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Healthcare quality done right, the first time

By following a proven three step framework, group healthcare purchasers can turn quality into their most effective tool for solving the healthcare affordability crisis.

In 2026, healthcare quality is no longer a luxury — it is a mandate. While point solutions appear to offer a direct path to immediate savings, they only provide temporary relief. They have failed to control costs over the long term and often force trade-offs between financial impact and member outcomes and experience. Too often, short-term cost-cutting compounds long-term healthcare trend by increasing fragmentation, low-quality utilization, and deferred care. Cost containment is necessary, but without a long-term strategy and accountability from partners, it can be short-sighted.

Three proven strategies

Reducing cost trend isn’t like flipping a switch. Effective strategies build on one another over time to deliver near-term savings while setting the stage for lasting, workforce-wide health improvements. 

This graphic outlines a three-pillar healthcare strategy—**Optimize**, **Influence**, and **Transform**—designed to drive cost savings and improve patient outcomes through virtual care and high-quality provider networks. ### **The Three Pillars of Value** * **Optimize (Replacement Savings):** Focuses on triaging patients to virtual care to avoid expensive in-person settings and unnecessary ER visits. * **Influence (Quality Drivers):** Utilizes top-quartile providers and expert opinions to lower inpatient (IP) and outpatient (OP) costs while reducing unnecessary surgeries. * **Transform (Health Improvements):** Targets long-term prevention of costly health events through better medication adherence, chronic condition management, and increased preventive screenings. --- ### **Key Performance Metrics** The strategy demonstrates significant impact across various stages of care: * **47%** of virtual care visits successfully replaced more expensive ER or Urgent Care (UC) visits. * **38% lower rate** of repeat knee surgeries when using top-quartile providers. * **38% reduction** in inpatient hospital costs for members engaged in Virtual Primary Care (VPC). --- ### **Financial Impact** * **$250** saved per virtual urgent care visit. * **$700** annual spend reduction for each high-quality referral in the first year. * **$4,600** in projected savings over three years for every VPC-engaged member.

1. Optimize

The journey begins with optimizing the value and experience of care. This means reducing and replacing low-value care, engaging people (and populations) where they are, and creating early wins that build trust. In this phase, virtual-first care, navigation, and comprehensive wraparound services improve access, reduce friction, and generate immediate savings by redirecting care to higher-quality settings and providers

2. Influence

This foundation empowers healthcare service providers to influence a broader set of healthcare decisions and behaviors. Population health insights and predictive analytics enable more targeted interventions, including identifying rising-risk members earlier, supporting chronic condition management, and guiding people away from unnecessary or inappropriate care.

3. Transform

Over time, this high-quality, high-value care transforms the health and well-being of the workforce, driving sustainable long-term reductions in cost trend while also continuing to deliver measurable short-term savings due to reduced waste, expert guidance, and smarter healthcare decisions. The result is not just lower costs today, but a healthier and more resilient workforce tomorrow.

Strategy in action

Download our Healthcare Cost Reduction Playbook to see the full framework in one glance and uncover real-world data and results that demonstrate savings from virtual care, high-quality navigation, and proactive member engagement.

Healthcare reduction playbook
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