The Cost-Plus Solution

Wholesale vs. Retail Pricing — The Power of Transparency

Every rate benchmarked against Medicare (100%).

Force 1

The Medicare Subsidy Gap

Hospitals lose ~20% on Medicare patients and shift those losses to commercial plans. With roughly two-thirds of patients on Medicare, employers end up charged 3–4× Medicare rates to make up the difference.

Force 2

Vertical Consolidation

Carriers bought providers and PBMs (pharmacy benefit managers) to guarantee the 85% MLR (medical loss ratio) rule works in their favor. Vertically integrated conglomerates now control insurance premiums, hospital prices, pharmacy pricing, and care pathways — 80% of the market is controlled by four conglomerates.

The Problem in Numbers

  • Traditional PPOs pay ~254% of Medicare nationally — and over 300% in California, Florida, and New York (RAND Hospital Price Transparency Study).
  • Self-funding alone doesn't fix it. Rented PPO networks still pay ~250% of Medicare. Changing who holds the risk doesn't change the price of care.
The Cost-Plus Difference

Change the math, not the doctor.

Instead of paying a discount off an inflated "retail" charge, your plan pays the greater of Medicare + 25% or Cost + 20% — a fair, transparent margin above the provider's actual cost. In 2025, 99.5% of claims were paid at exactly these terms.

Example
Same $10,000 claim:
$25,400$15,000
Payment approach as % of Medicare
Medicare100%
Cost-Plus Pricing150%
Self-Funded w/ PPO Network250%
Traditional PPO254%
Sources: RAND Hospital Price Transparency Study (Round 5.1); Milliman 2025 Commercial Reimbursement Benchmarks.
What Cost-Plus Membership Delivers

Three deliverables. Zero ambiguity.

Wholesale, pre-negotiated facility rates

Minimal employee disruption — your team keeps a top-five provider's card.

Advocate / Auditor / Litigator on your behalf

99% success rate in executing pre-negotiated rates in 2025 on behalf of clients across the US.

Full transparency

Complete access to your claims data — every payment traceable to a benchmark and a margin.

Ready to see your number?

We run the analysis on your own data — no charge, no obligation.

Get Your Free Analysis