Cost Containment Strategy

From Isolated Solutions to Real Savings

High-cost claims, specialty pharmacy, payment inaccuracies, and unmanaged utilization can all put pressure on a self-funded plan.

For brokers, the challenge is proving where savings can come from and building a stronger recommendation.

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Point C approaches self-funded cost containment in a way that supports broker strategy, employer decision-making, and stronger renewal conversations.

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The Limitations of a Fragmented Approach

Many employers are trying to manage rising healthcare costs without enough visibility into what is really driving plan spend, which can make it harder to build a recommendation that feels specific and supported.

  • Rising healthcare costs with limited control
  • Solutions that offer little transparency into performance
  • Difficulty tying recommendations to measurable savings
  • Fragmented vendor relationships
  • Pressure to bring employers a more defensible strategy

An Approach Designed Around the Real Cost Drivers

Cost containment works best as a connected strategy that looks at claims, pharmacy, stop-loss, payment accuracy, and care management together.

Point C helps brokers build a more defensible cost containment strategy by bringing those key drivers of self-funded plan cost into a more coordinated approach.

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The Levers That Shape Self-Funded Plan Performance

Network and Pricing Optimization

Provider pricing, reimbursement patterns, and site-of-care variation can all shape plan spend. A more intentional pricing strategy helps identify where the plan may be paying more than it should.

Claims Management and Oversight

Claims administration directly affects plan performance. Ongoing oversight uncovers patterns and avoidable spend in areas where earlier intervention may improve the financial outcome.

Pharmacy Cost Management

Specialty drugs and pharmacy trend are among the fastest-growing cost drivers. A coordinated pharmacy strategy looks at contract terms, rebates, and utilization to keep spend aligned with plan performance.

Stop-Loss Strategy Alignment

Stop-loss should be evaluated alongside overall plan performance. When claim activity, risk exposure, and funding strategy are considered together, renewal conversations become more grounded and more defensible.

Audit and Payment Integrity

Savings can come from making sure the plan is paying correctly in the first place. Audits, billing review, and payment oversight can reduce waste and strengthen plan discipline over time.

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Cost containment conversations are stronger when they are backed by measurable outcomes.

Care management is a nurse-led service that aids members navigating complex health needs while helping employers manage costs more effectively.

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Avg. Outpatient Authorizations for Care Management

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Avg. Savings on Pharmacy Spend After Rebates

These results come from a connected approach that addresses multiple cost drivers across the plan year.

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Point C is built to support the broker's strategy and strengthen employer conversations.

  • Co-branded Strategy Support
  • Ongoing Reporting for Client Reviews
  • Pre-sale Analytics and Modeling
  • Renewal and RFP Support
See the Difference

This gives brokers stronger substance behind recommendations and a better framework for year-round advisory conversations.

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Guide Employers with a More Effective Cost Containment Strategy

Go Beyond with Point C

Frequently Asked Questions

What is self-funded cost containment?

Self-funded cost containment is the structured effort to reduce avoidable healthcare spend through claims oversight, pharmacy strategy, payment integrity, care management, provider pricing, and stop-loss planning.

How can brokers reduce employer healthcare costs?

Brokers can reduce employer healthcare costs by identifying key cost drivers, recommending targeted strategies, and working with partners that connect analysis, oversight, and execution.

What drives healthcare trend in self-funded plans?

The biggest drivers often include high-cost claims, specialty pharmacy, provider price variation, payment errors, and gaps in care management.

Why is cost containment important for self-funded employers?

Cost containment is critical because self-funded employers assume direct financial risk for claims. Without active oversight and strategy, avoidable costs—such as billing errors, inefficient care, and unmanaged high-cost claims—can significantly impact plan performance and long-term affordability.

What strategies are most effective for self-funded cost containment?

The most effective strategies combine data-driven insights with active management, including payment integrity programs, specialty pharmacy oversight, network optimization, care navigation, and proactive stop-loss structuring. Coordinating these efforts ensures savings opportunities are identified and executed consistently.