MacroHealth provides a cloud‑based Marketplace Platform that unifies payer eligibility, claims, and market data to create a transparent, data‑driven procurement ecosystem. By connecting health plans and administrators with provider, specialty, and pharmacy benefit networks through standardized APIs and analytics, the platform enables real‑time cost estimates, price‑transparency tools, and optimized partner selection, delivering 6‑8% reductions in total cost of care.
Funding
$39.1M raised to dateRaised to date based on public sources. This may differ from the amount the company actually raised and is based only on what is publicly available on the internet.
NFounders
Product
Problem
Healthcare payers and providers struggle with fragmented data, opaque pricing, and inefficient point‑to‑point integrations that hinder cost‑containment, member experience, and strategic decision‑making across medical and pharmacy benefits.
Solution
MacroHealth offers a cloud‑based Marketplace Platform that unifies eligibility, claims, and market data into a single, secure ecosystem. The platform connects payers with a broad network of health market partners—including provider, specialty, and pharmacy benefit networks—through standardized APIs and repeatable workflows. By applying optimization algorithms and analytics, payers can identify high‑value partners, negotiate better rates, and generate real‑time cost estimates for members. Integrated tools such as the Member Care and Cost Search and Provider Search deliver MRF‑compliant price transparency and quality‑based steering directly to members. The result is a data‑driven marketplace that reduces total cost of care by 6‑8%, improves outcomes, and streamlines onboarding and ongoing management of multiple partners.
Target Audience
Payers such as health plans, third‑party administrators, and benefits consultants seeking data‑driven procurement and cost‑containment solutions, as well as health market partners (provider networks, specialty networks, and pharmacy benefit managers) looking to connect with payers through a transparent marketplace.
Features
- Unified data hub that combines payer eligibility/claims data with MacroHealth’s market data and optimization algorithms
- Standardized, repeatable API integrations for rapid onboarding of provider, specialty, and pharmacy benefit partners
- Real‑time, member‑specific cost estimates and price‑transparency tools compliant with Machine‑Readable Files (MRF) regulations
- Centralized analytics and on‑demand reporting dashboards for trend analysis, performance tracking, and ROI measurement
- Provider and specialty network search with quality scores, tiered options, and dynamic comparison features
- Scalable, cloud‑based architecture that reduces integration complexity and maintenance overhead