QualityPath®: A Higher Standard of Health Care


The Best Way to Buy Shoppable Care

Depending upon where a patient receives care, and who they receive it from, the cost of a surgery or test can vary by hundreds, even thousands of dollars. With QualityPath, you and your employees benefit from:


  • A single bundled price that covers your surgery or test from start to finish.
  • A warranty that protects you from the high cost of complications for surgeries. For tests, the warranty covers the need for repeating the same scan due to quality issues.
  • A higher standard of care. QualityPath requires participating doctors, hospitals, and clinics to follow specific procedures that lead to better health outcomes.

        Use QualityPath for these tests and surgeries.


        • Magnetic resonance imaging (MRI)
        • Computed tomography (CT) also known as computerized axial tomography (CAT) scans
        • Colonoscopies


        • Total hip replacement
        • Knee replacement

        The Alliance plans to expand QualityPath with more tests and surgeries as we search out more opportunities to identify high-quality care. Selected tests and surgeries must also offer the potential to negotiate savings based on guiding a higher volume of patients to QualityPath doctors, hospitals, and clinics.


        This is Health Care Made Simple


        Doctors, hospitals, and clinics pay for surgery complications or repeated tests due to quality issues, not the employer or employee.

        A New Way to Buy Care

        A single price covers most elements of surgeries and tests.

        High Quality

        Doctors, hospitals, and clinics meet quality measures and use practices that reduce unnecessary care.

        A Better Patient Experience

        You have less paperwork. For surgeries, the patient experience manager offers personal assistance.


        QualityPath is:

        • Saving an average of $12,000 per surgery; savings for tests are projected at 20 percent below current costs (actual results will vary by usage).
        • Reducing out-of-pocket costs for employees and family members.
        • Guiding employees and family members to high-quality care for surgeries and tests.
        • Inspiring and sustaining changes in the way you buy health care.

        Here's How it Works

        • The Alliance annually designates high-value doctors, hospitals, and clinics based on their ability to meet national quality measures, adopt processes that improve care and agree to a lower price.
        • Your business or organization signs up to participate. QualityPath is part of your Alliance membership, so there’s no additional fee.
        • You promote the program to employees so they understand what they can gain from QualityPath and how to use it.
        • Employees get a warranty, lower out-of-pocket costs (sometimes nothing!) and less paperwork.
        • For surgeries, employees also get support from a patient experience manager who can make appointments, transfer medical records, and serve as a liaison.
        • For tests, employees can notify The Alliance after they have a test appointment.

        View QualityPath Providers

        Click to find providers near you that participate in our QualityPath program.


        Plan Design For QualityPath

        The Alliance provides detailed SPD model plan language for employers to use when implementing QualityPath.

        Highlights of plan design language are provided below.

        Mandatory Elements

        For Tests (CTs, MRIs, and Colonoscopies)

        • 100 percent coverage for services in the bundle. The deductible is waived for QualityPathhowever, the employee still pays the deductible when using other health services. This is modified for plans with health savings accounts (HSAs) to comply with Internal Revenue Service (IRS) rules.
        • Patients are required to tell The Alliance when they are having a QualityPath colonoscopy by going to qualitypath.com/TellUs. Patients may also call The Alliance Customer Service Department at 800.223.4139 x6607. Patients who do not tell The Alliance in advance will not get QualityPath’s enhanced benefits. If the patient does not inform The Alliance, employers do not receive QualityPath pricing.
        • Patients are encouraged to tell The Alliance when they are having a QualityPathCT or MRI by going to qualitypath.com/TellUs. Patients who forget or do not use the Internet still get QualityPath’s lower price. However, they may be unaware of the warranty and end up paying more if a repeat scan is required.

        For Surgeries

        • 100 percent coverage for pre-operative care; inpatient care; post-operative care and physical therapy/cardiac rehabilitation; and any services covered under the QualityPath warranty. The deductible is waived for QualityPath; however, the employee still pays the deductible when using other health services. This requirement is modified for plans with HSAs.
        • Patients are required to call the Patient Experience Manager at 800.223.4139 x6607 to be eligible for QualityPath’s enhanced benefits. If the patient does not inform The Alliance, employers do not receive QualityPath pricing.

        Optional, Recommended Enhancements

        For Surgeries and Tests

        Optional enhancements can provide an incentive when a patient has already hit the out-of-pocket maximum and so does not benefit from 100 percent coverage. These enhancements may include:

        • Cash incentives or bonuses.
        • Reimbursement for travel expenses (mileage, parking, tolls).
        • Hotels.
        • Per-diem travel allowances.

        Eligibility & Eligible Services

        For Surgeries and Tests

        • Exclusive Provider Organization (EPO) plans are ineligible.
        • Only people who have primary insurance that uses The Alliance network qualify for QualityPath; patients with secondary insurance do not have access to QualityPath benefits and services.

        For Surgeries

        • QualityPath covers only medications given during the inpatient stay; coverage for other prescriptions is based on the employer’s health plan.
        • Sub-acute care provided at a facility such as a nursing home is covered only for a patient who has a bilateral knee replacement; for all other patients, this care is not covered.
        • QualityPath can be extended to employees outside The Alliance service area if your third party administrator (TPA) can support it. Talk to your Account Executive to learn more.

        QualityPath Toolkit

        Materials to help your employees understand the benefits of QualityPath. Learn more by clicking on the title of each piece.

        Quality Path Map

        The Alliance Network Map with QualityPath Hospitals & Clinics

        This map shows The Alliance network area and the locations of designated hospitals for QualityPath procedures.

        Employee Flyer

        Download this full-color flyer to share vital information about QualityPath with your employees. This flyer can also be combined with a letter for mailing directly to employees and family members at their homes. 

        Download the QualityPath ID Card

        Click to download the wallet-sized QualityPath program card designed with your employees and their family members in mind.


        These four-color graphics help employees understand how their care will move along the QualityPath for surgeries, colonoscopies and CT/MRIs.

        Contact Us

        Interested in joining QualityPath?