Employers carry the risk — but don't control how care begins.
Employees often:
Enter through hospital systems first
Employees default to the highest-cost, highest-intensity setting — before conservative options are even considered.
Escalate before conservative care
Without a directed pathway, referrals jump straight to specialists and procedures that could have been avoided.
Trigger high-cost claims early
Once the claim is filed, the lever is gone. The cost is already committed. Management at this stage is too late.
Costs are created at entry — not managed at claims.
THE SOLUTION
A control layer for employer health plans
HealCo sits upstream of your existing infrastructure — governing where care starts, how it routes, and which providers capture it. Your plan stays intact. Your broker stays. Your TPA stays.
Where care starts
How specialty referrals are routed
Which providers are used
// HEALCO GOVERNANCE LAYER
Member reports symptom
Entry
HealCo governance
CONTROL
Existing plan infrastructure
PRESERVED
Broker
TPA
PPO Network
Untouched
You keep your broker, TPA, and plan.
We control how care flows through it.
Designed to support employer fiduciary responsibility under ERISA and CAA.
HOW IT WORKS
A five-step governance system
01
Member reports symptom
The employee enters the system through a governed channel — not a hospital directory or Google search. First contact is captured.
02
Routed to governed first-touch
HealCo assigns the appropriate first-touch provider — clinically appropriate, cost-aligned, and governed by your plan's rules.
Clinical triage
Cost-aligned
03
Directed to pathway
Care is directed to the most appropriate, lowest-cost pathway — DPC, physical therapy, a specialist, or a bundled procedure.
dpc
PT
Specialist
Bundle
04
PPO fallback when needed
When governed pathways aren't appropriate, the existing PPO network is available as a structured fallback — not a default.
05
Decisions logged and improved
Every routing decision is logged, measured, and fed back into the governance layer. The system improves with each member interaction.
Audit trail
Fiduciary record
// HEALCO GOVERNANCE LAYER
Entry governance
Pathway routing
Provider matching
PPO fallback
Decision logging
OUTCOMES
Measurable. Documented. Executive-level.
What governance produces — for your plan, your people, and your fiduciary record.
Reduced specialty escalation
Fewer members bypass primary care to reach high-cost specialists. Each deflection is a documented governance decision.
Lower cost volatility
By controlling the entry point, you reduce the unpredictable high-cost events that swing your plan's cost year over year.
Clear oversight of cost drivers
Every decision logged. Every referral tracked. Your team gains real visibility into what's generating cost and where it starts.
Stronger fiduciary position
A documented governance record demonstrates that your organization actively managed plan costs — not just reacted to them.
DEPLOYMENT
Start with a focused deployment.
Low friction. Fast signal. Designed for employers who want proof before scale.
POPULATION
150–400 lives
FOCUS AREA
MSK-first
TIMELINE
60–90 days
Outcome: First governance report + documented savings
Your board, CFO, and fiduciary committee receive a complete record of governed decisions, deflected costs, and pathway performance.
DEPLOYMENT TIMELINE
Configuration
Governance rules aligned to your plan, broker, and TPA. No infrastructure changes required.
Days 1–14
Go-live: MSK population
Focused on musculoskeletal — your highest-volume, most governable entry point.
.png)
