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Medical Benefit Management for health plans

Discover simple solutions for complex conditions.

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Reduce costs, manage risk, improve outcomes

Medical Benefit Management (MBM) offers an integrated suite of benefit management services. 

These services help health plans and self-insured employers reduce total cost of care, manage organizational risk and improve outcomes for members facing complex disease states.

MBM relies on a four-pronged strategy of network management, utilization management, care management and claim review.

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MBM strategies

  • Care management
  • Utilization management
  • COE/Network
  • Focused claims review

By combining these condition-centric capabilities with flexible funding models, including full risk transfer, MBM delivers the greatest impact to the patients and payers who need it most.

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How we help

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Bariatric Resource Services

Offer cost effective, quality proven, weight-loss surgery.

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Focused Claims Review

Ensure billing accuracy of professional and facility claims.
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Musculoskeletal (MSK) Solutions

Manage escalating spend and utilization.
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Oncology Care Management Programs

Manage cancer costs, improve outcomes and quality of care.
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Transplant Solutions

Get significant savings and statistically superior outcomes.
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Kidney Disease Management

Attain comprehensive, cost-effective disease management.
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Specialty Pharma Solutions

Manage specialty medical drug expenses.

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