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For Employers · Brokers · TPAs

Smart information for self-funded surgical decisions

Your members make surgical decisions on incomplete information. Your plan absorbs the cost variance. SurgiQuality is the smart-information platform that gives members access to risk-adjusted outcomes data, multi-opinion infrastructure, and cross-specialty consultation.

Daubert-defensible
methodology used in medical-malpractice forensic analysis
STS · NSQIP · CMS-aligned
same statistical framework as public surgical reporting
iOS · Android · Web
member-facing apps + plan administrator portal
Surgeon-founded
Sanjay Prasad, MD FACS — 30+ years clinical experience
The ROI

What your plan would save

Self-funded employers save $500–$1,000 per employee per year when members access risk-adjusted outcomes data, multi-opinion infrastructure, and cross-specialty consultation. Below is what that translates to at typical plan sizes — measured against your plan's own surgical-spend baseline, not promised in advance.

1,000 EMPLOYEES
$500K – $1M
annual savings
Pilot-friendly scale. Typical 6-month pilot deployment recovers cost within the pilot window.
5,000 EMPLOYEES
$2.5M – $5M
annual savings
Volume-tier discounts apply. CFO-grade ROI; multi-year deployment commitment unlocks deeper engagement.
Platform fee waived for qualifying employers — engagement structured around shared savings. Per-case admin fee continues; total cost flexes to actual utilization. Two-component pricing detail in the Cost section below.
Get Your Plan's Custom Savings Model

Submit your plan basics. Sanjay responds within one business day with year-1 + year-3 projections, recommended pilot framework, and methodology white paper.

The Service

How SurgiQuality delivers the savings

Self-funded plans spend a meaningful share of medical dollars on surgical episodes. Most plans have no rigorous, risk-adjusted outcomes data on the surgeons their members see. Existing surgical-management vendors offer "centers of excellence" claims and proprietary scoring you can't audit. SurgiQuality is structurally different — published methodology, member-driven choice, plan-level transparency.

Three pillars

Pillar 1

Risk-Adjusted Outcomes Data

Procedure-specific surgeon outcomes data with confidence intervals, validated against EMR data where possible. Same statistical framework as STS public reporting, ACS NSQIP, and CMS Hospital Compare — applied at the individual surgeon level.

5-star outcomes scoring as the member-facing presentation; risk-adjusted statistics underneath.

Pillar 2

Multi-Opinion Infrastructure

Members can solicit second and third opinions through the platform before scheduling surgery. Patient-driven; no platform direction. Roughly 15–30% of recommended elective procedures are reconsidered when members have rigorous second-opinion access.

Mobile and web; opt-in for members who want better information.

Pillar 3

Cross-Specialty Consultation

A member considering spine surgery can also receive opinions from PM&R, pain medicine, or interventional specialists who manage the same condition non-surgically. A bariatric candidate can hear from obesity medicine and endocrinology.

Surfaces non-surgical alternatives where they exist.

How members and plans use it

1

Member-driven access

Plan members opt in via mobile app or web. They search for procedures, see risk-adjusted surgeon outcomes data, request second opinions, schedule cross-specialty consultations.

2

Informed decision

Members make their own choice — armed with data, multi-opinion review, and cross-specialty perspectives. SurgiQuality provides the information; members decide.

3

Plan-level reporting

Quarterly aggregate reporting on member utilization, plan savings vs. baseline, outcome differences, and member satisfaction. No PHI exposure to the plan; aggregate only. Fits standard QBR formats.

4

Pilot to deployment

Most employers start with a 6-month limited pilot — defined member subset, measurement against control. Plan-wide deployment based on pilot results. Light implementation lift; works alongside existing TPA / health plan / PBM.

For Benefits Brokers · Consultants · TPAs

Built broker-friendly

No commission complications

SurgiQuality is paid by the employer, not by the broker. You can recommend us to self-funded clients without commission disclosure issues, AKS exposure, or referral-fee complexity.

QBR-ready reporting

Plan-level utilization, savings, and outcome reporting flows through you — formatted for the quarterly business reviews you already run with your employer clients. Measurable savings data is your conversation, not ours.

