Will insurance actually pay for it? Evaluating women’s health and menopause telehealth platforms
What “we work with insurance” usually means, why TPAs are the channel these platforms skip, and the medical-versus-pharmacy swim lanes that send members on a reimbursement chase.
Do benefit differentials actually work? Evaluating cost-containment solutions that depend on member behavior
Home infusion, imaging navigation, centers of excellence, international sourcing. Whether the differential gets built, enforced, and acted on by a member facing their own doctor, and what a founder’s answer tells you.
2026 03
Will plans actually cover it? How to evaluate a healthcare point solution’s viability
Plan coverage, payer integration, how the service gets paid, and the provider-side failures that kill utilization before the plan sees a claim.
2026 04
What a cost-containment vendor’s “savings” number actually means
Savings against what, who counts it, what the fee is charged on, and what the plan actually paid once the provider responded.
2026 05
How to evaluate a TPA’s operations before you invest
What the auto-adjudication rate hides, where the manual work lives, how to read eligibility and retention, and what to request in the data room.
2026
These are written for the associate running a diligence process, but they are the same questions a plan sponsor should ask before signing and an operator should be able to answer before raising. If you want them asked on your behalf, that is the diligence advisory practice. Choosing a TPA for a plan instead? Read Under the RFP: Vetting a TPA.