HealthJoy + ParetoHealth:
Off to a Great Start! 

INDUSTRY: HEALTH BENEFITS CAPTIVE

HealthJoy and ParetoHealth, the country’s largest health benefits captive, collaborate to bring care navigation to small and mid-sized businesses to combat the rising cost of healthcare. ParetoHealth subsidizes the cost of HealthJoy for its captive members working with HealthJoy’s integrated TPA partners.

Together, HealthJoy and ParetoHealth power improved health outcomes, increased utilization of cost management benefit solutions and significant savings.

Results Overview
Since the subsidy took effect, HealthJoy has driven a $21 per employee per month estimated ROI for 335 employers in the ParetoHealth captive and an average monthly utilization rate of 70 services utilized per 100 employees. 

How HealthJoy Drives Savings

ParetoHealth leverages HealthJoy to steer employees to high-quality, affordable care and drive increased utilization of integrated cost management (ICM) solutions (e.g. CancerCare, KISx Card, etc.)

HealthJoy has established data integrations with preferred TPA partners to enable proactive redirection. These integrations allow HealthJoy to access numerous data sources including plan design, precertification and claims to personalize the benefits experience and proactively engage employees before they even seek care.

This maximizes the number of members who receive the care they need and improves utilization of ParetoHealth’s ICM programs.

ICM Steerage in Action: KISx Card

One of ParetoHealth’s ICM solutions is KISx Card – a surgery and imaging program that provides procedures at NO COST to the member.

Employers who have taken advantage of the subsidy are now able to provide employees with direct access to KISx Card through the HealthJoy mobile app.

When HealthJoy receives data via our Member Health Goals questionnaire or our TPA integrations, HealthJoy’s smart navigation platform and healthcare concierge team work together to steer to KISx Card through in-app recommendations, proactive member outreach and digital marketing. 

From November 2023 to February 2024, KISx Card was recommended 555 times through a combination of pre-certification and member requested support – resulting in an estimated savings of $925K.

Loved by Employees

With an average monthly utilization rate of 70 services utilized per 100 employees and a 90% satisfaction rate, employees are fully embracing access to HealthJoy.

One employee shared, “Working 60 hours a week with limited time to make personal
calls, HealthJoy is extremely helpful.”

HealthJoy works closely with ParetoHealth and the captive members to engage the
51,000 eligible employees.

To do this, HealthJoy uses a combination of smart navigation technology and human-guided support to drive activation, ongoing engagement and, ultimately, better health outcomes for employees.

Continued Collaboration

As healthcare costs continue to rise, ParetoHealth and HealthJoy are on a shared mission to guide employees to affordable, high-quality care options while helping employers contain costs.

HealthJoy is proud to collaborate with ParetoHealth and looks forward to continuing to drive significant cost savings. HealthJoy clients can access estimated savings or
utilization reporting in the HealthJoy Dashboard.

Reflects data from 11/1/23-2/19/24 for all groups receiving the subsidy.