How One ACL Surgery Delivered a $28K Savings and Cut Recovery Time in Half

Who is this for?At-a-Glance The Problem The Turning Point The Solution The Outcome Strategic Insight Testimonial

Who is this case study for?

Employers with active or labor-intensive workforces prone to knee injuries

At-a-Glance

Procedure Type: ACL Repair

Total Bundle Price: $19,800

Typical PPO Allowed Amount: $48,000+

Savings to Employer: $28,200

Time Off Work: 9 Days vs. 3-4 weeks

Location: Austin, Tx

The Problem

A 160-employee roofing and renovation company in Austin was seeing rising costs and extended downtime from orthopedic injuries. Their existing PPO network often routed employees to high-cost facilities with long wait times and no pricing transparency. After one employee’s prior ACL surgery resulted in a surprise $52,000 bill and 4 weeks off work, the company and their broker began looking for a more predictable, efficient solution.

The Turning Point

When another ACL injury occurred, the employer and their benefits broker leveraged TMM’s pre-negotiated bundled pricing. The employee was referred directly to a board-certified orthopedic surgeon with ASC access in Austin.

The Solution

TMM arranged an all-inclusive, flat-rate bundle of $19,800 that covered every aspect of care—surgeon fees, facility, anesthesia, as well as pre-op and post-op services. Scheduling was handled within 48 hours, streamlining the process for both the employee and HR. The procedure took place at a high-efficiency ambulatory surgery center with a proven track record of zero complications for this procedure type. Post-operative support included a direct referral to physical therapy and ongoing case tracking to ensure a smooth and timely recovery.

The Outcome

The employer saved $28,200 compared to their historical average for ACL repairs under their PPO plan. Even more notably, the employee was medically cleared to return to light-duty work just nine days post-surgery—a significant improvement over the typical 3–4 week recovery. There were no surprise bills or hidden charges; every element of care was included in the bundle, eliminating financial uncertainty. HR later shared that the employee and their spouse expressed unsolicited appreciation for how simple, fast, and supportive the experience had been.

Strategic Insight

This case illustrates a growing opportunity for self-funded employers and their advisors: reclaiming control over surgical spend without compromising quality or employee satisfaction. Musculoskeletal claims remain one of the top cost drivers in employer-sponsored plans, yet most networks offer little pricing transparency or care coordination. By bypassing the traditional PPO system and contracting directly through TMM’s bundled model, this employer not only reduced total spend by over 50% but also minimized downtime and improved the employee experience. For TPAs and brokers looking to offer more than incremental savings, this kind of episode-based strategy delivers measurable impact—and trust from both the C-suite and the front line.

Testimonial

“We’ve had multiple ortho claims blow past $40k under our PPO plan. This was different! It was all-inclusive, fast, and our employee was back at work in under two weeks. We’re rolling this out across the board.”

Jason Ranner, HR Manager

Central Texas Health

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Phone: (512) 275-6471

ADDRESS:

1001 S Mays St #205 Round Rock, TX 78664

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