The quality & accountability layer for self-funded health plans
Your company spent millions on healthcare last year. Nobody checked the bills.
It's your second-biggest expense — and the only one no independent party ever checks. Grounded Health is the quality layer for self-funded plans: we confirm the care you paid for was real and priced right — and what we find, you get to reinvest in your people.
Free scorecard from public data · no claims data, nothing to install, no obligation.
The problem
Health costs are out of control.
Costs are climbing faster than they have in a generation, and a quarter of every dollar never becomes care. Now AI writes the notes, codes the claims, and prices the care — billing your plan more, at scale.
+9%
projected 2026 cost increase for large employers — the steepest in over a decade.
Business Group on Health, 2026 Employer Health Care Strategy Survey
25%
of every U.S. health-care dollar is wasted — more than $1 trillion a year that employers help fund but never see.
Peter G. Peterson Foundation, 2025
1.7%
of total health spend is now AI upcoding alone.
Garner Health, 2026
49%
of plans took a $1M+ claim last year — up from 23%.
Aegis Risk, 2025
Why you can't see it
The system as designed keeps you in the dark.
Your plan is run by the same brokers, TPAs, PBMs, and carriers who earn more when spend goes up. That isn't a conspiracy — it's just how the incentives are wired. Every party in the chain earns more when your costs go up. We don't.
Total annual plan cost
$26M
self-insured employer
grows with headcount
Revenue = covered employees × ~$17k blended plan cost (KFF 2025) × each party's share of the plan dollar: providers & Rx ~80%, stop-loss ~7% (Aegis 2025), carrier & TPA ~6%, broker ~4% (KFF 2025, range 2–7%), point solutions ~3% (est.). Provider and point-solution shares are estimates and vary by employer.
“Insurance companies and PBMs have departments of people and AI to find new ways to downcode, add fees, mark up, deny, underpay and more. Employers cannot even get claims data reliably. And that is by design.”
How we create value
Grounded Health turns the lights on.
Grounded Health is a platform: specialized agents review every claim as it lands, check bills against contracts, watch your rates against the market, track renewals, and score every vendor — 24/7, whether or not anyone's logged in. From reactive healthcare spending to proactive financial management.
Flag Overpayments and Billing Errors
Independent QA on every claim, to catch billing and coding errors.
Proactive Major Claim Management
Hold the care-management vendor you already pay accountable, with automated care-management QA.
Industry Benchmarking Intelligence
See what you pay for care and services compared to your peers — broker, stop-loss, carrier, and down to the cost of individual procedures.
Your plan, actively managed — $1.81M freed to reinvest.
How it works
Start with easiest savings, mature to continuous oversight and automatic optimization.
Every step ends in a decision you control. Nothing material? Keep the report — we walk away.
What we need from you
What you get
Contract Review
Sign an NDA
Just your contract documents — your PBM agreement, fee schedules, plan docs. No claims data, no PHI.
The contract diagnostic: your PBM contract scored against ten fiduciary-aligned standards — spread pricing and retained rebates, missing audit and data-ownership rights, network steering, hidden admin fees, and clean-exit barriers — plus your CAA 2026 readiness and the model language to close each gap at renewal.
Claims Recovery & Assurance
De-identified claims data
Runs inside your own cloud; nothing sensitive leaves. To recover, only the flagged claims and the PHI our partner needs are shared — you approve exactly what's exposed.
Money found and recovered: every claim checked — not a 1% sample — for billing that doesn't match your contract, duplicate and erroneous charges, and above-market rates. A vetted partner recovers the overpayments on contingency (we take $0), and agents keep every vendor accountable so it never drifts back.
Care Quality Verification
BAA + EHR authorization
A signed BAA and your authorization to pull clinical EHR data — matched inside your cloud, surfaced only as de-identified, aggregate insight.
Is the care any good: billed-vs-delivered verification, which of your people are the clinical outliers, care-gap and acute early warnings, and your population's trends vs. national norms — proof your people get the care you pay for.
The questions we answer
What you've always wanted to know. Delivered.
Not a list of features — the things you'd actually want to know if you could see inside your own health plan.
Am I paying market rates — or is my competitor paying less?
The fees nobody itemized, sitting in your own filings — broker commissions, admin loads, spread you never agreed to.
$2,700 / employee
One employer's annual broker fees alone — before anything else.
Were we actually billed correctly?
Out-of-network claims paid as in-network. Duplicate and above-contract charges. And the deeper one: did the care I paid for in claims actually get delivered?
4% → 12.3%
Postpartum-hemorrhage diagnoses jumped while transfusion rates stayed flat. Care billed, not delivered.
BHI / BCBSA, 2026
The vendors promising to save me money — are they actually doing it?
Is anyone even using the point solution you pay for? Are they closing the gaps they were hired to close, or grading their own homework?
128 members
Pre-diabetic and not enrolled in the diabetes program you already pay for.
Is the care any good — and did my people actually get better?
Are there better providers I should be steering my team to? The deepest check nobody runs.
2× the benchmark
The surgical group your employees use most has a repeat-procedure rate double the regional norm.
40% above peers
MSK spend runs 40% above peers — with no PT-first pathway. Build the plan around who your people actually are.
22 points below
Cancer-screening completion below benchmark — the rare fix that's the right thing and the cheap thing.
Proof
We're new. The playbook isn't.
The transparent, fiduciary-aligned approach Grounded runs on has already cut costs 20–40% per capita for hundreds of employers — years before us. Here's what people say when they see it applied to their own plan.
“I didn't even think this was possible — we've all had this apathy of thinking we don't have any control over any of it. And I've never been able to get data that's actually actionable around this.”
CHRO
Private-equity-backed healthcare company
“Relying on your broker to check this is kind of like letting the fox guard the henhouse.”
SVP
Fortune 500 payments company
“After five years in healthcare, this is the problem Alyssa has finally cracked — real visibility into what enterprises are actually paying their brokers.”
Health-plan advisor and author
Former benefits executive
The 20–40% results belong to employers running transparent plans through the Health Rosetta community — not Grounded clients. It's the approach we build on. See the full track record →
Why it matters
Know before they ask.
For CFOs
Controls, an audit trail, and recovered dollars straight to EBITDA — on the one line item that has none of them today.
For HR
Real-time answers when costs move, proof your program works, and a care-quality story that's a benefit — not a cut.
It isn't about cutting. It's about what you get to reinvest.
Give it back
An illness fund for employees facing a serious diagnosis.
Do better
Richer benefits, lower member cost-share, or raises.
Win-win-win
Healthier members, a stronger plan, a story you're proud to tell.
Start here
See your scorecard.
Search public Form 5500 data for an early view of what's working, what's overpriced, and what deserves a closer look before renewal.
Free. Built from public data. No claims data required, nothing to install, no obligation.
Prefer to talk it through? Book a quick call and we'll walk you through it live.
Run the public-data scorecard
Open the Grounded Health scorecard experience to search by employer and review plan signals from public filings.
Open free scorecard