Fixing healthcare means fixing the money.
Employers need to think like actuaries and proactively manage health plan risk. When insurance carriers negotiate arbitrary discounts on arbitrary charge masters - employers lose control over quality and cost of their plans.
Culminate Health is an InsurTech start-up focused on building a secure marketplace to empower self-funded employers that want to build and manage direct networks, scale their ACO plans, and manage specialty providers so they can focus on quality and control health benefit cost.
Direct networks are the future of value-based, employer-funded plans and we aim to be the technology and data backbone to enable them.
Employers and their advisors need the ability to take control, streamline broken industry processes, negotiate and transact with providers directly and at scale.
Access to plan data? No problem. We use blockchain to secure employee/patient data so analysts can apply continuous improvement strategies.
Because prices are agreed upon up front we can easily apply AI to high quality claims adjudication and focus Third Party Administrators on facilitating high quality care.
Complex Payer-Focused Ecosystem
The Problem We Solve
Employees and employers are paying more and getting less. 25 years ago health benefits averaged 5% of employee total compensation. Today health benefits are often up to 30%.
Employer self-funded health insurance remains a complicated ecosystem with antiquated systems, human error, fraud, and a lack of accountability and transparency.
Smart plan designers are saving employers up to 40% of their health benefits cost with proactive management and direct networks but those plans didn't scale - until now. We provide plan designers with the ability to enroll employers and members, forge compliant contracts directly with providers, analyze plan performance, and adjudicate claims - all on the same platform.
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Culminate Health enables employers and plan designers to manage direct networks, scale reference-based pricing negotiations, and manage employee members in a highly secure marketplace.
We use AI for scalability and Blockchain for security and transactions.