ABRIDGED PREVIEW EDITION
Give your employees a raise, increase benefits & lower healthcare costs
MEET THE BUSINESSMAN AND DOCTOR WHO ARE
CHANGING THE WAY YOU BUY HEALTH CARE FREE MARKET MINUTE MEG FREEDMAN p. 6
INTERVIEW WITH DR. KEITH SMITH AND FMMA JAY KEMPTON p. 10
CRASH & SWITCHâ&#x20AC;&#x201D; 3 MALIGNANT STEPS TO SINGLE PAYER p. 14
Self- Funded Employers
Do you know how much of your health plan assets are being wasted? Surgery Center of Oklahoma ($)
National Average ($)
10,000.00 - 31,000.00
40,000.00 - 65,000.00
4,500.00 - 9,000.00
40,000.00 - 125,000.00
3,800.00 - 30,400.00
9,000.00 - 20,000.00
7,000.00 - 25,000.00
50,000 - 150,000.00
16,000.00 - 65,000.00
You can know. Transparent, Bundled, Cash-Based Prices. Shop and Compare Online at SurgeryCenterOK.com
Offering the highest quality at the lowest cost. CO-FOUNDER
PREVIEW FREE MARKET EDITION HEALTHCARE SOLUTIONS
MEDIA KIT FEATURES
7 Move Along, Nothing to See Here An honest look at Healthcare.gov
Introduction to Free Market Healthcare Solutions magazine
Free Market Minute, Meg Freedman
News and information about the good guys in healthcare
10 Free Market Healthcare Mavericks Interview with Jay Kempton and Dr. Keith Smith
From the Editor
Free Market Glossary
12 Patient Experience What do clients and patients really think of us?
14 Crash & Switch
How the government designed Obamacare to fail
In partnership with
J. “JAY” WAYNE KEMPTON, JR. p. 10
President & CEO of The Kempton Group and Co-Founder of the Free Market Medical Association
FREE MARKET HEALTHCARE SOLUTIONS © 2017 Published monthly or bi-monthly by Free Market Healthcare Media, LLC 181 Town Center Blvd #500 Jarrell, TX 76537 Periodicals postage paid at Jarrell, TX and additional mailing offices. No part of this publication may be reproduced, translated, stored in a database or retrieval system or transmitted in any form by electronic, mechanical, photocopying, recording or other means, except as expressly permitted by the publisher. For permission contact Publisher@USHealthMedia.com. POSTMASTER: Send address changes to Free Market Healthcare Solutions Subscriptions P.O. Box 217, Jarrell TX 76537 FREE MARKET HEALTHCARE SOLUTIONS is produced using Adobe Suites. Articles and written content are the property of Free Market Healthcare Media, LLC, or are used with permission of the contributing authors as noted in the publication. Photos and graphics not otherwise credited are property of Free Market Healthcare Media, LLC.
FREE MARKET HEALTHCARE SOLUTIONS
SOLUTIONS FREE MARKET
from the P
STAFF Editor-in-chief Cathy Payne email@example.com Graphics / Production Ann Marie Ludlow firstname.lastname@example.org Elysia Davis email@example.com Senior Marketing Director Ben Daniel firstname.lastname@example.org Administration / Accounting Debbie Tolliver email@example.com Circulation Dave Schumacher / Tom Higgs firstname.lastname@example.org
Our Mission: To promote revolutionary yet common sense changes in the way Healthcare is viewed, purchased, and used in America to the benefit of employers, providers, and consumers. Our Standard: Quality is never an accident; it is always the result of high intention, sincere effort, intelligent direction and skillful execution; it represents the wise choice of many alternatives. -William Foster Free Market Healthcare Solutions is seeking individuals, groups, or organizations with information, opinions or ideas that enhance the mission of this publication. Please submit contributions to info@USHealthMedia.com.
