The new payment model ties costs directly to individual engagement, simplifies budgeting operations, and supports regulatory compliance.
MINNEAPOLIS—June 16, 2026—MOBE, the whole-person condition management company, announced a claims-based billing model that gives health plans and employers a new way to pay for MOBE’s services. MOBE transforms health and lowers total cost of care in year one through clinically supported, integrated human and digital whole-person care across more than 36 conditions and health concerns. And backs it with a risk-free savings guarantee. The new billing model gives health plans and employers more line of sight between their investment and the services MOBE delivers.
The model operates alongside MOBE’s existing payment options, giving partners the flexibility to choose the approach that best fits their financial and operational requirements. “MOBE already guarantees results regardless of how health plans and employers pay for our offering. The addition of a claims-based billing option gives health plans and employers a clearer view of what they’re paying for, interaction by interaction,” said Megan Betterman, Vice President of Product at MOBE.
For health plans and employers, the shift from administrative fees to claims expenses is both operational and financial. Costs move from the administrative budget to the benefits ledger, eliminating monthly invoicing cycles, administrative approvals, and budget-cycle delays that slow program launches. The model also specifically supports health plan medical loss ratio (MLR) compliance under the Affordable Care Act.
MOBE uses case rates and bundled payments structured across three levels of service intensity. Each individual generates one monthly charge billed to payers based on their highest level of service during that month. The three levels of service are:
MOBE produces standard 837 files for every billed claim, giving compliance and finance teams full audit-ready documentation.
MOBE’s claims-based billing model is now available to health plans and employers. Organizations interested in learning more or evaluating which payment model best fits their needs are encouraged to contact a MOBE account representative or visit mobeforlife.com/get-started.
MOBE was founded in 2014 by health industry veterans who uncovered a way to use deep data science to identify people whose health care needs (and costs) are going up, but whose health concerns are not resolved. MOBE combines this deep data science with digital health and a novel, one-to-one personalized approach—engaging and supporting participants to achieve healthier and happier lives without any additional cost to the health system, employers, or insurers.
