OUR VALUE
Services
Health Care Cost Containment Solutions for Health Plans
Drive Value. Reduce Spend. Elevate Member Outcomes.
Health care costs continue to rise, challenging the financial sustainability of health plans nationwide. At Aegis Cost Containment, we help health plans contain costs while maintaining quality care for members.
Our innovative cost containment strategies are built around data-driven insights, clinical expertise, and a deep understanding of today’s fragmented health care environment.
Health Plan Design Services
Customized, Data-Driven Plan Design to Maximize Value and Improve Outcomes
Our Health Plan Design Services help employers and health plans create benefit structures that align with organizational goals, control costs, and enhance member satisfaction. We take a strategic, consultative approach to plan development, focusing on quality, affordability, and member engagement.
Our services include:
- Plan Architecture & Strategy: Design of high-performance health plans including PPO, HDHP, HMO, value-based, and reference-based models.
- Cost Modeling & Actuarial Analysis: Predictive modeling to evaluate the financial impact of plan changes and optimize cost-sharing strategies.
- Benefit Optimization: Alignment of benefits with clinical outcomes, including incentives for preventive care and chronic disease management.
- Regulatory Compliance: Ensuring plans meet all federal and state requirements, including ACA, ERISA, MHPAEA, and others.
- Member Experience Focus: Simplifying the member journey with intuitive design, clear communication, and support tools to drive smarter healthcare decisions.
Why Choose Us:
- Evidence-based design supported by claims and utilization data
- Vendor-neutral recommendations tailored to your workforce
- Support for implementation, employee communication, and performance tracking
Utilization Management
Ensure appropriate care, at the right time, in the right setting. We reduce unnecessary services through:
- Prior authorization reviews
- Concurrent and retrospective case management
- Medical necessity audits
Claims Review & Payment Integrity
We help you prevent overpayments, detect fraud, and recover inappropriate claims through:
- Pre-pay and post-pay claim reviews
- Out-of-network repricing
- DRG validation & coding audits
- Subrogation and coordination of benefits (COB)
Provider Network Optimization
Leverage custom or wraparound networks to steer members to high-value care:
- Narrow and tiered networks
- Reference-based pricing options
- Direct contracts with high-performing providers
Chronic Care & High-Cost Case Management
Target your highest-risk members with proactive, personalized care navigation to reduce avoidable costs and improve outcomes:
- Complex case management
- Disease management programs
- Behavioral health support
Why Choose Us?
- Proven ROI: Our clients save 10%–30% on average through integrated cost-containment strategies.
- Member-Centric: We never compromise care quality or experience.
3.Scalable Solutions: From small regional health plans to national payers, we tailor programs to fit your population and goals.
4.Compliance-Focused: All processes align with CMS, ERISA, HIPAA, and state regulatory standards.
Partner With Us
At Aegis Cost Containment, we don’t just cut costs—we build sustainable, smarter health plans.
Let’s Talk
Schedule a free cost analysis or strategic consultation today.
Contact: sc@a3-cc.com
Learn More: www.a3-cc.com evidence based provider selection health and medical value based care