The MedExpert Difference

The Medical Information Company

Healthy Members, Reduced Costs

Results among highly varied client populations have shown ROI results in the 10:1 to 16:1 range. Among larger groups (>100,000 members), ROI has reached 20:1 year over year. These results come from more-appropriate utilization of care resources, lower claim counts, reduced ER visits, and reduced duplicative and unnecessary testing. Appropriate care choices also push down hospital recidivism rates, and MedExpert clearly reduces rates of unnecessary elective surgery.

Validated Findings

  • Served more than 365,000 beneficiaries across all 50 states
  • Reduced inpatient hospital admissions by 15%
  • Reduced use of skilled nursing facilities by 15%
  • More than 85% of all beneficiaries were touched
  • More than 45% engaged medically at a “low intensity” level
  • 12% engaged medically at a “high intensity” level
  • 95% of participants gave MedExpert an “Excellent” rating
  • 99% said they would participate again
  • Decreased emergency room use by 25%
  • Decreased overall expenditures by 14%
  • Decreased inpatient stay, reoperations, outpatient procedures by 14-17%
  • 67.30% of the member population improved their blood pressure
  • 58.50% of the member population improved their glucose values
  • 50.79% of the member population improved their cholesterol values
  • Provided services on more than 1,800 unique medical topics and reduced readmission and reoperations
Behavior Change







Among a group of “super-utilizers” in a Medicaid population, MedExpert’s interventions have significantly reduced opioid use, as this chart shows:

ABOVE: A MedExpert group consisting of the same 5,107 members commenced MedExpert care coordination and care management services in January 2015.

The 2014 year identifies opioid purchases prior to commencement of MedExpert services.

NOTE: Results for 2017 subject to claim lag. Last claim load shown occurred in October 2017. Data reported by incurred date.

UnitedHealthcare - MedExpert Medicare Total Population Performance Results (144,456 Medicare Beneficiaries)

Percent Change Between Base Year and MedExpert Service Year HCE - ME Review of the MedExpert CMS CMMI Pilot 2014-2015[1]

[1] Claims incurred through February 28, 2014 and paid through April 5, 2015. No completion factors applied. Measurement period compared difference between May 2013 – Feb 2014 compared to pilot period of May 2014 to Feb 2015. Total population of markets in program: 144,456 Medicare beneficiaries.

What Clients Say

about MedExpert

"In the last ten years, MedExpert has earned a reputation of trust with our membership. Our members rely on MedExpert."
Trust Fund
"Other vendors “talk” but they don’t have the resources or commitment to make it work. MedExpert is committed to leveraging technology and engineering staff to solve issues."
Trust Fund
"We love working with MedExpert. They aways exceed our expectations."
HR Department