This modeled case study illustrates how a mid-size health share network can leverage hospital price comparison tools to systematically reduce sharing amounts — using real published hospital prices and industry benchmarks.
Network Profile
A faith-based health share network with 50,000 members across 12 states. Annual sharing pool of approximately $180M. Members share medical needs through monthly contributions, with the network facilitating matches between needs and available funds.
The Challenge
Rising healthcare costs were putting pressure on the sharing pool. Monthly member contributions had increased 15% over two years, and member satisfaction surveys showed growing frustration with sharing amounts for planned procedures. The network had no systematic way to help members find lower-cost care before scheduling procedures.
The Solution
The network integrated MyCareCost's health share member tools across three touch points:
- Member portal link: one-click access to price comparison from the pre-authorization workflow
- Pre-care guidance: automated email with price comparison instructions when a member submits a sharing request for a planned procedure
- Network care coordinators: trained to use price data when guiding members through high-cost procedure decisions
Results (Modeled)
Over a projected 12-month period, the model shows:
- 32% of members with planned procedures used the price comparison tools
- Members who used the tools selected providers averaging 22% lower cost
- Average savings per member who used the tools: $2,200 per procedure
- Projected annual community savings: $8.4M across all planned procedures
- Projected impact on monthly contributions: 4-6% reduction possible
How the Math Works
With 50,000 members, approximately 12,000 planned procedures occur annually (CMS utilization rate). At 32% tool adoption, 3,840 procedures used price comparison. Average savings of $2,200 per procedure yields $8.4M in annual savings. At the PMPM rate for bulk access, the network's annual cost was $180K — a 47:1 ROI.