Reduce My Costs for Self-Insured Employers

Pay less in out-of-pocket expenses for procedures and tests. And get cash rewards.

Did you know that the costs of medical tests and procedures often vary widely with no significant difference in quality?

Reduce My Costs* is a voluntary program that can:

  • Help your health plan participants save on outpatient tests and procedures
  • Pay cash rewards to members who use low-cost providers

Reduce My Costs is administered by Tandem Care LLC on behalf of Harvard Pilgrim.

How Reduce My Costs works

1. Call 855-772-8366 whenever your doctor recommends an outpatient test or procedure such as:

  • Bone density study
  • Colonoscopy
  • Lab tests
  • Mammogram
  • Ultrasound
  • Radiology (e.g., MRI and CT scan)
  • Other non-emergency outpatient tests and procedures

2. A Reduce My Costs nurse identifies lower-cost Harvard Pilgrim-participating providers in the area, and can assist in rescheduling appointments and help with necessary paperwork.

Potential Savings Per Service
Colonoscopy, screening Range: $1,180 – $3,870
Potential Savings: $2690
MRI: Lumbar Spine
(without Contrast)
Range: $260 – $1,840
Potential Savings: $1,580
Common Routine Labs Range: $110 – $720
Potential Savings: $610

Ranges based on Harvard Pilgrim’s data in New Hampshire. Actual service prices by provider location.

3. Members who choose to have their test at one of the lower-cost providers, receive a cash reward. Reward amounts are set by each group based depend on service and/or associated cost savings.

Reward checks are mailed directly to members approximately 45 days after they receive their Activity Summary from Harvard Pilgrim.

  • Rewards are considered taxable income; please consult with your tax advisor.
  • Individuals covered through MA-based employer, may earn up to five rewards per calendar year.
Here are some reward examples. Rewards are defined by the employer.

Example 1:

  • $10 for members who are already using a low-cost provider *
  • $25 if the savings are $100-$299
  • $50 if the savings are $300-$499
  • $75 if the savings are $500-$999
  • $100 if the savings are $1,000 or more

* Minimum price variation of at least $100 is required to quality for $10 reward.

Example 2:

  • Each adult member receives a reward of $20 the first time they call and “register” with Reduce My Costs.
  • For eligible tests and procedures, members receive $20 or 20% of the savings, whichever is greater.
Reporting and program administration
  • Details of each call are tracked and documented by Tandem
  • Reward checks are issued by Tandem after Harvard Pilgrim processes the claim
  • Monthly employer reports include number calls, projected savings, confirmed savings and rewards – see example on next page
  • Year-end report recaps utilization and savings each calendar year
  • Year-end tax reporting for reward payments
Employee training and communications
  • Letter from Harvard Pilgrim to members introducing Reduce My Costs and including card sleeve as a handy program reminder.
  • Reduce My Costs employee flyer
  • Employer’s online communication toolkit includes ready-made templates for your company to use as e-mail reminders, program fliers and newsletter articles
  • Online member tools and resources
  • Monthly email reminders for easy distribution to employees

The program’s success depends upon promotion of Reduce My Costs within your company. The more you spread the word, the more your employees will use it, and you’ll see savings on medical costs.

Reduce My Costs fees and return on investment

$2.50 per health plan subscriber per month administration fee

Employer funds reimburses Tandem for reward payments made directly to members.

Employer’s return on investment varies by employer group, depending on:

  • Geographic location of members
  • Group demographics
  • Benefit design
  • Employee training and communication

For groups who have been with Harvard Pilgrim for at least 12 full months and have 150 or more health plan participants, Tandem can provide an analysis showing the potential return on investment (ROI) using the group’s own paid claims data.

Live help

For more information:
Harvard Pilgrim’s Reduce My Costs
Employer Page