Simple Healthcare Roadmap finds $54M in potential savings from $426M in employer health spend

Simple Healthcare has made its Roadmap tool generally available to self-insured employers and their advisors. In beta, the platform analyzed $426 million in plan spend and identified $54 million in potential savings, as employers face rising medical costs and increased scrutiny of plan fiduciary decisions.

Why it matters: - Simple Healthcare Roadmap is designed to show self-insured employers where their healthcare dollars go, what lower-cost options exist and how much each change is worth. - In beta, the tool found $54 million in potential savings across $426 million in employer plan spend, or about 13% of spend. - Employers in the beta ranged from small to large, and Roadmap found an opportunity in every one. - The launch comes as medical cost inflation is running above 7%, the highest level in more than a decade. - The timing also matters because lawsuits against plan fiduciaries, including cases involving Johnson & Johnson, Wells Fargo, Kraft Heinz, Aramark and Ford, have raised pressure on employers to document plan decisions.

What happened: - Simple Healthcare made Simple Healthcare Roadmap generally available on Aug. 20, 2026. - The platform is available directly to self-insured employers and through their advisors. - The company is based in Orlando, Florida. - Roadmap analyzes an employer’s de-identified claims and compares them with payer and hospital price transparency data, plus hundreds of additional data sources. - The company describes the approach as applied price transparency, using published prices on actual employer claims instead of leaving raw files untouched.

The details: - Roadmap gives employers three outputs: where the money is going today, what can be done about it, and what each change is worth in real dollars. - The platform prices opportunities such as carrier switching, renegotiating rates with specific providers, direct contracting, reference-based pricing and moving care to lower-cost settings. - The analysis can show value even if an employer does not act on the recommendations. - Roadmap also ranks opportunities and recommends how to pursue each one. - The tool prices care as a total episode, including follow-up care, rather than one billing code at a time. - Roadmap pairs cost with quality so plan decisions can weigh both. - The highest savings rate in the beta reached up to 21.6% of plan spend and did not require a carrier switch. - That savings came from repricing, site-of-service changes and reference pricing. - The methodology is peer-reviewed. - Claims data are de-identified and encrypted at rest and in transit. - Simple Healthcare does not receive protected health information and does not require a HIPAA business associate agreement. - Simple Healthcare is not owned by an insurer or a healthcare provider.

Between the lines: - The product is built to help employers see the market price for the same care across providers, a view many plans do not have today. - The company is positioning analysis and execution as separate tasks, with advisors handling renewals, negotiations and vendor relationships. - That setup suggests Simple Healthcare wants to fit into existing advisory workflows rather than replace them. - Founder and CEO David Muhlestein said the platform surfaced money in every plan reviewed and that employers have lacked a usable view of what the broader market pays. - Muhlestein also said fiduciaries now need to show their work when making plan decisions. - The launch reflects a broader push to turn federal transparency files into actionable employer savings tools.

What's next: - Simple Healthcare expects advisors to run the engagement where one is already in place, while employers can also work directly with the company. - The company says details are available at simplehc.com. - Simple Healthcare says interviews, methodology briefings and product walkthroughs are available on request. - The company will likely use live employer deployments to prove whether beta savings can translate into ongoing contract and benefit changes.

The bottom line: - Simple Healthcare is betting that public price data can move from compliance files to real employer savings, with Roadmap now available to help self-insured plans find and quantify those opportunities.