The Human Side of Cost Containment: A Swedish Expat’s Complex Care Journey
- Written by: iPMI Global

International cost containment often conjures a simplistic image: apply network discounts, reduce costs billed, and proceed. However, as demonstrated in the below complex case managed by New Frontier Group (NFG), the reality can be a deeply human-centered and intricate process. Each decision not only impacts financials, but also the well-being of patients, families, and caregivers.
Case Overview
NFG received an urgent call about a 24-year-old Swedish expatriate in Los Angeles who fell from a 10-story building. The case began as a medical emergency but quickly evolved into a multifaceted, emotionally-charged scenario. From coordinating immediate surgical interventions to managing parental dynamics and police investigations, NFG exemplified a meticulous, human-focused approach.
Coordinating Complex Care
Upon notification, NFG immediately engaged with the hospital to establish themselves as the care management team. The patient, who suffered extensive trauma requiring multiple surgeries, needed consent for non-emergency procedures. NFG facilitated communication between the hospital and the patient’s parents—divorced and residing in Sweden—to obtain necessary permissions.
Beyond medical coordination, the team managed logistical and emotional challenges. For instance, NFG supported the transport of the parents to the US and addressed disruptions caused by their disagreements in the hospital. At the facility’s request, NFG mediated the situation.
Unexpected Challenges
The case’s complexity deepened when police investigations determined the fall was actually the patients attempt to end their life. NFG’s team supported the patient and family aligning with the hospital’s psychiatric resources to address the patient’s emotional and psychological needs.
Family and Repatriation Logistics
As discharge neared, NFG faced new obstacles. The patient’s mother resisted repatriation, overwhelmed by the care responsibilities awaiting her. Collaborating with our insurance client, NFG negotiated an additional two-day hospital stay, contingent upon the mother agreeing to repatriate with her daughter.
NFG meticulously planned the transition:
- Coordinating prescriptions for the flight and a two-week supply for post-arrival care.
- Securing ground transportation to the airport.
- Ensuring a seamless transfer to an air ambulance for the journey back to Sweden.
- Care continuation in Sweden.
Despite logistical and emotional hurdles, the patient safely arrived at a rehabilitation center in Sweden.
Financial and Collaborative Efforts
The cost of care included over $5 million in facility charges and nearly $1 million in physician fees. NFG navigated cost containment through negotiation, review, and audit processes, ensuring every charge was justified and reduced to the lowest possible cost.
Collaboration was vital, involving case managers, treating physicians, police, pharmacists, and the client. NFG maintained constant communication, aligning stakeholders to prioritize the patient’s well-being while managing financial responsibilities.
Lessons and Insights
This case underscores the intricate layers of cost containment. It’s not just about reducing expenses—it’s about delivering the best outcomes through empathy, preparation, and adaptability. NFG’s commitment to cultural sensitivity, problem-solving, and human connection transformed an overwhelming situation into a managed resolution.
As Gitte Bach, CEO of NFG, emphasizes, “Cost containment is not just about numbers. It’s about the people behind every case, their stories, and ensuring they receive the care they deserve – which ultimately equates to lower costs with higher outcomes.”
This case highlights NFG’s role as more than a cost containment provider—it positions the organization as a champion of human-centered care.