Cathy Payne was born and raised in Norman, Oklahoma. Like many of the best in her craft, she has a specialized degree—in her case, hard science—and a gift for writing. She found her voice and fulfillment reporting and writing news and magazine features for a regional Central Texas audience. She is the senior editor at Fidelis Publishing Group, LLC and provides daily support for multiple news magazines, marketing campaigns and books.
rolific American writer Mark Twain once penned, “The more you explain it, the more I don’t understand it.” This comment is repeated in the C-suite of some of our country’s brightest and most successful entrepreneurs every time the insurance broker makes his annual hurry up, there’s no time to shop it this year, and it’s going up 20% visit to renew their employee health insurance plan. The current model of healthcare coverage for employees and employers is designed to be complicated, convoluted, and cost prohibitive. After all, when you’re paid based on a percentage of premium, you want costs to keep climbing. While the traditional insurance system may not have started out this way, layer upon layer of Federal regulations have been added by Congress, thanks to the perpetual generosity of lobbyists. Today, healthcare has devolved to a point that consumers have not the first clue as to what healthcare or procedures performed using their healthcare should cost. And why should they? In many cases, premiums are paid or subsidized by the employer, and employees simply go where they’re sent for treatment and write a check for whatever co-pay amount the receptionist says. Then comes the true bill. That’s life, they shrug. What can you do? That is, until now. The Free Market Medical Association (FMMA) has begun the revolutionary task of educating employers on common sense ways they can improve employees’ health coverage, while lowering costs significantly. Think it can’t be done? Ask the tens of thousands who already enjoy much better coverage, improved benefits, and lower claims—in most cases, with not a penny out of pocket. It’s not rocket science, but it is a well-kept secret. And, if the big insurance providers have their way, you’ll never hear about the things that might change how you purchase coverage for your employees, how healthcare should be delivered, and what it really should cost. Free Market Healthcare Solutions magazine, in partnership with FMMA, is dedicated to providing employers with information about the newest changes and most relevant trends in Free Market healthcare, and how to secure better employee benefits at a much lower cost. You’ll find this to be among the most valuable resources in your mailbox. You can also stay up to date at USHealthMedia.com and learn directly from the industry’s most innovative thinkers on YouTube at USHealthMedia. I guarantee you’ll recognize a new paradigm for purchasing and administering healthcare benefits. It doesn’t have to be complicated or expensive. Now you know. Enjoy,
Cathy Payne Editor-in-chief
In a world full of Edisons
Choose Tesla Self-Funded employers working directly with Free Market Providers. Thatâ&#x20AC;&#x2122;s right. We invented it. The Kempton Premier Provider program began when CEO Jay Kempton and Dr. Keith Smith got together to discuss the cost of care and strategies to reduce it. When Dr. Smith realized that self-funded employers really were cash pay buyers, an idea was born; allowing these employers to utilize the bundled cash prices at free market friendly facilities was a win, win, win for everyone. Since 2011, this program saved millions of dollars for our clients and their employees.
At Kempton, transparency is not a buzz word. Itâ&#x20AC;&#x2122;s a way of life. A fully transparent third-party administrator who believes in promoting and supporting transparent, free market providers is a game changer for a self-funded employer. We are that TPA. Kempton is working with free market partners to fix the healthcare system, encouraging and promoting all free market providers who believe we can change the way people make healthcare purchasing decisions.
