Secondary payers have relied on Emerging Therapy Solutions for decades to manage the cost of complex transplant cases. Today, the ETS360™ platform extends that expertise across transplant and cell & gene therapy—combining proven cost containment with CGT forecasting, pipeline intelligence, underwriting support and specialized clinical capabilities.
Whether ETS is supporting an individual catastrophic claim or helping manage risk across an entire book of business, our goal is the same: give secondary payers better information before the claim and better economics when it occurs.
Historically, ETS has supported secondary payers when complex, high-cost claims occur. But transplant and cell & gene therapy are changing the risk landscape long before a claim reaches reimbursement. New therapies, expanding indications, evolving eligibility criteria and rapidly changing treatment pathways can affect exposure costs across an entire book of business.
Managing that risk requires visibility before the claim happens—and specialized clinical, provider and financial capabilities when it occurs.
One platform for managing complex therapy risk before and after the claim. Use individual capabilities, subscribe to ongoing intelligence, or embed ETS360 into your own product.
WHAT ETS360 MANAGES
The network access and cost containment services you know.
With a much broader platform behind them.
HOW ETS360 WORKS FOR SECONDARY PAYERS
Predict™
Navigate™
Care™
Protect™
Forecast • Educate • Underwrite • Plan
Understand emerging exposure, support underwriting decisions and prepare the organization before advanced therapies become claims.
Navigate • Contract • Contain Cost • Manage
Access specialized providers, transparent contracts, clinical expertise and claim-management support.
Embed • Differentiate • Strengthen the Product
Use ETS360 capabilities to strengthen stop-loss, reinsurance and MGU offerings.
Secondary payers can use ETS360 in the way that best fits their existing infrastructure, strategy and internal resources.
For Actuarial
Access quarterly CGT exposure forecasts across Commercial, Medicare and Medicaid.
For Underwriting
Use current guidelines, plan document resources and direct clinical consulting.
For Clinical
Stay current on therapies, eligibility, evidence and provider requirements.
For Claims
Reduce severity through best-in-class rates, transparent contracts, claims management and auditing.
For Product
Embed ETS360 capabilities into differentiated stop-loss and reinsurance offerings.
For Education & Leadership
Keep teams current through ETS University, continuing education credits (CEUs) and ongoing market intelligence.
Stop-loss carriers, reinsurers and MGUs can embed ETS360 capabilities into their own offerings—combining financial protection with proactive intelligence, specialized provider access, clinical expertise and cost containment.
For example, a plan might need:
Give employer and health plan clients access to specialized complex therapy capabilities without requiring a separate carve-out.
From quarterly CGT forecasting and clinical underwriting intelligence to best-in-class provider rates and catastrophic claim management, ETS360 gives secondary payers the specialized infrastructure to understand advanced-therapy risk before—and after—it becomes a claim.
Manage the claim.
Access negotiated rates at 180+ medical centers nationwide leveraging existing transparent, comprehensive contracts for transplant and cell & gene therapy. ETS can help manage the total episode of care, manage claims, and reduce the underlying cost of catastrophic cases.
Manage the risk before the claim.
Give underwriting, actuarial, clinical and product teams ongoing access to specialized cell & gene therapy intelligence—including quarterly forecasting, pipeline monitoring, underwriting resources, clinical consulting and continuing education.
You already trust ETS when the catastrophic claim arrives. Now let us help you understand the risk before it gets there.
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