Specialty care was driving most of the City of Appleton's plan spend. By guiding members to top-ranked specialists for their exact condition, Proximal returned 5x its cost in 2025, and members rated the care they got a perfect 10 out of 10.
In 2025, just 126 members facing specialty episodes drove 65% of total plan spend, across surgical hospitalizations, pregnancy, cancer, severe autoimmune disease, and other hospitalizations. Every one started with a member choosing a specialist, often for the first time, under stress. That choice shaped both the quality of care and its cost.
Gave members a simple way to find the top-ranked specialist for their exact condition, plus a cash benefit. Proximal guided them to in-network specialists, corroborated across independent sources, surfaced each doctor's expertise, and let them choose. Members who experience a covered event claimed a $1,500 cash benefit for a designated specialist and $300 for any other in-network specialist with feedback. Proximal handled comms, search, and claims, with no changes to the City's existing plan.
5.02x ROI in 2025 (up from 3.86x), from $429K in plan savings YTD plus $72.9K in supplemental benefit paid to employees.
the member who chose a designated specialist came in at $13,408 vs. $22.5K–$36.3K, an average $16K / 55% savings, rated 10/10.
a member chose a top-ranked designated specialist and an outpatient site of care → $11,934 saved (32%), 10/10, on-time return to work.
50%→59% logged in, 11%→15% claiming.