kemptongroup.com | kppfree.com
by Meg Freedman
T oday should be a national holiday. Why? Because it is the day the first issue
third parties and vendors to NOT work in your best of Free Market Healthcare Solutions hits interest. For a your desk! This publication was created self-funded emfor you, the self-funded employer, with ployer, these costs the objective of helping you lower your are not monopoly claims costs, reduce your risk, and offer money. The cost better benefits through embracing the increases can mean the difference free market in your health plan. Every between paying claims verses giving month, this column will include news raises, buying new equipment, or and information about this movement increasing staff. that will affect you. One goal of this publication, this Transparency is vital to a self-fundmonthly column, and FMMA is to ed health plan. For too long, employexpose the corruption, educate you on ers have had to rely on networks and protecting your plan, and introducing third parties to manage their plan. you to the good guys in healthcare. Many no longer work for the employThe idea of connecting self-funded er, but instead with unscrupulous employers with free market facilihospital systems and ties was born when a The goal of this providers to keep costs free market surgery high. To quote Dr. Keith publication and the center owner and a Smith, “The jig is up.” Free Market Medical gimmick-hating Third Healthcare systems Party Administrator Association is to are masking revenue expose the corruption, CEO became friends. streams, taking federal educate you on what Dr. Keith Smith from dollars to reimburse you can do to protect the Surgery Center themselves for ‘unof Oklahoma had your plan, and compensated care’, bundled, transparent introduce you to the pricing for cash pay and relying on political good guys in favors to maintain mopatients. Jay Kempnopoly status. They are healthcare. ton of The Kempton bankrupting patients Group provided TPA and self-funded health plans while services for self-funded employers. claiming imminent bankruptcy. Self-funded employers are essentially PPO networks negotiate a percash paying customers! centage off billed charges from these They worked together to create a providers, but keep a piece of this strategy that would enable employers discount, along with your access fee. to pay the Surgery Center of OklahoTheir contracts are “proprietary”, and ma’s cash price. Prices were so much providers are coming forward with lower, and quality so much better, tales of negotiating misconduct. that employers could pay the cost Insurance carriers masquerading as at 100% and still save money. The Third Party Administrators (ASOs) success and expansion of this idea are rewarded when Plan costs are led Smith and Kempton to found high. Like the PPO networks who the FMMA. The association connects are taking a portion of ‘savings’ as buyers and sellers to reduce costs and an additional revenue stream, all increase quality. Our members inASOs, and many other TPAs have clude self-funded employers, cash pay similar pricing strategies, and bury patients, free market-friendly facilities these fees in layers of legalese in their and physicians, and select, approved contracts. Employers keep hiring facilitators and vendors. more and more vendors who claim to To use our Shop Health pricing have quick fixes, only to see their costs search tool and learn more about the rise every year. These third parties Free Market Medical Association, and vendors are being paid by other go to FMMA.org. 6
Move Along, Nothing to See Here Business as Usual at Healthcare.gov by Meg Freedman, FMMA Executive Director
Oops I Did it Again… more than 800,000 participants
who purchased policies on the federally created Marketplace Exchanges received incorrect tax documents from the marketplace overseers for tax year 2014. These are the ACA mandated 1095-A IRS forms for individual tax payers. One critical piece of information included on the forms is used to determine the amount of premium tax credit (subsidy) an individual was eligible to receive. This piece of information, which could drastically alter a citizen’s tax liability, was calculated incorrectly for nearly 20% of participants. To echo the sentiment many lawmakers expressed after learning of this debacle, it is astounding the administration has managed to create a healthcare law that is so complex that those who created it cannot properly comply with it. Nearly one million taxpayers had to wait to file their taxes or file amended returns.
What’s Good for the Goose
While this is outrageous and disconcerting at best, let’s look at what this would mean for those who do not participate in the Exchanges. In 2014, only the Exchanges had to provide 1095-A documentation to individual participants. For 2015, employers had to provide similar documentation (1095-B/1095-C) to their employees for inclusion in their 2015 tax filings. If an employer fails to provide correct forms to employees, the fine is $100 per employee (it’s $250 if you did it “on purpose”)! Of course, there are limits; they wouldn’t want to bankrupt folks, would they? You only pay $100 per employee up to $1,500,000. They were benevolent enough to reduce the fine if you figure it out and fix it quickly enough (de minimis rules also apply). So what would Uncle Sam’s bill have been if subject to the same rules? If you look at how many participants were affected, when the affected will have corrected documents in hand, and apply the appropriate cap, it looks like they owe $60 x 800,000 people = $48,000,000; but the cap is $500,000. Wow, good thing those rules only apply to the rest of us, right? FREE MARKET HEALTHCARE SOLUTIONS
Predicting the Future
If history is any indicator of how things will go for the federal Exchange “Marketplace”, it should prove to be entertaining at the very least with website crashes, data breaches, and tax debacles. As much as some want to sit back and laugh at every failure, the truly disheartening part of it is that there are American citizens who have been forced into utilizing this new ‘system’ being harmed by all of these glitches, failures, and disasters. When these situations make you angry, as they should—just remember, when we succeed, and keep succeeding; when we expand the movement, and keep expanding, all citizens will have options and the new power to make a Choice where there wasn’t one before.
