A medical shared savings unit receives a selection from one or more computing devices to select a medical provider in a region outside the United States for a patient as part of a medical savings plan, and accesses the medical plan information from the data store, and calculates a savings based on a difference between a cost of the medical procedure performed in the region outside the United States and a cost of the medical procedure performed within the United States. The medical shared savings unit further divides the savings between the insurer and the employer based on a medical savings plan model when the patient undergoes the medical procedure in the region outside the United States.