Walking the Walk: How Transcarent Is Putting Its Benefits Philosophy to Work

Philia Swam, Sr. Director Total Rewards, Transcarent

Open enrollment is one of the biggest tests of an employer’s benefits philosophy.

Talk about affordability, better navigation, and a more connected healthcare experience is found across the industry. What separates rhetoric from reality is the ability to effectively put those ideas into practice when costs are rising, employees have different needs, and healthcare decisions affect both people’s wellbeing and the bottom line.

The forces driving healthcare spending are well known. Specialty medications are becoming a larger share of pharmacy costs. Chronic and complex conditions require more support. High-cost claims can have an outsized impact on employer plans.

Transcarent is not insulated from these trends because we are a healthcare company. As an employer, we face the same challenges. We believe our own benefits strategy should reflect the same principles we bring to our clients by utilizing data, targeted interventions, thoughtful plan design, and a focus on helping people access the right care at the right time.

Managing Costs Without Relying Only On Cost Shifting

A sustainable benefits strategy cannot depend on a single lever. It should be varied to address the different needs of employee populations.

Employers are increasingly looking beyond employee contribution changes to manage healthcare costs. They’re turning to strategies like prevention, clinical management, pharmacy oversight, data analytics, provider partnerships, and efforts to ensure care is delivered in high quality and appropriate settings.

Some employees prioritize lower payroll deductions and the opportunity to save through an HSA. Others use healthcare regularly and place greater value on predictable out-of-pocket costs. Families managing ongoing and complex health needs may have different priorities all together.

Benefits plan design must account for these differences. At Transcarent, we are focusing on the areas where better information, earlier clinical support, appropriate site of care, pharmacy management, and high-quality providers can make meaningful changes to balance affordability today with long-term sustainability.

Putting Our Own Platform to Work

Our benefits strategy also gives us the opportunity to use Transcarent the way our clients and their employees do. Through Transcarent for Transcarent, employees and their families have access to our AI-powered WayFinding® platform.

An employee filling a prescription can check exactly what it will cost before getting to the pharmacy counter. Someone who has been told they may need surgery can seek a second opinion before deciding how to proceed. A parent trying to find care for a family member can ask the Care Assistant to find an in-network provider and schedule a visit rather than searching provider directories or waiting on hold.

Using our own solutions gives our teams a direct view into what works well and where we can improve because our employees are Members, too.

Open Enrollment Is A Sprint, Engagement Is A Marathon

During open enrollment, employees will be encouraged to use support tools, consider their expected utilization, and attend webinars covering plan comparisons and frequently asked questions. But most healthcare decisions do not happen in the first few weeks of fall.

Employees need to know where to turn when their health needs change throughout the year. They need to understand their options when a provider recommends a procedure. They need help evaluating medication costs.

Benefits create value only when they are usable in these crucial moments. That’s why our strategy extends beyond open enrollment communications. We want our employees to have an easy place to start, clear information, and support that helps them move from questions to the right care no matter the time of year.

The Takeaway For Employers

Our 2027 benefits strategy reflects the reality every employer is confronting when it comes to rising healthcare costs requiring more than annual changes to premiums and deductibles.

We are balancing affordability with long-term sustainability. We are investing in prevention and earlier support, and we are making our own platform a meaningful part of the employee benefits experience.

For employers, the lesson is straightforward. Managing healthcare costs requires a coordinated strategy across plan design, utilization, navigation, clinical support, and engagement.

At Transcarent, we are putting that strategy to work for our own people, and we are continuing to learn from the experience to make our solutions stronger.