New! Free Market Medical Jobs Website! As our Free Market grows, many of us are expanding our operations. We are also experiencing the challenge of finding new physicians and surgeons. Likewise, physicians and surgeons looking for Free Market job opportunities are finding similar challenges. FMMA and Free Market Medicine Jobs have joined together to offer the first national Free Market Medicine Job site.
FMMA member-created Free Market Medicine Jobs website
Post open positions and apply for jobs online with other like-minded free market medical practices
FREE to FMMA members!
SOLUTIONS FREE MARKET
Why advertise? Ensure complete coverage by delivering your message when, where, and how executives want it. Free Market Healthcare Solutions’ integrated media platform brings executives the information they need —and your message— in a language they understand. Focus on the right top executives in all the right markets.
Who reads Free Market Healthcare Solutions? The printed magazine is delivered by mail to 15,000 C-level executives, industry-related affiliates, DPCs and FMMA members in all the key markets in 46 states. Free Market Healthcare Solutions is available online at USHealthMedia.com and you can follow news and key players on YouTube at USHealthMedia.
2018 PUBLICATION SCHEDULE ISSUE DATE
Premier Issue 4Q 2017
Nov. 1, 2017
Jan. 17, 2018
Feb. 14, 2018
Mar. 21, 2018
Apr. 18, 2018
May 16, 2018
Jun. 20, 2018
Jul. 18, 2018
Aug. 15, 2018
Sept. 19, 2018
Oct. 17, 2018
Nov. 14, 2018
Dec. 12, 2018
100% C-Level Focused Key information resources from the Free Market Medical Association and Free Market Healthcare Media have combined strength and market knowledge to create the first fully focused and integrated message vehicle for the corner office — Solutions. We target the challenges and opportunities faced by employers in health care plans and benefits. Such a full-scale, high-level media focus hasn’t existed until now.
ASK ABOUT DIGITAL ADVERTISING ON
USHEALTHMEDIA.COM AND ON YOU TUBE AT
AD SIZES 1/3 VERTICAL
DOUBLE TRUCK trim 16.75” × 10.875”
FULL PAGE trim 8.375” × 10.875”
HALF PAGE HORIZ trim 8.375” × 5.5”
HALF PAGE BLOCK 8.375” × 10.875” (no bleed)
Artwork and print proofs should be submitted via email or Dropbox link to: design@USHealthMedia.com For general inquiries, call 512-746-4545 or email info@USHealthMedia.com
2/3 PAGE VERT trim 5.5 × 10.875”
1/3 PAGE VERT trim 3” × 10.875”
1/4 PAGE BLOCK 4” × 5.25” (no bleed)
Artwork on CD can be sent to: Free Market Healthcare Media P.O. Box 217 • Jarrell, TX 76537
CMYK Color Included / Rates are per issue
• Acceptable ad formats: (PC or Mac) Adobe Illustrator, Photoshop, or InDesign.
• Print-ready ads should be submitted as print resolution PDF. All text MUST be converted to outlines or exported from InDesign.
• Live matter should be kept 3/8” from the trim size.
• Bleed ads should contain a minimum of 1/4” bleed from trim on all sides.
• Convert black and white images to Grayscale.
*Full page only: Back Page / Inside Back Page / Inside Front / Page 3
• Make all images 300 dpi in the native application at 100 percent.
Double Truck $4800 (ROP) $5800 (Premium - Pg 2/3, Center, Inside Back) 10% discount for 3 or more runs annually
• Convert all Pantone colors and Spot colors to CMYK. Provide all colors in CMYK Process format.
DIGITAL ADS on USHEALTHMEDIA.COM (rates are per month)
Front page banner rotating
Inside page banner rotating
Banner ad static
Block ad static premium
Block ad (run of site)
FREE MARKET HEALTHCARE SOLUTIONS
• Scan all photographs as CMYK files. Convert JPGs to CMYK and save as .eps.
