White Paper For American Employer

Find here a short excerpt of our whitepaper you can download the full pdf version at the bottom of this page


As an American employer, you  are confronted to a massive and complex problem :

  • You want to provide health coverage that keeps employees healthy and productive, preventing absenteeism and/or presenteeism, but  by the same time you need to rein in costs of this very significant operating expense ;
  • In a time of full-employment, you need to attract qualified, engaged workforce, so you  want employees to like their health benefits, which these are very attached to

Healthcare benefit is  the first choice for 35% of the workforce, and comes only second to retirement savings when looking at top 3 choices combined :

A second figure of this survey showed that 60 % of the respondent employees would prefer better benefits over take-home money ;

a third one, that working Americans trust employers most as a source for high quality health coverage…

source : American Benefits Council National Poll November 5-9 2017

A decreasing rate in premiums hikes in the last decade

Source: Keiser/HRET Survey of Employer Sponsored Health Benefits 2001-2016

Efforts deployed by employers to curb premiums ,  have produced results in the  last decade :  its  increasing pace is decelerating rapidly since 2006. But we will see below that this trend in premium hikes masks opposite evolutions in volume of care on one side and  evolution in prices on the other.  As it appears in a 2018 study released by HCCI (Health Care Cost Institute) : prices continued to soar, in every category of health services, while utilization staggered or even declined.


A study published recently by JAMA, after comparing health care use in the U.S. with 10 other high-income countries concluded that while utilization levels did not differ, the US still overspent them by double in 2016.

So the study came to the only one possible conclusion: The biggest culprit for high premiums today is high prices. Per unit, all U.S. health care cost factors, labor, pharmaceuticals, devices and administration are much higher than those of other developed countries.

And hence, there is only one logical conclusion :”Efforts targeting utilization alone are unlikely to reduce the growth in health care spending in the U.S.”

The above mentioned study issued by the HCCI (Health Care Cost Institute) in January 2018 illustrates this reality, applied to the ESI . Based on the claims data from 3 of the most important health insurers (totaling 40 millions insured) in ESI (Employer Sponsored Insurance) and covering 2012 to 2016, its results are very clear :

in almost every type of health serviceprices soared and utilization declined :

The chart presents the evolution of three different factors :

  • on the upper left : evolution in prices of four categories of health services
  • on the lower left : evolution in utilization
  • on the upper right, combination of both, resulting in spending (e.g. insurance premium)

Two examples :

  • Inpatient utilization shrunk by 12.9%, while prices grew by 24.3% ; inpatient spending went up by 8.3%
  • Drugs volume grew by 1.8%, but since prices soared by 24.9%, spending growth hit 27.2% in only 4 years !

The conclusion we can draw is clear :


    Regarding the level of utilization, this is all the more concerning, since data showed a preexisting record level of unmet care needs due to costs  in the United States, especially then it is compared to similar, high developed countries, as it appears in the opposite figure.

    The above mentioned  HCCI’s study, is available on their site :  http://www.healthcostinstitute.org/

    and so are its appendix tables, and the underlying machine-readable data tables. We analysed them to produce very precise data on different items, in order to find practical solutions to your problems.


    Taking the lion’s share, hospitalization costs represent 56% of your healthcare expenses

    In- and outpatient, represent 56% of the total average spending in 2016, once the related costs of professionnal services provided in hospitals have been integrated (see chart below).

    SURGERY saw soaring prices and sharp declining utilization

    • Inpatient surgery prices soared by 30%, while utilization declined by 16%
    • Outpatient surgery prices got up by 19% while  utilization declined by 6%
    • Surgery accounted for 29%, in 2016 of the average healthcare spending, (more than prescription drugs : 23%)

    An average episode of inpatient surgery amounted to 41.702 $


      1. Upfront, Care2care has selected the best French hospitals and clinics in different specialties (orthopedics, cardiology, cancerology, bariatric, …)
      2. Day after day, via a secure workflow, your employees who are considering surgery, will obtain a free medical quotation guarantying a set pricefor a specific procedure. The file will be submitted to 2 or 3 HCF, which in return will provide a proposition for treatment, in a time limit of 48 hours ; we will help your employee to make up his choice.
      3. Once they have accepted the proposition, Care2care provides full chaperoning and an all-in-one concierge service to organize:
        1. Travel to and stay in France
        2. Admission to the HCF

        presence all along the care pathway, including potential care follow-up return to home

      4. Your carrier or TPA will obtain the data in the predetermined format
      5. We will stay at your side to ensure that your personal had a good understanding  of the solution


    In relation with you broker or consultant,  we are offering a preliminary assessment of the implementation of our solution, that can be flexibly adapted to the needs of your team members:

    •  Analysis of available statistics on claims in order to show the benefits of the interested parties : management, employees, service provider
    • Summary of opportunities and recommendations
    • Design of incentive program to enhance attractiveness of the medical travel solution
    • Design of services for integration into your Healthcare Plans
    • Deployment (upgrading of information and follow-up tools, etc.)

         We will be happy to discuss our proposition with your HR, your consultant or broker

       Download our complete whitepaper here :

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    What’s a Mail Order Program ?

    What is a Mail Order Program and why use it?

    Specialty drugs are far more affordable outside the US. (Products are exactly the same since most medicines sold in the US are in fact produced outside of the U.S.). Defining with the employer the best fitted formulary, we allow the employees to order their drugs via our website.

    The order will be reviewed by a Doctor, to ensure there is no medical problem. One of our qualified pharmacist partner will then deliver the medicines the patient needs; the pharmacist will send them via mail order and the patient will receive them in his mailbox within a fortnight.