expenditures remain a daunting reality. We have seen companies that help businesses reform their health care networks, but Careledger goes a step further to offer service recommendations which would enable employees to receive free, high quality care.

This is how their model works. Careledger first analyzes the employer’s current paid price for each procedure and test. They then search for the best services with good ratings, which can provide care with the lowest price that is under the insurance coverage, and offer those recommendations to the employees. A colonoscopy, for example, can cost from USD 5,000 to 10,000, so Careledger would find — out of its established networks of quality healthcare providers — physicians that would charge within the insurance limit, resulting in free care for the employee. They also recommend services based on location and convenience. The startup will only receive payments when the care is free, and works on a 50/50 shared-savings model, which means that they will only get paid when they actually drive savings for their clients.

Though bigger corporations such as Walmart are also aiming to provide free health care to employees in a similar way, Careledger makes the plan available to smaller self-insured companies who may not have the resources and help from insurance corporations to look into it themselves. Are there other overlooked demographics that could benefit from a health care reform?