Mar 4, 2025

Lantern open sources its full savings methodology; proposes a new standard for healthcare claims analysis March 04, 2025 08:00 ET Lantern DALLAS, March 04, 2025 (GLOBE NEWSWIRE) -- Lantern , a Specialty Care Platform connecting people with the best surgery, cancer and infusions care, announced today that the company has publicly released its full savings methodology. By revealing how it calculates cost savings and exposing challenges with alternative approaches, Lantern is empowering benefits leaders and employers with the data and tools to make informed, cost-effective healthcare decisions. Lantern is also calling on the broader healthcare industry to embrace transparency, urging organizations to disclose their own savings methodologies and provide feedback on Lantern’s approach. Lantern’s methodology is an open-access framework for calculating surgical savings, addressing key challenges that often make it difficult to get accurate cost comparisons. Traditional savings calculations suffer from inconsistent definitions of care episodes, inaccurate benchmarks that fail to adjust for geographic and site-of-service variations, and a reliance on incomplete or distorted claims data. For example, Lantern’s analysis shows that 36% of surgical claims dollars remain unaccounted for after 30 days, and 7% are still missing after 180 days, which can translate to millions or hundreds of millions in missing spend depending on the size of an employer. “Employers, who provide health insurance coverage to more than half of Americans, have the potential to be hugely powerful in driving healthcare market dynamics. But their influence is challenged by unclear and inconsistent savings calculations that make meaningful benchmarking and comparison almost impossible,” said John Zutter, Lantern’s CEO. “By making our methodology public, we’re inviting feedback from the larger industry, but we’re also calling on others to similarly commit to real transparency, which is the only way that benefits leaders can confidently compare costs, negotiate better rates, and make smarter, more cost-effective healthcare decisions.” By offering a rigorous, transparent approach grounded in hard-dollar savings for standardized episodes of care, Lantern ensures that employers and benefits leaders can make data-driven decisions based on real, verifiable savings. Lantern’s transparency also sets a new industry standard and aims to begin a larger conversation about disclosure, accountability, and fostering a more open, fair, and data-driven approach to healthcare pricing. The report further exposes how common data pitfalls, such as improper handling of outliers, failure to account for claims lag, inaccurate benchmarking, and the exclusion of key cost drivers like implants, can distort savings calculations by tens of thousands of dollars per case. It also reveals how traditional industry tools, such as machine-readable files and episode groupers, often generate misleading savings estimates by overlooking critical variables like patient acuity, site-of-service variation, and the true cost of implants. For instance, implant costs, one of the most significant drivers of surgical expenses, are frequently omitted or inconsistently reported in claims data, even though procedures like joint replacements frequently have implant costs exceeding $10,000. By adopting Lantern’s transparent, data-driven methodology, which systematically accounts for these factors, employers and benefits leaders can make more precise cost comparisons, ensuring they fully understand actual expenses and achieve real, verifiable savings. Lantern’s methodology has been reviewed by leading academic and industry experts, and Lantern welcomes additional feedback. Employee benefits leaders and others can now access the full report to gain the tools needed for more accurate cost comparisons, smarter negotiations, and better-informed healthcare decisions. They can provide feedback by joining the conversation on LinkedIn . About Lantern Lantern is the Specialty Care Platform connecting people with the best care when they need it most. By curating a Network of Excellence comprised of the nation’s top specialists for surgery, cancer, and infusions, Lantern delivers excellent care with significant cost savings to employers and their workforces. Lantern also pairs members with a dedicated care team, including Care Advocates and nurses, for the entirety of their care journey, helping them get back to good health, back to their families and back to work. With convenient access to specialists nationwide, Lantern means quality care is within driving distance for most. Lantern is trusted by the nation’s largest employers to deliver care to more than 6 million members across the country. Learn more about us at lanterncare.com. Media Contact