There's a clear answer, and a different path. Learn how healthcare actually gets priced, and how PR Health points members toward high-quality care that costs the plan less.
None of this is a scandal. It's how the market is structured. The figures below are drawn from public hospital price-transparency and Medicare data, shown as illustrative reference.
The same procedure can cost wildly different amounts at facilities a few miles apart, for clinically identical care.
A network discount comes off a list price the hospital sets. A discount off a high number can still be a high number.
Published quality scores don't track price. A lower-cost facility often scores the same or better on the procedure you need.
This data isn't on a price tag at the point of care. Most people are left to figure it out alone, at the worst possible moment. PR Health does the navigating with you.
When a member needs care, the plan can pay the first price it's handed, or it can guide the member to an equally good provider at a fair price. Here's the difference, side by side.
Same member, same medical need. The route changes who pays what.
Bars show relative direction, not specific dollar amounts. Members are guided to better-value providers, never restricted to them. When the plan pays less and the member follows the plan, everybody wins.
PR Health assembles a curated stack and stands behind it as one program. Here's what that looks like for a member and a plan.
Members are guided toward high-quality, lower-cost providers, with the data to back the choice, never a restriction.
Virtual primary care that's one tap away, so members start with someone who knows them before care escalates.
Claims are priced against transparent benchmarks: Medicare's published rate plus a fair margin, backed by direct provider contracts, instead of a hospital's self-set list price.
A care team helps members find the right place for the right service, and handles the logistics around it.
Administration, primary care, pharmacy, pricing, navigation, and stop-loss arrive as one program.
It's our program to stand behind, so members, employers, and brokers don't have to manage the parts.
Explore the approachEach lesson stands on its own. Start anywhere. The visuals do the explaining.
How pricing works, why network discounts can mislead, and where your premium dollar actually goes.
Read the lessonThe same procedure can cost far more at a facility that scores lower on quality. Here's how to navigate it.
Read the lessonWhat self-funding is, how stop-loss caps the risk, and how the HIPAA firewall protects member privacy.
Read the lessonWhy the same drug costs more depending on where it's given, and what PR Health's pharmacy approach does about it.
Read the lessonCompare illustrative facility prices, check a prescription, and run a rough savings estimate for your group.
Open the toolsHow the curated stack is coordinated as one program, and exactly what PR Health does and doesn't do.
See the approachNo pressure and no obligation, just a clear look at how the plan would work for your people.