• Ads submitted in the native application, be sure to include all fonts (must be TTF), artwork, and linked images. When possible, use a preflight program to package into one folder. • Submit your ad via e-mail, Dropbox, FTP, or CD. • Artwork, copy changes, film conversion, other prep work are billed at net, no agency discounts. Materials are stored by publisher for 1 year from issue date; may be destroyed unless otherwise instructed by the advertiser or agency. INSERTS Please contact production manager for details and specs. 9
The complete text of this interview will be included in the premiere issue of Free Market Healthcare Solutions, due 4Q 2017.
FREE MARKET HEALTHCARE
Maverick, noun, mav•er•ick, a person who refuses to follow the customs or rules; an independent individual who does not go along with a group or party. by Meg Freedman
Dr. Keith Smith. Jay Kempton. These names are, in many ways, synonymous with the current free market movement, and for good reason. When Dr. Smith and Mr. Kempton were introduced in 2011, they had no way of knowing their partnership would become what it is today and create a new movement in the healthcare space. The Surgery Center of Oklahoma (SCO), a 32,535 square foot, state-ofthe-art multispecialty facility in Oklahoma City, is owned and operated by
40 of the top surgeons and anesthesiologists in central Oklahoma. Dr. Keith Smith always knew their prices and quality were superior to competitors, but the insurance companies didn’t care about low cost and high quality. In 2008, SCO decided to post their low, bundled, cash prices publicly on their website. Dr. Smith states, “In the beginning, the only patients taking advantage of these amazing prices were cash pay patients and Canadians. Then Dr. Smith met Jay Kempton. The passage of the ACA, the persistent and sharp increase in his clients’ claims costs year after year,
and the gimmicks and cost saving schemes promoted by vendors, seemed to be making the situation worse. During a yearly client meeting, a health plan member spoke up and told him he needed to call Dr. Keith Smith. Dr. Smith was convinced Mr. Kempton was ‘just another insurance guy’ there to convince him to raise prices to show a discount. Mr. Kempton was convinced Dr. Smith was just another administrator looking for big bucks. Instead, they discovered a mutual passion—changing the healthcare system. Dr. Smith’s posted, bundled prices were up to 80 percent less than
Jay Kempton, President & CEO of The Kempton Group, a family-owned, independent Third Party Administrator, was having a crisis of faith in the U.S. Healthcare system and his ability to help his clients maintain a high level of benefits, while protecting their Plan dollars.
the PPO allowable, and self-funded employers could function as cash pay customers. A new partnership formed. The Kempton Premier Provider™ program was the first thing to come out of this meeting. Self-funded employers would incent their employees to use SCO for a 100 percent benefit. SCO got more cash-pay patients and were paid, from a simple invoice, in less than five business days. This program was not just successful, it became a movement, to eventually include more than 20,000 covered patients, 72 free market facilities, and more than 3,600 medical services. The replication of this idea by other TPAs and health plans is saving hundreds of millions of dollars for self-funded employers, and state and local governments. Because of the growth, and the increasing demand for expansion into more states, Dr. Smith and Mr. Kempton decided to form the Free Market Medical Association. Their goal was to teach other providers, other TPAs, and self-funded employers how to replicate what was happening in Oklahoma. Why the FMMA? Smith: We knew we had stumbled onto something much larger than any of its parts. These ideas were not meant to be kept under our hat and only benefit our clients. They were so powerful, and applicable in so many places, we thought everyone should know. We felt an obligation to promote what we learned. It was our desire to acknowledge that this movement was so much bigger than what we were doing alone. Kempton: Dr. Smith and I had been doing business together in this fashion for 2-3 years. We could see the tremendous benefits the patients were receiving, employer groups who were seeing tremendous savings, and a greater level of transparency. Dr. Smith’s surgeons, and his surgical facility, also saw amazing benefits. It was such a refreshing way to do healthcare. Dr. Smith was being asked when he was going to franchise into their locations, and I was getting the same kinds of requests from folks in other states. We decided what we re-
