Monocle Health

A wide range of healthcare stakeholders benefit from Monocle’s unique insights into care quality and price efficiency.

Improving Quality, Reducing Costs

Every organization involved with healthcare delivery and payment seeks the same goal – ensure patients receive the best possible care while attaining high levels of efficiency. While the goal is simple, achieving it is not.

The healthcare industry has wide price efficiency and quality disparities. However, in a recent case study, Monocle demonstrated that a 20% change in referrals (at random) to higher performing providers generated a 30% reduction in claim costs.

Monocle’s high-value solution is a cost-effective way to differentiate your organization while empowering patients with the information they need to make the best provider choice.

Who Needs Monocle, and Why?


Additional high ROI product offering supporting customized plan design with quantifiable savings, supports consumerism

Network Management Companies

Develop/refine high-performing provider networks, support risk reimbursement (capitation and bundled payment), P4P

Payers/Third Party Administrators

Monetize raw claims data using Monocle’s analytics to identify savings opportunities; support innovative plan design, consumerism and transparency

Medical Management/Complex Chronic Care Management Companies

Monocle’s analytic tools segments patients by disease complexity for early identification, proactive engagement and direct patients to optimal providers; in addition, they can now document the treatment protocols of the high performing providers and publish these “best practices” to be replicated by other providers

Health Systems/ACOs

Improve quality scores to mitigate CMS quality penalties, increase bonus payments/shared savings from value-based purchasing arrangements/pay for performance programs and make risk-based reimbursement profitable using Monocle for referral optimization

Telemedicine/Remote Patient Management/Concierge Companies

Optimize patient engagement and referral assistance to patients in a proactive manner

Employer/Labor Plan Sponsored Health Plans

Reduce health plan costs and increase quality using Monocle for referral optimization to guide patients to the most price efficient, high-quality providers on a diagnosis-specific basis

Reinsurers/Stop-Loss Carriers

Referral optimization will reduce the number of cases exceeding stop/loss limits and, by definition, reduce aggregate stop/loss risk

Data Analytics Companies

Provide ancillary analytics reporting as an addition to current reporting suites