Aligned Care Decisions and Smarter Provider Payments
Lower costs and better outcomes come from combining upgraded support with rational pricing strategies—not relying on networks alone.
Plan Member Support and Cost Control
Care Coordination
Better Decisions
Provider Payments
Better Pricing
From call center support to real care coordination
Instead of a traditional member services model, Cultura replaces the function with a dedicated care coordination team designed to guide, coordinate, and support members more effectively.
Traditional model
Call center-based support
Transactional interactions
Limited clinical context
Reactive help when issues arise
Improved model
Dedicated care coordination team
Proactive member guidance
Provider and care navigation
Clinically supported team, with half of members being registered nurses
Provider Payments
Cash Pay / Direct Pricing
Reference-Based Pricing
Provider bill audited & discounted after service
Large reduction in claims
Broad access
Why it Works?
Without coordination
Poor decisions
Without pricing strategy
High Cost
Together
Better decisions + Better pricing
Options
Care Coordination + RBP
Care Coordination + Cash Pay
Hybrid