ally needed to do was form an entity that would help bring the magic that was happening in OKC, and extend it beyond the borders of Oklahoma—to be a beacon of free market healthcare others could see, evaluate, learn about, and then follow. Creating the FMMA allowed SCO and Kempton to influence others beyond the scope of our own individual businesses. Often passion is fueled by the anger of injustice. What makes you angry about the current system? Smith: The Surgery Center of Oklahoma was founded out of frustration. Dr. Lantier and I had seen the quality of care that patients received dwindling, while hospitals built on a wild spree. Hospital administrators proliferated, as did their salaries. The patients were receiving substandard care and people were bankrupted by this system. I didn’t sign up for being a part of that, and I didn’t want to be a tool in the destruction of patients’ health status or their bank accounts. The injustice and frustration is really what fueled the creation of the Surgery Center of Oklahoma. After we put our prices online and we began working with self-funded clients we became aware of even more details of the abuses inflicted on patients and payors by the current system, which vindicated our decision and our desire to take the free market path that we did. I’ve joked with clients that I wonder if we have actually had clients entertain contracting directly with us, not because they thought that it would be a better monetary deal for them, but because they were so maltreated; not strictly because of the injustice. They wanted to send a message to those thieves and gangsters that had ripped them off. Injustice has fueled the buyers and the sellers in this movement. Kempton: So many employees had not seen an increase in their actual take home pay for years. Not because the employer was a cheapskate but that a majority, if not all, of the raise given to employees was absorbed into the upward spiral of healthcare costs. When you understand how this business really works, you can see the effect of the dysfunction I just described; but when you learn more
FREE MARKET HEALTHCARE SOLUTIONS
about the cause, you can see the patients’ actual financial concern is not even on the radar of big healthcare. Hospitals really do not understand that their price gouging trickles down into wage stagnation to employees. They say, “We’re raising our prices, but it only hurts the big insurance companies.” That’s never the way it works. Employers can’t afford to absorb the increase, so they lower or decrease the employee raises, or they reduce the benefits, or both. If you could tell someone just one thing about the free market in healthcare what would it be? Smith: The free market is not about sellers having their way with consumers; brutalizing the poor, or people who are trying to pay for their own care. It is an exchange between buyers and sellers that is mutually beneficial, where both parties emerge feeling it was a good exchange. Any time the media quotes a corporate exec or politician bemoaning the tough future that a seller might face given some policy that might be enacted, should be discounted or ignored. The focus has to be on the consumer, and on whether a consumer’s decision to buy A or B is a value to that person. I want people to know this movement is about servicing consumers. Period. Any concerns or desires sellers have to be protected from the preferences of consumers must be seen as the source of the problem that we all face. Kempton: The free market and healthcare is the only true healthcare reform that has a chance of being sustainable. Anything else is just rearranging the deck chairs on the Titanic. It’s truly the only solution that’s going to last, whether it’s more government, single payer, price fixing, whatever, they’ve all been tried, and failed. Until we empower patients to look at their healthcare buying decisions the way they look at everything else, where there is a mutually respectful marketplace in healthcare, there will be no rewarding bi-directional transaction between the buyer and the seller. That’s just a fancy way of saying sellers will not respond with high quality and low cost and the buyers will always pay too much. 11
Patient Experience is #1 with
Free Market Providers One of the most important pieces of the Free Market Movement is not just saving patients money and a better work environment for providers, but how different the patient experience can be. After nearly four years we have so many patients who have commented on quality, and how differently they are treated.
