HealthCareTN Major Initiatives
Whole Person Health
Whole Person Health Management is more than just a wellness initiative—it is a risk management strategy. Because self-funded employers pay for claims directly, every unaddressed health factor (mental, physical, or social) represents a financial liability and a barrier to member well well-being.
Cost & Quality
For a self-funded employer, the provider network is not just a list of doctors—it is the primary driver of the plan’s financial performance and the legal safety of the company’s leadership. Because self-funded employers pay for every claim directly, the “cost and quality” of the network are the two most powerful levers they have to control their spend. HCTN can show employers where to look for low value care opportunities to eliminate and high value care opportunities to implement.
Innovation & Disruption
For a self-funded employer, fiduciary integrity is not just an ethical ideal—it is a legal mandate with significant personal and corporate consequences. Under the Employee Retirement Income Security Act of 1974 (ERISA) and the more recent Consolidated Appropriations Act (CAA), employers who self-fund their health plans are legally classified as “fiduciaries.” This means they are managing someone else’s money (the employees’ contributions and the company’s assets) and are held to the highest standard of care under the law.
Data Analysis, Education, Identifying Innovators
Our work focuses on the main drivers of healthcare claims expense.
Chronic Illness Management
HCTN provides fresh perspectives and pilot project opportunities to keep chronic illness management state-of-the-art.
20% of your members drive 80% of your claims. That is Chronic illness 80/20 rule and an employers greatest challenge (or opportunity). Unlike an acute injury (like a broken arm), which has a defined start and end cost, chronic conditions like diabetes, hypertension, and musculoskeletal (MSK) issues represent compounding financial interest that the employer pays indefinitely. Developing a sound strategy that includes prevention, screening, appropriate treatment, and attentive management. HCTN can show you how and connect you with innovative vendors and programs.
Pharma Benefit Management
HCTN helps employers manage the vendors that manage PBM.
Without transparency, alignment, and trust, employer plan sponsors will continue to react to a PBM market that drives more expensive treatments. Visibility and alignment foster trust. HCTN can show you how.
High-Cost Claims
HCTN help employers dig in to high-cost claims.
High-cost claims come from all direction. Whether they are expensive drug treatments, like GLP1s or cell and gene therapies, or expensive conditions like cancer or high-risk maternity, there are many avenues for claimants to exceed stop loss. Comprehensive strategies, strong utilization and clinical management are essential. HCTN works with employers to understand what high costs events are driving their claims.
Value Happens When Employers Work Together
Your voice is important. Combined with other employers, it is unstoppable.