Complex Care Program:
An Employer Health Solution
At Mayo Clinic, we understand that managing employees’ complex medical conditions can be challenging. That’s why we developed the Mayo Clinic Complex Care Program. It’s a customizable center of excellence program designed to help provide quick and easy access to Mayo Clinic for high-cost, high-risk employees.
Small volumes, big impact.
Data shows that 1% of a population spends more than 30% of plan dollars*. This is often due to:
- Serious or complex conditions
- Inappropriate care
- Misdiagnosis
- Overuse
- Unknown diagnosis (diagnostic odyssey)
- Wrong treatment plan
*American Health Policy Institute (AHPI); High Cost Claimants: Private vs. Public Sector Approaches
By providing high-quality care for a small subset of complex patients, the Mayo Clinic Complex Care Program can have a significant impact – both on patients' lives and on overall plan costs.
Discover how Hydro-Gear, a leading U.S. manufacturer, revolutionized its employee healthcare strategy through the Mayo Clinic Complex Care Program. Hydro-Gear shares how the program delivers faster diagnoses, coordinated expert care, and life-changing outcomes for employees.
Better Outcomes. Long-term cost savings.
Many individuals seen at Mayo Clinic through the program experience a change in diagnosis or treatment plan. Getting the diagnosis right leads to better care for the patient and long-term cost savings for employers.
Based on medical record review of 573 patients (across multiple employers) who travelled for care as part of the Mayo Clinic Complex Care Program in 2024
How Does the Complex Care Program Work?
The program is a collaborative effort between Mayo Clinic, employers, and trusted payer partners. It’s specifically designed to address the unique needs of individuals with serious, complex or undiagnosed medical conditions.
Employers Provide:
Mayo Clinic Provides:
- High-quality, cost-effective care for individuals with serious, complex, or undiagnosed medical conditions.
- Expedited scheduling
- Condensed appointment itineraries
- No administrative fees or PM/PM
Benefit design changes that reduce barriers for members who need evaluation or treatment at Mayo Clinic:
- Travel and lodging benefits
- Waived out-of-pocket costs (when possible)
- Waived prior authorization while patient is at Mayo Clinic
Are you a Broker, Consultant, TPA, or Patient Navigation Service?
Mayo Clinic works with many national brokers, consultants, TPAs and navigation services. The Mayo Clinic Complex Care Program can complement what you're already doing to support self-funded employer groups' high-cost claimants. We'll work with you through existing pathways or create a customized offering to meet your needs. Email us to get started.
Life-changing care.
Is the Complex Care Program Right for My Organization?
For many self-insured employers, the answer is “yes.” If the following items are impacting your organization, it’s likely a fit for you, too.
Do you have employees who are:
- Generating high-cost medical and pharmacy claims?
- Seeking answers for an undiagnosed condition or unmanaged symptoms?
- Struggling to coordinate multiple medical specialists?
- Challenged with coordinating care across multiple medical specialists?
Unparalleled Patient Experience
“Getting the opportunity to see all the specialists within a matter of 2-3 days is a tremendous value.”
Father of a patient with a primary
immunodeficiency disorder
“Having a plan, knowing that we’re going to be getting the best care possible, gave us tremendous peace of mind.”
In 2023, 97.1% of patients in the Complex Care Program rated their likelihood to recommend Mayo Clinic to others as “good” or “very good.”
Patient with neuroendocrine tumor
*2023 Patient experience survey administered by Press Ganey. “Good” and “Very Good” are top 2 boxes.
Want to learn more? Let's continue the conversation!
If you’re interested in learning more about our program, please email us and we’ll work with you to develop a custom offering based on the needs of your population.
Want to schedule an appointment at Mayo Clinic?
The above information is intended for organizations, not individuals. If you are an individual seeking medical care at Mayo Clinic, please visit our appointment page.
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