.png){kind=spacer}
What Are Healthcare Cost Transparency Vendors?
Read more
Frequently Asked Questions
Find answers to common questions about Garner
For Employers
Garner uses better data and smarter incentives to steer care to the best doctors in your network, driving cost savings for employers and better outcomes for employees. Members search the Garner app or ask the Concierge team for a recommendation, and get reimbursed for their out-of-pocket costs when they see a Garner Top Provider. Garner helps you save on the cost of your benefits because better doctors follow the latest research, avoid unnecessary procedures, and help patients get healthier faster.
The savings come from steering members to more appropriate care. Higher quality care is often actually less expensive. The best-performing doctors are more likely to diagnose the first time correctly, order the right tests, and recommend surgery or medication only when it truly helps the patient. They don’t order unnecessary procedures and have lower surgical complication rates, keeping costs down while improving member outcomes.
Garner evaluates doctors using one of the largest medical claims databases in the country, covering 75% of all claims nationally and more than 320 million patients. Using 550+ clinical metrics across 80+ specialties, Garner identifies the top doctors in your network who follow the latest medical guidelines, avoid unnecessary procedures, and help patients get healthy faster. Recommendations are personalized to each member's location, network, and care needs.
The incentive follows the doctor, not the building. When a member has a procedure with a Top Provider, the eligible out-of-pocket costs tied to that episode of care qualify, including separately billed services like anesthesia and pathology. Members are never penalized for parts of the care team they did not choose. You decide which cost categories (such as emergency services or prescription drugs) qualify under your plan design, and your Garner team maps those rules during implementation.
No. Garner works as an out-of-the-box solution that doesn’t require network changes or further integrations. For your employees, it’s as simple as installing the Garner app and finding the best doctors in their network immediately.
HRA incentive size and plan design changes are key drivers of behavior change. When employees are rewarded for choosing higher-performing doctors, we see real behavior change, and real improvements in outcomes and costs. You set your incentive to match how much you want to shift member behavior. A small incentive adds a reward on top of your existing plan for modest savings, a standard design pairs that reward with a small deductible change to disincentivize non-Top Providers, and an enhanced design combines a higher deductible with a larger incentive to drive significantly more engagement and savings. The bigger the incentive, the more members engage, which is why many employers now start with a richer design.
Yes. Garner works with PPO and HDHP/HSA plans alike, whether self-funded or fully insured, and does not affect your employees' eligibility to contribute to their HSAs. On an HSA-qualified plan, the incentive is structured to follow IRS rules, either by reimbursing costs after a member meets the IRS minimum deductible or by rewarding members from the first visit through Garner's first-dollar HSA model.
Yes. Under IRS rules, paying a member's costs before they meet their deductible would normally make them ineligible to contribute to an HSA, so Garner rewards members through the account itself instead. Garner's first-dollar HSA model, available with WEX, Optum, HealthEquity, and other major HSA providers, seeds the member's account with an amount equal to their out-of-pocket cost, which is designed to preserve the member’s eligibility while still rewarding them for choosing Top Providers. Members have a reason to engage on day one, and we see that the share of employees seeing top-performing providers nearly doubles in the first year (from 23% to 43%). If you offer an HSA plan, we’ll determine the right setup during implementation.
The incentive is structured as an employer HSA contribution, so it follows federal IRS rules and works consistently across the country with a few state-specific considerations that may require extra planning. The main difference to plan for is state income tax, since a few states (including California and New Jersey) tax HSA contributions even though the federal government does not. That changes how a contribution is taxed for some employees, not whether they can receive it. Garner reviews any state-specific considerations for your population during implementation.
Garner charges a simple per-employee-per-month fee. That fee already includes administration and the amount Garner will pay out in member incentives. There are no hidden costs, and fees are tied to Garner's performance against an agreed savings target. Your Garner team will model the exact pricing and projected savings for your population during evaluation.
Garner ties its fees to a net trend target and backs that target with its own money. For groups with 500 to 5,000 enrolled, up to 300% of fees are guaranteed against the target, and larger groups are guaranteed up to 100%. The per-employee-per-month fee already covers administration, broker compensation, and the most Garner will pay out in incentives, and 100% of any surplus is returned to you. Garner carries real downside if it does not deliver.
For Providers
Garner applies 550+ proprietary clinical metrics to over 60 billion de-identified claims from 320M+ patients, evaluating clinical outcomes, adherence to evidence-based care guidelines, and cost efficiency. Providers who rank in the top tier of their specialty and geographic market earn the Top Provider designation.
Garner excludes the most complex cases entirely, since those outcomes cannot be risk-adjusted reliably, then adjusts the remaining cases for patient comorbidities and demographics before comparing doctors. This keeps the comparison focused on similar patients rather than penalizing physicians who take on difficult ones.
Garner refreshes its underlying data monthly and scores a doctor when about three months of claims are available. Contact and availability details in the directory update close to real time, while quality metrics update each month.
