Transforming Health Plans for a New Era

Rising healthcare costs combined with administrative overhead, expensive specialty drugs, and increased utilization are increasing financial pressures while regulators are simultaneously mandating significant cost controls. Freed helps health plans sustain financial health by implementing cost-containment strategies, optimizing provider partnerships, transforming lines of business, and applying alternative value-based payment models.

With healthcare regulations continually evolving at both the federal and state levels, health plans face increasing pressure to keep pace. Navigating these changes is essential to avoiding compliance risks, financial penalties, and operational disruptions. Freed partners with health plans to ensure regulatory adherence by translating complex policies into actionable steps, implementing necessary operational changes, supporting audit readiness, and addressing corrective action plans.

Health plans are under increasing member and consumer demand to deliver better access, affordability, quality and price transparency in coverage and services. At the same time, they must continuously enhance care outcomes and address evolving regulations and reimbursement models, driving the need for member-focused innovation and solutions. Freed helps health plans improve the member experience by enhancing digital tools, embedding quality metrics into operations, optimizing provider collaboration, and leveraging analytics to drive measurable improvements in care delivery, health equity, health outcomes, and member satisfaction.

Health plans must keep pace with rapid technological advancements in healthcare while ensuring operational efficiencies, data security and regulatory compliance. Many health plans continue to struggle with infrastructure that slows innovation and creates inefficiencies in member and provider interactions. Freed helps health plans with systems selection, implementation, data governance, interoperability, modernization, and scalability. Additionally, Freed enables the adoption of AI-driven solutions that streamline administrative processes, address bias, enhance decision-making, and personalize member engagement.

Rising demand for mental health and community health services, coupled with provider shortages and fragmented care, are straining health plans’ ability to provide comprehensive coverage. Freed supports health plans in integrating both behavioral and community health, assessing and scaling partnerships, improving network adequacy, and leveraging new funding sources to improve access and sustainability.