The goal of this publication and the Free Market Medical Association is to expose the corruption, educate you on what you can do to protect your plan, and introduce you to the good guys in healthcare.
Today should be a national holiday. Why? Because it is the day the first issue of Free Market Healthcare Solutions hits your desk! This publication was created for you, the self-funded employer, with the objective of helping you lower your claims costs, reduce your risk, and offer better benefits through embracing the free market in your health plan. Every month, this column will include news and information about this movement that will affect you.
Transparency is vital to a self-funded health plan. For too long, employers have had to rely on networks and third parties to manage their plan. Many no longer work for the employer, but instead with unscrupulous hospital systems and providers to keep costs high. To quote Dr. Keith Smith, “The jig is up.”
Healthcare systems are masking revenue streams, taking federal dollars to reimburse themselves for ‘uncompensated care’, and relying on political favors to maintain monopoly status. They are bankrupting patients and self-funded health plans while claiming imminent bankruptcy.
PPO networks negotiate a percentage off billed charges from these providers, but keep a piece of this discount, along with your access fee. Their contracts are “proprietary”, and providers are coming forward with tales of negotiating misconduct.
Insurance carriers masquerading as Third Party Administrators (ASOs) are rewarded when Plan costs are high. Like the PPO networks who are taking a portion of ‘savings’ as an additional revenue stream, all ASOs, and many other TPAs have similar pricing strategies, and bury these fees in layers of legalese in their contracts. Employers keep hiring more and more vendors who claim to have quick fixes, only to see their costs rise every year. These third parties and vendors are being paid by other third parties and vendors to not work in your best interest. For a self-funded employer, these costs are not monopoly money. The cost increases can mean the difference between paying claims verses giving raises, buying new equipment, or increasing staff.
One goal of this publication, this monthly column, and FMMA is to expose the corruption, educate you on protecting your plan, and introduce you to ‘the good guys’ in healthcare.
The idea of connecting self-funded employers with free market facilities was born when a free market surgery center owner and a gimmick-hating Third Party Administrator CEO became friends. Dr. Keith Smith from the Surgery Center of Oklahoma had bundled, transparent pricing for cash pay patients. Jay Kempton of The Kempton Group provided TPA services for self-funded employers. Self-funded employers are essentially cash paying customers!
They worked together to create a strategy that would enable employers to pay the Surgery Center of Oklahoma’s cash price. Prices were so much lower, and quality so much better, that employers could pay the cost at 100% and still save money. The success and expansion of this idea led Smith and Kempton to found the FMMA. The association connects buyers and sellers to reduce costs and increase quality. Our members include self-funded employers, cash pay patients, free market-friendly facilities and physicians, and select, approved facilitators and vendors.
To use our Shop Health pricing search tool and learn more about the Free Market Medical Association, go to FMMA.org.