MacroHealth helps commercial and provider-sponsored health plans leverage the power of data to optimize and connect healthcare costs across medical and pharmacy benefits – all within a unified ecosystem of vendors focused on delivering the highest quality and most affordable care to members.
Contact UsThe MacroHealth Intelligent Exchange™ (MiX) platform provides Payers with data, analytics, and unbiased comparisons to design optimized provider network solutions that can reduce costs and improve member experience. Once established, Payers can then leverage industry-standard interoperability to connect with the Health Market Partners best-suited for their needs – all while ensuring alignment between financial goals and member priorities.
Smarter Partner Selection
Compare Health Market Partners across multiple business and solution criteria to select best-fit partners.
Centralized Intelligence
Access centralized reporting and analytics to understand trends and track outcomes by business, region, or solution type.
Accelerate Performance Across Ecosystems
Streamline procurement and integration through pre-established standards and reusable connectivity.
Health plans have long been held back by fragmented data, siloed partners, and outdated procurement processes. MacroHealth solves this by unifying the ecosystem and creating a connected, interoperable marketplace where partner alignment, cost control, and operational efficiency are built in. With MacroHealth, every decision is data-driven and every partner is strategically aligned from day one.
Go beyond baseline Machine-Readable File (MRF) compliance with transparency tools that build trust and support your cost-containment strategies, all with a seamless provider search experience that reflects contracted rates, benefit alignment, and quality scores. Configurable tiered and preferred provider displays help steer members toward high-value care options aligned with your plan strategy.
Price Transparency and Provider SearchExperience greater discounts and better expansion opportunities with MacroHealth’s out-of-area solution, all while improving member experience with better coverage and lower prices.
And with MacroHealth’s out-of-network solution, we help Payers ensure that their out-of-network claims will be reimbursed, while also helping reduce claim costs so members are not balanced billed.
Network SolutionsMacroHealth’s pharmacy solutions enable health plans to evaluate and optimize pharmacy benefit manager (PBM) performance, compare Health Market Partner offerings, and pinpoint inefficiencies in pharmacy spend.
Pharmacy Solutions“When we selected our new national network, Aetna Signature Administrators, it was critical that we find a partner like MacroHealth who could help us navigate the implementation process and necessary data exchanges. Throughout the implementation process, MacroHealth quickly surfaced, analyzed, and organized a complex and encompassing set of needed requirements. Their expertise helped us keep momentum and led to a smooth rollout. We’re pleased to welcome them as a long-term partner.”
Tony KopkiVice President of Commercial Programs
PacificSource Health Plans
“Through our collaboration with MacroHealth, we’ve seen significant reductions to the level of effort needed to operationalize and connect to network and pricing solutions.”
Brad GarriguesChief Growth Officer
Providence Health Plan
“MacroHealth is an easy company to work with. They have great people who understand our business and work collaboratively to help us achieve our goals. I highly recommend using MacroHealth for your savings needs in the US.”
Taka KatsubeCost Management and Medical Assistance Director
TuGo
“MacroHealth has helped UHA to offer a robust, high-quality network of physicians and hospitals for our members while they are away from Hawaii. We are pleased to work together with MacroHealth in this effort to offer a simpler and easier experience to our members.”
UHA Health Insurance
“MacroHealth’s actionable and real-time data gives Providence Health Plan a competitive edge with prospective member groups.”
Brad GarriguesChief Growth Officer
Providence Health Plan
Payers sit at the heart of the healthcare industry and are uniquely positioned to be the catalyst for innovation. In this eBook, we share why data-driven innovation is critical to the healthcare industry, what’s possible with the right information technology in place, and how Payers can lead in streamlining their healthcare purchasing decisions.
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Podcast
In this episode of the Becker’s Healthcare Payer Issues podcast, Virgil Bretz, the CEO and co-founder of MacroHealth, discusses […]
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Case Study
UHA Health Insurance, based in Honolulu, Hawaii, sought guidance in their search for a more comprehensive mainland network solution.
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Technology
Healthcare Payers are frustrated by the long-standing challenges that have become a barrier to success. There are three main challenges tha…
Learn MoreMake more informed decisions, connect with the best-fit partners, and uncover new opportunities for savings and performance with MacroHealth.
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Witness data-driven healthcare transformation firsthand. Request exclusive access to the MiX Platform Demo video now.