Providers currently cannot access their individual rankings directly. Garner's methodology is built on de-identified claims data that is not provider-reported, which keeps the rankings objective and independent.
Yes. Members using Garner are actively guided toward Top Providers through personalized recommendations and financial incentives. Top Providers in markets where Garner operates may see increased patient volume from Garner members who are actively seeking care. Learn more about Garner for providers.
Garner covers over 80 sub-specialties, including primary care, orthopedics, cardiology, gastroenterology, OB/GYN, and more. Coverage is prioritized in the specialties and markets where quality variation and cost impact are greatest.
For Health Plans
Health plans can offer Garner as a value-added benefit that reduces total claims cost, improves member outcomes, and differentiates their product in competitive employer markets—without changing plan design or network contracts. Learn more about Garner for health plans.
Yes. Garner works with both fully insured and self-funded arrangements, in addition to level-funded plans.
By directing members to high-quality, cost-efficient providers, Garner reduces unnecessary procedures and avoidable complications, while also helping members get healthy faster. The result is lower total claims spend without restricting member choice or changing plan benefits.
Garner analyzes about 75% of U.S. medical claims across more than 320 million patients, several times a single carrier's view, and adds Medicare, Medicaid, and price-transparency data. Because it is not tied to one insurer, it can measure both quality and cost and follow outcomes as members move between plans.
Garner recommends several ranked options per specialty within a reasonable drive time, so volume spreads across a pool of high performers rather than one name. Garner also works with health systems to raise the performance of other doctors, widening the supply of high-quality care over time.
Yes. For the employer groups a plan serves, Garner guides their employees to high-quality, cost-efficient providers, which lowers the group's total claims cost, cuts unnecessary procedures, and helps employees recover faster. It also layers onto the plan employers already have, so they improve outcomes without changing plan design or network.
Garner provides regular reporting on member engagement, Top Provider utilization rates, estimated claims savings, and many other metrics. Health plans can use this data to demonstrate ROI to employer clients and track the benefit's impact over time.
For Members
Garner uses data science to identify the top 20% of doctors. These Top Providers:
- Practice based on the latest medical research
- Successfully diagnose problems
- Produce the best patient outcomes
- Get the highest patient satisfaction ratings
After seeing Top Providers, Garner reimburses your qualifying out-of-pocket medical costs. By receiving the best care, you'll generally save money on your health care, and you're likely to be healthier overall. It's a win-win. Learn how it works.
- Create a Garner account online at getgarner.com or by downloading the Garner Health app.
- Find Top Providers in the Garner Health app or website. Doctors with a Top Provider badge are automatically added to your list of approved providers as soon as their badge appears on your screen.
- See your Top Provider.
- Get reimbursed. Out-of-pocket medical costs from approved providers will qualify for reimbursement on or after the date the provider was added to your list.
Yes. Traditional insurer directories are often wrong about who is in network or accepting patients, so Garner verifies each provider three ways: claims data showing they are taking new patients, AI that checks real booking and website availability, and a call center that phones offices directly. This brings Garner’s directory accuracy to 92%, showing you only verified, in-network options.What if my preferred doctor isn't a recommended provider?
You can still see any doctor in your network. You simply would not earn the Garner reimbursement for that visit. Some plans also let you keep a current primary care doctor, OB, pediatrician, or behavioral health provider and still take part in the Garner program. Garner's care team can also explain why a doctor is or is not recommended and help you find strong alternatives.
Garner finds the best existing in-network options within a realistic drive time and compares them only to other doctors serving the same region. Drive-time ranges widen for specialized care, so a complex specialty may include options farther away than a routine visit. Garner can also point you toward high-quality virtual care.
Check the "Your benefit" page in the Garner Health app to learn which types of costs qualify under your Garner plan.
Your out-of-pocket medical costs will qualify for reimbursement if:
- You have created a Garner account and added the provider to your list of approved providers prior to the date of service.
- Your provider is in-network and the cost was covered by your health insurance plan. (Check your health insurance plan.)
- The type of cost qualifies for reimbursement under your Garner plan. Depending on your Garner plan, costs for things like prescription drugs or emergency services may or may not qualify for reimbursement. (Check the "Your benefit" page to learn more.)
- If your health insurance plan is paired with an HSA, you will need to incur costs greater than the minimum deductible. (Check the "Your benefit" page in the Garner Health app to see if this requirement applies.)
Garner follows the provider on each claim, so the costs tied to a surgery are counted and covered even when the anesthesiologist or pathologist bills separately and happens to be out of network. You are not penalized for parts of the care team you did not choose.
No, Garner does not let doctors pay to show up in our recommendations. Unlike insurance directories, Garner ranks doctors based on real patient outcomes so you can be confident you're seeing the best doctors.
No. Garner is not your health insurance. Garner is a separate benefit that is paired with your health insurance plan to help you find the best providers and reduce the amount you must pay out of pocket before you meet your insurance deductible. Garner is a Health Reimbursement Arrangement (HRA) and is funded entirely by your employer.
