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For Payors & Health Plans

Reduce Episode Cost.
Prevent Avoidable Spend.

Deploy DocSpera at affiliated clinics to proactively assess surgical patients, divert unnecessary ER visits, and manage total episode cost under value-based care contracts.

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↓ ER Visits
Proactive diversion of avoidable admissions
↓ Readmissions
Post-op monitoring reducing costly returns
VBC-Ready
Episode cost management under managed care contracts
The Right Message
One Platform.
Total Episode Visibility.
DocSpera gives payors and health plans the tools to proactively manage surgical populations — before, during, and after the procedure — turning reactive claims into predictive care management.
Key Capabilities
What DocSpera Delivers
for Payors
Four core capabilities that directly reduce episode spend and prevent avoidable utilization.

Pre-Surgical Readiness Assessment

Deploy at affiliated clinic level to identify high-risk surgical patients before the procedure. Flag contraindications, medication gaps, and comorbidities that drive avoidable complications and ER visits.

Divert Unnecessary ER Visits

Proactive post-surgical coordination identifies patients trending toward ER use and routes them to appropriate lower-cost care pathways — before they present at the emergency department.

Prevent Costly Readmissions

Post-operative monitoring via automated patient engagement tracks recovery milestones, flags warning signs, and triggers care team outreach — reducing costly 30-day readmissions.

Manage High-Risk Surgical Populations

Stratify and monitor your highest-risk surgical members across the full episode — from pre-auth through 90-day recovery — with real-time data that supports value-based care contract performance.

Who We Serve
Built for Every
Payor Segment
Whether you manage commercial, Medicare Advantage, or managed Medicaid populations, DocSpera's surgical episode intelligence adapts to your contract structure and risk model.

Commercial Insurers

Reduce surgical episode cost variance across employed and network populations. Integrate with pre-authorization workflows and drive value from bundled payment programs.

Medicare Advantage Plans

Proactively manage your highest-cost members — surgical patients. Capture HEDIS-aligned outcome data, reduce avoidable utilization, and demonstrate quality performance under Stars ratings.

Managed Care Organizations

Deploy at affiliated clinics across your network. Standardize pre-surgical readiness protocols, close care gaps, and reduce total episode spend for your surgical Medicaid population.

Value Summary
What You Get with DocSpera

Pre-surgical readiness assessment at clinic level

Identify and act on patient risk factors before the OR — not after an avoidable admission.

Divert unnecessary ER visits via proactive coordination

Real-time post-op monitoring that routes patients to the right care setting before they escalate.

Prevent costly readmissions with post-op monitoring

Automated patient engagement tracks recovery and triggers clinical outreach at the first sign of complications.

Manage high-risk surgical populations + episode spend

Population-level dashboards and care coordination tools designed for value-based contract performance.

Ready to Manage Surgical
Episode Cost?

Learn how DocSpera can help your health plan reduce avoidable utilization and improve surgical outcomes at scale.

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