For employers & benefits advisors

Lower your plan's healthcare spend, before and after care

For self-funded employers, most plans overpay: care delivered at the priciest site, bills nobody questioned, spend that a lower-cost option would have avoided. CareRoute helps employees choose lower-cost care before it happens, and disputes excessive or erroneous bills after. You pay only from the savings we deliver.

Before care

Employees compare costs and find lower-cost, in-network options and sites of care.

After care

Bill Defense reviews and negotiates down excessive or erroneous medical bills.

Paid from savings

No platform fee. Nothing owed unless measurable savings are realized.

Self-funded savings estimator

Enter two numbers to size the healthcare savings opportunity in your plan. This is an illustrative estimate grounded in public research, not a prediction. Nothing is saved.

Leave plan spend blank and we estimate it from covered lives using a public benchmark (about $7,500 per covered life).

Illustrative estimate for informational purposes only, not a guarantee of savings. Ranges are national and grounded in public research (KFF, RAND, CMS, and peer-reviewed studies); your plan-specific opportunity depends on your claims, network, and market. Last updated 2026-09-15.

How CareRoute lowers plan spend

CareRoute already does this one person at a time on the consumer side, cutting real money off individual medical bills and steering people to lower-cost care through tools used thousands of times. For a self-funded plan, the same two levers compound across a whole workforce:

  • Before care: employees use CareRoute's cost tools to see what a service should cost and where to get it for less, shifting shoppable care to lower-cost sites.
  • After care: Bill Defense audits, disputes, and negotiates bills that are excessive, erroneous, or wrongly out-of-network.
  • Independent and outcome-based: CareRoute is not tied to a carrier or network, and is paid only from the savings realized.

How we calculate the estimate

The estimator applies published national benchmarks to the numbers you enter. It is deliberately transparent and conservative: it sizes an addressable opportunity range, not a predicted result. If you leave plan spend blank, we estimate it from covered lives at about $7,500 per covered life (KFF Employer Health Benefits Survey (blended average total plan cost per covered life)). The overall range is a blended 5 to 15 percent of medical plan spend, drawn from four overlapping categories:

CategoryRange (% of spend)
Price variation & fair-price steering2% to 6%
Site-of-care & shoppable services1% to 4%
Avoidable ER & low-value care1% to 3%
Billing & payment integrity0.5% to 2%

Because the categories overlap, the headline figure is a conservative blended range rather than the sum of the parts. These are national illustrative ranges; a plan's real opportunity depends on its claims, network, and market, which is exactly what a precise assessment measures. Benchmark set version 2026-09-15.

Frequently asked questions

What is this savings estimate based on?

It applies published, national benchmarks to the numbers you enter. The ranges come from public research (the KFF Employer Health Benefits Survey for plan cost, the RAND Hospital Price Transparency Study for commercial-to-Medicare price variation, CMS and Health Care Cost Institute data on shoppable and site-of-care spend, and peer-reviewed studies on avoidable ER use). It is an illustrative opportunity range, not a prediction or a guarantee.

How does CareRoute actually help an employer capture these savings?

On both sides of care. Before care, CareRoute helps employees understand their options, compare costs, and choose lower-cost sites of care. After care, CareRoute Bill Defense reviews and negotiates down excessive or erroneous medical bills. For a self-funded plan, those reductions flow straight back to the employer.

What does it cost?

CareRoute is paid only from the savings it delivers. There is no platform fee and nothing owed unless measurable savings are realized. That keeps the incentive fully aligned with lowering the plan’s spend.

Is this specifically for self-funded employers?

Yes. Self-funded (and level-funded) employers pay their own claims, so every dollar of avoidable spend or overbilling that CareRoute removes is a dollar the employer keeps. The estimator sizes that addressable opportunity for your plan.

Can benefits advisors and brokers use this with their clients?

Yes. Advisors can run the estimator for a client to size the opportunity before a deeper conversation. A branded, client-ready advisor assessment is on the roadmap. In the meantime, request a precise assessment and note that you are an advisor.

Related

The savings estimate is illustrative and for informational purposes only. It is not a prediction or a guarantee of savings, and does not constitute financial, actuarial, or insurance advice. Ranges are national and grounded in public research; actual results depend on your plan, claims, network, and market. Last updated: September 2026.