Medical Cost Management

Medical Cost Management (MCM) is a healthcare management organization that provides clinical oversight and cost-containment services to the self-insured industry. Founded in 1986 and acquired by Payer Compass (now part of Zelis) in 2021, the company specializes in utilization management, catastrophic case management, and population health programs. MCM utilizes a physician-led approach to evaluate medical necessity and optimize treatment plans for complex health conditions. Their services are designed to help third-party administrators and employers manage healthcare spend while ensuring high-quality care for plan members. The company's portfolio includes specialized health programs such as maternity management and chronic disease intervention. By integrating data analytics with clinical expertise, MCM identifies high-risk members to provide early intervention and improve long-term health outcomes.