Star Metro - HealthJoy's Benefits Operating System Drives 18% Savings on Medical Procedures Through Intelligent Steerage

CHICAGO, IL / ACCESS Newswire / May 21, 2026 / HealthJoy, a benefits operating system for employers nationwide, today released a new actuarial cost savings report quantifying the impact of HealthJoy's AI-driven solution on medical spending among employers and their employees. Independently validated by Axene Health Partners (AHP), the study reveals that HealthJoy-guided care can drive down procedural healthcare costs by nearly 18% and even more in high-volume care categories such as specialists, labs, and mental health. This seminal study indicates that intelligent guidance, at the right time and in the right context, can be a vital lever to control healthcare costs. The findings come at a critical time for benefits leaders facing escalating costs and fragmented point solutions.

"At a time when healthcare costs are rising faster than ever, and stubbornly remain the second-largest line item on the P&L, employers are running out of options to contain costs," said Justin Holland, CEO of HealthJoy. "Navigation tools are no longer enough. There's a need for a personalized, proactive system that follows members beyond the 'front door' and guides them in the moments that can make a huge difference to their health and their wallets. This analysis shows the tip of the iceberg in terms of what HealthJoy's Benefits OS can deliver in cost savings for employers."

Instead of a traditional ROI model, HealthJoy employed a "Service Level Cost Efficiency" model to remove the noise of health status and care-seeker selection bias, isolating the financial impact of intelligent steerage. HealthJoy identified the specific price paid for more than 6,000 individual procedures, comparing HealthJoy-guided claims data against non-guided claims data provided by leading third-party administrator BRMS.

According to the analysis, HealthJoy's intelligent steerage delivered cost savings across a number of dimensions:

• 18% average savings per service: Members choosing HealthJoy-guided procedures are 17.79% less expensive than market average across more than 6,000 procedures.

• $327 savings PEPY: Conservatively, cost savings add up to $326.92 per employee per year on average, and even greater among high utilizers.

• 205% greater impact mitigating high-cost claims: Savings efficiency increased significantly as procedure complexity rose, with HealthJoy acting as a financial safeguard and "shock absorber" against the most expensive care episodes.

• Increased savings for specialists, labs, and mental health: The study highlighted a 24.5% reduction for specialist visits, >50% reduction for labs, and 40% savings for mental health services by influencing initial care decisions that impact downstream costs.

• 50% engagement with high-risk members: HealthJoy successfully influenced the care decisions of nearly half of the highest-cost claimants, the top 20% of members who drove 95% of total plan spend.

"HealthJoy's thorough, multi-year analysis has revealed the impact and efficiency of its intelligent guidance in driving meaningful cost savings for employers," said David V. Axene, FSA, FCA, CERA, MAAA, Managing Partner of Axene Health Partners. "Findings suggest that HealthJoy's strategy for engagement and targeted mitigation are steering employees towards more affordable care, with estimated cost savings of $326 per employee per year."

The study provides further evidence that HealthJoy's Benefits Operating System is a critical lever for engaging and influencing members to ensure they get the most out of their benefits strategy. In addition to the quantified cost savings from proactive steerage, HealthJoy helps employers and employees manage spending by addressing medical bill errors (averaging $689 in savings per bill) and surfacing the best medication prices through partnerships with GoodRx, CareGLP, and others.

For more information about the findings, download the full report here.

About HealthJoy

Founded in 2014 and headquartered in Chicago, HealthJoy is a Benefits Operating System that closes the execution gap between the benefits strategy employers design and how employees actually use it. Trusted by more than 1,800 employers and over a million members nationwide, HealthJoy acts as the active engine of your plan - using proprietary AI to identify and engage members in need before a claim occurs, then executing the logistics to ensure the right care actually happens. Unlike siloed carrier apps and navigation tools that wait for members to come to them, HealthJoy's proactive model steers every member to the highest-value care across the entire benefits stack, backed by a 24/7 Healthcare Concierge team trained on each employer's specific plan design. The result: benefits strategies that finally perform as designed - and the data to prove it. HealthJoy is a Series D company backed by leading healthcare and technology investors.

About Axene Health Partners

Axene Health Partners (AHP) is an independent health actuarial consulting firm dedicated to making a positive impact on the healthcare industry by advancing lower costs, higher quality, and greater efficiency. AHP serves a broad range of clients across the healthcare spectrum, including health plans (large and small), hospitals, government entities, cost containment organizations, employee benefits groups, and legal teams requiring expert testimony. AHP's team combines best-in-class analytical expertise, deep clinical experience, and innovative technological capabilities. The firm emphasizes data-driven insights, analytical rigor, and practical strategies to help clients navigate the financial and operational complexities of healthcare-ultimately improving quality of care while controlling costs.

CONTACT:

Iz Conroy | [email protected]

SOURCE: HealthJoy

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S.Clark--SMC