Employers & TPAs / Pilot planner
Explore a pilot break-even point
Use a hypothetical complete-episode benefit and total program cost. This arithmetic is not a claim of achieved savings or a price quote.
Illustration: $50,000 ÷ ($500 − $100) = 125 episodes. Dollar inputs are hypothetical, not quoted fees or measured savings.
Fixed pilot cost ÷ (assumed complete-episode benefit − variable cost per episode), rounded up. No break-even exists when per-episode net benefit is zero or negative.
Illustrative assumptions only. No live patient, claims, provider, or pricing data are connected. Inputs stay in this page and are not saved or sent to NeXtriage.
Turn a scenario into a useful pilot.
Replace example values with a documented baseline, then vary one assumption at a time. Agree who will collect each measure, which population it covers, and when the team will review it.
Ask your benefits adviser and TPA to agree on a comparison cohort, episode definition, follow-up window, and claims runout. Track member experience and subsequent utilization. An accepted recommendation alone does not prove a prevented emergency visit.