Model Optimal Care launches online academy for self-funded health plans

Model Optimal Care has launched The MOC Academy, a 10-program online training library for self-funded health plans and their advisers, with enrollment now open at MOClearn.com. The company says the courses are built to stay current as rules around pharmacy benefit managers, AI in prior authorization, and fiduciary duties keep changing.

Why it matters: - Self-funded plans now cover 71% of workers with employer health coverage, including 85% at firms with 200 or more workers, according to KFF's 2026 Employer Health Benefits Survey. - CMS projects U.S. healthcare spending reached $5.7 trillion in 2025. - Research cited by Model Optimal Care puts waste at 25% to 30% of every healthcare dollar, or as much as $1.7 trillion a year. - The Academy is aimed at helping plan sponsors and advisers keep up with fast-changing rules around pharmacy benefit managers, AI, ERISA, and stop-loss coverage.

What happened: - Model Optimal Care launched The MOC Academy, an online training library for people who work with or advise self-funded health plans. - The Academy opens with 10 programs and 184 hours of training. - The catalog includes the Certified Professional in Model Optimal Care, or CP-MOC, designation, plus nine focused courses. - Two of the courses are free. - Enrollment is open now at MOClearn.com.

The details: - The Academy builds every program around one method from Jude Odu's book, Model Optimal Care: End US Healthcare Waste, One Health Plan at a Time. - Course content has been updated for changes since the book went to print. - Each course includes dated update cards that show what changed and cite the source for each figure. - Fast-moving courses such as AI, pharmacy, and stop-loss are reviewed every January and July. - The rest of the courses are reviewed each January. - Quiz and exam questions test only stable facts. - Every course uses a fictional employer called Northfield Components. - Hands-on exercises run in MOC Fiduciary Intelligence, Model Optimal Care's AI platform, at no added cost. - Learners do not upload real member data. - Every course earns a verifiable Certificate of Completion. - Continuing education credits count toward CP-MOC recertification. - The CP-MOC program includes about 100 hours across six modules and a 105-question final exam. - CP-MOC holders learn to assess a self-funded plan against five Model Optimal Care principles and ERISA and Consolidated Appropriations Act duties. - The designation renews every two years with 30 continuing education hours. - The free courses include Becoming Self-Funded and Benefits Literacy for HR Teams. - The catalog also includes Price Transparency and Provider Pricing, Claims Payment Integrity and Fraud, Waste, and Abuse, Utilization, ER Redirection, and Care Management, and other courses focused on fiduciary oversight, pharmacy benefits, AI, and stop-loss. - Pharma and AI content reflects 2026 policy changes, including Medicare's WISeR model beginning AI-based prior authorization reviews in six states on January 1, 2026. - The pharmacy benefit oversight course covers contract terms, audit rights, formulary waste, and specialty and GLP-1 spending. - The stop-loss and captive course addresses how to judge a group captive proposal. - The Academy also serves brokers, consultants, TPAs, stop-loss carriers, captive managers, CFOs, benefits committees, and HR teams. - Corporate seats are available at volume pricing.

Between the lines: - The launch is a bet that self-funded benefits education needs a continuously updated format, not a static book or one-time conference session. - Model Optimal Care is positioning the Academy as a current, sourced reference point in a field where rules, lawsuits, and plan design are changing quickly. - The company is also tying training to continuing education credits, which makes the program easier for employers and professionals to justify. - Ernie Clevenger, president and publisher of MyHealthGuide and a past president of the Health Care Administrators Association and the Self-Insurance Institute of America, said the book offers current methods, innovations, and practical arguments that sharpen service to the self-funded community. - Founder Jude Odu said the Academy keeps the method current so people learn what applies this year, with the evidence in front of them.

What's next: - The company says fast-moving courses will keep getting updated twice a year. - Employers can use an educational assistance program under IRS Section 127 to cover professional education costs, and the company says every paid course fits within the 2026 tax-free limit of $5,250 per employee. - Paid courses include a reimbursement packet. - CP-MOC credential holders and MOC Fiduciary Intelligence subscribers receive discounts on paid courses. - Model Optimal Care also operates MOC Fiduciary Intelligence at fiduciaryIQ.ai and publishes The MOC Brief, a twice-weekly industry newsletter.