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Same procedure. Same facility. Three times the cost.
The prices billed to private health plans in Indiana can vary radically from what hospitals charge Medicare. They average 281 percent more for facility and physician fees in inpatient settings and 320 percent more for outpatient care, according to research by the Employers’ Forum of Indiana and RAND Corporation. The gap is among the highest in the country, motivating government and businesses to find new ways to control healthcare costs.
Indiana has become a national leader in healthcare price transparency since the Employers’ Forum sponsored a first-of-its-kind study of hospital transactions in 2016. That research has since expanded nationwide and inspired the Indiana Legislature to take a number of steps to help rein in medical pricing. In recent years it has banned excess hospital fees, prohibited non-compete clauses for primary care providers and increased scrutiny of mergers. A law passed last year also set a cap on how much five of the state’s largest hospital systems can charge employer-sponsored health plans relative to Medicare.
Faced with cost increases that averaged 9 percent in 2026, plan sponsors are also looking for new solutions, including approaches to care outside the typical fee-for-service model.
Bringing care directly to employees
Over the last decade, more than 50 Indiana businesses, government organizations and union-sponsored Taft-Hartley plans have adopted an approach to primary care that has saved an average of $3,100 annually per engaged employee. Marathon Health operates advanced primary care health centers located where employees work and live. By offering free or low-cost preventive care and services that can cover up to 90 percent of healthcare needs, employers have meaningfully improved the health of their workforce in ways that reduce costs. More than three-quarters of at-risk members working for Marathon partners in Indiana have improved health metrics like cholesterol, blood pressure and BMI. Better management of chronic disease, fewer visits to the emergency department and more engagement with providers who can treat issues early translates to lower healthcare spending.
“There’s a correlation with having the health center onsite and the hard dollar savings that we’re seeing,” said the benefits manager of one Marathon partner in Indiana that has saved more than $2.7 million in healthcare costs versus their expected spending.
Across all clients and delivery channels nationally, Marathon partners average 1.2x ROI in the first year and up to 3.7x in year five. These results have driven the expansion of Marathon’s network of offsite health centers in Indianapolis, which will include eight locations after a new health center in Wayne Township opens this fall. As more health centers open, members working for Marathon partners have more convenient options for appointments at no additional cost to their organizations, which pay only for the care delivered based on a tiered-engagement pricing model.
Managing one of the biggest drivers of healthcare costs
Another benefit of the growing Marathon network is the expansion of services available to employees. The Wayne Township location will add occupational health services, and an expanded Greenwood location recently introduced physical therapy. Both can reduce the impact of musculoskeletal conditions, which 71 percent of employers cite as a top driver of their healthcare costs.
One midwestern manufacturer reduced the average cost of injury claims by 40% and cut injury-related time away from work by nearly half after implementing a customized occupational therapy program with Marathon Health. “It’s a game-changer from a financial perspective. You can see the results within our workers’ comp claims and our risk,” said the company’s benefits manager.
Employers working with Marathon to open new network health centers can help shape the care they offer. In addition to services that address musculoskeletal conditions, these often include mental health, health coaching and pharmacy dispensing on site. New locations go live in about nine months. Or partners can begin offering access to existing locations in about 90 days. Marathon owns the real estate, eliminating capital risk, and completely manages the health center’s operation. Employees’ access to this quick, convenient care soon drives better quality of life, while employers benefit from a new resource to control escalating healthcare costs.
Learn more about Marathon’s Indiana network and how local organizations have accomplished 98 percent patient satisfaction for advanced primary care that helps control costs.
Marathon Health is a leading advanced primary care provider, partnering with employers, unions, and health plans to improve health for millions of Americans. With nationwide onsite, nearsite, and network health centers, and virtual primary care, Marathon delivers a value-based model that enhances the health care experience for members and providers, while driving meaningful cost savings for plan sponsors. Learn more at Marathon Health’s website.