Differentiator for your book

Most surgical-management vendors are interchangeable. Methodology that's published, Daubert-defensible, and member-driven (not steerage) gives you something concrete to bring to your competitive renewals.

Light lift for you and your client

Implementation alongside existing TPA / health plan / PBM. No vendor stack rebuild. Member communications + plan-document language are the integration footprint. Pilot first, scale second.

Why this isn't another surgical-management vendor

Most surgical-management vendors
SurgiQuality
Proprietary outcomes scoring you can't audit
Methodology white paper published; same framework as STS / NSQIP / CMS Hospital Compare
Centers-of-excellence steerage with limited member choice
Smart-information platform; member-driven multi-opinion + cross-specialty consultation
Marketing-driven savings claims
Aggregate reporting at the plan level; savings measurable against baseline
Methodology not pressure-tested in adversarial settings
Same methodology used in our medical-malpractice forensic outcomes service (Daubert-defensible)
Multi-vendor stack required
Single platform; works alongside existing TPA / health plan / PBM
Broker commission complications
Paid by the employer; brokers recommend without disclosure friction

Cost

Two-component pricing — a base platform fee covering infrastructure, plus a per-case admin fee billed only when a member actually uses the platform for a procedure decision.

Component 1

Platform Fee

Annual flat fee covering plan-level reporting, data integration, methodology updates, and member-facing apps (iOS, Android, web).

Predictable. Independent of utilization. Scoped per engagement based on plan size and reporting cadence.

Component 2

Per-Case Admin Fee

Billed only when a member used the platform for outcomes review, second opinion, or cross-specialty consultation that informed their procedure decision.

Pay-for-use. Aligns SurgiQuality interest with member engagement and measurable savings.

Pilot framework: most employers start with a 6-month limited pilot — defined member subset, measurement against control. Pilot pricing structured for pilot scale; converts to full deployment based on results.

Specific dollar amounts scoped per engagement based on plan size, current vendor stack, and target deployment scope. Submit the Cost Analysis form below — full custom model with both fee components returned within one business day.

Go deeper

Frequently asked questions

Can you guarantee the $500–$1,000/employee savings?

No vendor can guarantee savings without a member-mix and utilization analysis. Our pilot framework is structured to measure savings against your plan's baseline, not promise them in advance. Self-funded employers consistently see savings in the $500–$1,000 per-employee-per-year range. SurgiQuality uses two-component pricing (platform fee + per-case admin fee); the platform fee is waived for qualifying employers under a shared-savings structure.

Will this conflict with our TPA or health plan?

No. SurgiQuality runs alongside your existing TPA / health plan / PBM. We don't replace administrative infrastructure. Plans typically integrate via member communications and plan-document language updates.

What member data do you receive?

Aggregate utilization data only at the plan-sponsor reporting layer. Member-level PHI stays within the platform under HIPAA-aligned data handling. We do not share member-level information with the plan sponsor.

How do members find the platform?

Plan-document updates, open-enrollment communications, employer benefits portals, and onboarding for new hires. Implementation includes member communication templates for HR teams to use.

Is the methodology Daubert-defensible?

Yes. The same methodology is used by our forensic outcomes service for medical-malpractice defense — including Daubert hearings. Full white paper at surgiquality.com/legal/methodology.

How does this work for us as the broker?

SurgiQuality is paid by the employer, not the broker — no commission complications, no AKS exposure, no referral-fee disclosure friction. Plan-level reporting flows through you in standard QBR formats, so you walk into your client business reviews with measurable savings data. Pilot, then scale, alongside your existing vendor stack — light implementation lift on you and your client.

What's the typical evaluation timeline?

60–90 days from initial scoping call to executed pilot agreement. Pilot itself runs 6 months. Full plan-wide deployment evaluated based on pilot results. The Cost Analysis Form below kicks off the scoping conversation.

Insisting on Surgical Excellence

Two paths to start. Both lead to a customized savings model and an optional 20-minute scoping call with Sanjay Prasad, MD FACS.

Or email [email protected] directly. Outcomes-Driven. Member-Empowered.

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