Client Success Story: Maximizing Savings on ESRD Dialysis Claims

End-Stage Renal Disease (ESRD) continues to drive high-cost claims. In this case, H.H.C. Group helped a health plan achieve net total savings of $750,524.79 (90.1%) using its $300 per treatment flat rate pricing model— securing predictable costs and avoiding tens of thousands of dollars in excessive repricing company charges.

Challenge

The billed amount for a 56-year-old male patient's dialysis treatments totaled over $833K. Without intervention, the plan faced massive financial exposure.

Solution

H.H.C. Group applied its Reference-Based Pricing model, benchmarking to Medicare and charging only a flat $300 per treatment instead of basing payment on a percentage of the savings. The result:

• Provider Charges: $833,054.41
• Repriced Amount: $39,329.62
• Flat-Fee Total (144 treatments): $43,200.00
• Net Plan Savings: $750,524.79 (90.1%)

Results

• 90.1% cost reduction on a high-dollar claim
• Transparent, flat-fee dialysis pricing
• No balance billing for the patient

Real People. Real Savings.

With RBP and a flat-fee structure, H.H.C. Group delivers substantial added savings and peace of mind to self-funded plans — especially on recurring, high-cost treatments like dialysis.

For more information on how H.H.C. Group can help you achieve similar savings, contact us today.