- Healthcare Cost Crisis: The U.S. healthcare system faces escalating and unpredictable costs for critical medical services, creating significant challenges in quantifying and managing expenses.
- Catastrophic Costs Skyrocket: In 2023, catastrophic claims surged 15%, with billions spent on transplants, oncology, and gene/cell therapy—where costs alone grew at a 24% CAGR.
- HealthRate’s Mission: HealthRate is committed to making life-saving treatments affordable and accessible by providing transparency, consistency, and fairness in healthcare costs.
- Innovative Solution: HealthRate’s SaaS platform offers precise cost outcomes, and helps employers, insurers, reinsurers and stoploss providers better manage high-cost cases with confidence.
- Investor Support: With new funding, HealthRate is positioned to revolutionize the management of specialty healthcare, bringing immediate ROI and clarity to the market.
September 2024 – HealthRate, a cutting-edge SaaS platform focused on bringing transparency and predictability to the most complex and costly medical services, has closed its first round of funding. This investment will accelerate HealthRate’s mission to make life-saving treatments more affordable and accessible, ensuring transparency, consistency, and fairness in healthcare costs.
Addressing a Critical Market Need
Despite the recent push for transparency in healthcare legislation, the industry continues to grapple with the daunting task of publishing compliant data, accessing machine-readable files (MRF), and accurately applying contract, rate, and claims information in line with fiduciary duties. These challenges are further exacerbated by the escalating healthcare costs that U.S. employers face in 2024, with $1 million+ claims no longer rare and $2 million+ claims becoming increasingly frequent. According to SunLife, “87% of employers were likely to experience a stop-loss claim in any given year.” This surge in complex medical services intensifies the variability in healthcare costs, making it increasingly difficult for insurers and employers to plan effectively.
Recognizing the urgency of these issues, HealthRate has developed a cutting-edge platform designed to tackle these challenges directly. By leveraging a complex data set and real healthcare contracts, HealthRate exposes pricing transparency and mitigates costs, equipping payers to realize swift, tangible financial improvements.
“We built the HealthRate platform to deliver immediately quantifiable financial results by proactively identifying the optimal source and cost of care,” said Tim Michaels, CEO & Co-Founder of HealthRate.
As the healthcare landscape continues to evolve, platforms like HealthRate are essential in helping employers manage the financial risks associated with catastrophic claims, 90% of which are paid at between 140% and 800% of quoted case rates.
HealthRate’s Solution
HealthRate was founded to tackle these challenges head-on. Our platform is designed to transform complex, opaque healthcare payment methodologies into clear, actionable decisions, allowing employers, reinsurers, payers, and stop-loss providers to mitigate risks, plan more effectively, and ensure the sustainability of our healthcare system. By narrowing the staggering 800%+ rate differentials for identical services provided by the same specialists within the same health systems, HealthRate brings much-needed transparency and fairness to the market.
Our sophisticated, real-time decision support platform empowers users to make fact-based decisions with simple inputs, enabling them to manage risks and control costs confidently. Whether it’s pricing and re-pricing real-world claims scenarios or accurately predicting costs within seconds, HealthRate simplifies the most complex aspects of healthcare financial management.
Investor Confidence
Jon Phillips, Managing Director of First Trust Capital Partners, expressed confidence in HealthRate’s vision and capabilities:
“At First Trust Capital Partners, we search for innovative solutions that address critical market challenges, and we believe HealthRate fits those criteria. With catastrophic healthcare events on the rise, highly variable costs, and the increasing difficulty in managing risk, HealthRate has built a platform that resonates deeply with our mission. Their approach offers immediate ROI and does so with minimal impact on business operations. We believe in HealthRate’s ability to bring clarity and efficiency to the complex issue of rising healthcare costs, making HealthRate a vital player in the future of healthcare spend management.”
Changing the Game
HealthRate’s purpose is clear: to ensure that life-saving treatments—such as transplants, complex oncology, and novel cell and therapies—remain affordable and accessible. By providing tailored risk management, fast contract comparisons, and case-level analysis, we empower healthcare organizations to manage their financial performance more effectively,
As prices for advanced treatments like cell and gene therapies continue to soar, often exceeding $4 million, HealthRate’s platform offers a solution to manage these costs without compromising the quality of care.
Looking Ahead
HealthRate is poised to revolutionize the way healthcare costs are managed and understood. We are committed to delivering the transparency, consistency, and fairness that the healthcare market so desperately needs, ensuring that essential treatments remain accessible to all. For more information, visit www.healthrate.io, and follow on LinkedIn.
CONTACT INFORMATION:
HealthRate
Nikki Ahlgren
Chief Commercial Officer
612-840-2908
[email protected]
