For Health Plans

Commercial benefits are moving to aligned health plan design.

Aligned health plans identify top-performing specialists and give members a clear benefit for choosing them. Your members get better clinical and financial outcomes. Your groups get better control of spend and trend.

What is Proximal?

Proximal is an aligned supplemental benefit.

When a member faces a serious illness or potential hospitalization, they have to find a specialist and cover the out-of-pocket costs, often after hard news. We address both needs. First, we guide them to top-ranked in-network specialists for their specific condition. Second, we provide a supplemental benefit they can claim to help offset out-of-pocket costs.

Top-ranked specialists, matched to a member's specific condition.

A supplemental benefit for certain hospitalizations and illnesses.

Configurable for your networks and products.

Focused on specialty care

Specialty care is driving spend and trend.

You see it in your own numbers: a small number of serious illnesses and hospitalizations drive 60% of plan spend and 75% of annual trend. Every one of those members has to find a specialist first. Proximal focuses there, guiding them to top-ranked specialists who can improve clinical and financial outcomes for the member and the plan.

75%
of trend
90%
of stop loss
60%
of spend
Compatible by design

Turn any of your plans into an aligned health plan.

Proximal is a supplemental benefit, so it works with the plans you already offer. You can turn any of your plans into an aligned health plan by adding Proximal.

Any
  • carrier
  • network
  • plan design
  • funding type
Purposefully simple

No heavy lifting and no CAPEX.

We handle member communications, engagement, registration, network analysis, search tools, member service across every channel, and results and ROI reporting back to you.

No changes to plan documents
No changes to processes
No heavy lifting
No claim integrations
No CAPEX

A benefit your members actually use, and remember.

Proximal makes finding and choosing a top-ranked specialist simple. Members use it, they rate it highly, and they associate the positive experience with your plan.

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9.1 / 10

Average rating members give
Proximal-designated specialists.

95%
of members meet or beat their
goal for return to work or school.