Congratulations to the
2017 Beacon Award Winners
“I had an appointment in less than 24 hours. The doctor was fantastic and did the procedure in his office the day of the consultation so we didn’t have to wait!” “Let me tell you it was the best experience ever. Not only was I treated with compassion, but my pain is so minimal I can actually function and do most of my daily tasks. The nursing staff made me feel like I was the only patient there. They gave me full attention and I never had to ask a question because they were constantly keeping me informed.” “Everything went very well. Since they knew I was from out of town, they made my appointment later in the day. After filling out the paperwork, it couldn’t have gone quicker.” “When my family’s history of bad knees finally caught up with me, my doctor told me I needed a knee replacement. I could not believe how simple the facility made it. Knowing that I saved thousands of dollars just makes it that much better. ”
Many believe you have to pick two of the three: service, quality, price. But we are in on the joke and know that the free market in healthcare drives all three and enables patients to make valuable healthcare purchasing decisions. Timely scheduling with great service and exceptional quality, all at a reasonable price—what more could you ask? 12
Lee Gross, M.D. Epiphany Health, Docs4PatientCare Foundation
Patrick Kelley, M.D. Texas Free Market Surgery Center
Texas Free Market Surgery Center
CRASH AND SWITCH A story is making the rounds about
a 68-year-old recovering from major surgery in a hospital hallway. This article is shocking to those who consider this barbaric, and not up to the standard of care we are used to. What is more shocking than the article, are the comments. Some are indicative of the righteous fury we should expect. What is more disconcerting are those who seem resigned to it. This is a shining example of the plight of a generation subjected to government-run healthcare their entire lives; recovering in a hallway, and threat of infection inhibiting recovery, are just something they shake their heads at. Many are in on the joke that Obamacare was never meant to succeed. It was written in such a way
Three Easy Steps To Single Payer
that true compliance is impossible for the majority, and the mechanisms in place are unsustainable. The joke is that the true goal of Obamacare was not a bait-and-switch, but a Crash-and-Switch, which is accomplished in three easy steps: 1. Enable government to be involved in all insurance policies and plans with access to health data. Force as many as possible onto the exchanges. done Force insurers and self-funded Plans to feed data to HHS via the new Health Plan ID. done 2. Annihilate the current system. Outlaw health benefit plans not generous enough, levy taxes on generous plans. Keep everyone guessing as to what is covered so you can fine at will. in process Bankrupt employers with fees and fines for impossi-
ble-to-comply-with regulations, forcing them to drop employee coverage. Repeat Step 1. in process 3. Eliminate physician independence. Reimburse hospital employed physicians at a much higher rate than independents. done Outlaw physician-owned hospitals so government friendly hospitals get all the patients. done This Crash-and-Switch is already 2/3 complete. As our country continues debating the validity of a single payer system which, in truth, is government run, we must continue to press against the tide and make our voices heard. If we fail in our endeavors to create a thriving free market system, being forced to recover lying in the hallway of an overcrowded hospital is just one of the benefits we can look forward to.
GLOSSARY Check out the full Glossary
fmma.org/wp-content/uploads/2016/04/FMMA-Glossary.pdf Free Market Movement The free market/transparency movement pioneered by Surgery Center of Oklahoma and The Kempton Group is beginning to have a major impact on healthcare costs around the country. The proof that free-market, transparent healthcare works is proven by looking at the dollars saved by both patients and employers. When consumers become aware that high value healthcare is far less costly, they begin to change the way they perceive their healthcare buying decisions. Healthcare services can and should be viewed just like any other purchase we make—based on VALUE, which includes both quality AND price. Whether you are a business owner providing healthcare benefits to your employees, or a consumer concerned about the rising cost of healthcare in America, only your persistent demand for transparent pricing from providers will revive a true free market healthcare system. Free Market Medical Association Founded in 2014 to expand on the premise of connecting self-funded employers, patients, and free market sellers (physicians, facilities, imaging providers, etc). Based on their mutual desire to change the face of healthcare, the goal of the FMMA is to bring together buyers and sellers of healthcare goods and services – reducing costs and increasing quality. The Free Market Medical Association is a non-partisan association that provides resources, support, and education to our membership, and to the public, about the free market movement and why it is so important. The FMMA helps to defend and expand the practice of free market medicine against the interference and intrusion of the government or other third parties. The FMMA membership includes both the buyers and sellers of healthcare goods and services. The FMMA connects free market minded providers with individual patients and self-funded employers who have embraced transparency in healthcare; educating physicians, self-funded businesses, third party administrators, and other health care service
FREE MARKET HEALTHCARE SOLUTIONS
The complete text of this article will be included in the premiere issue of Free Market Healthcare Solutions, due 4Q 2017.
providers/facilitators in how to further the movement. The FMMA website includes ShopHealth, a free market shopping experience where patients and employers can search by provider type, location, procedure, CPT, and more. The site is open to the public. The FMMA now has over 300 members in 41 states, with 18 local chapters. Pricing The FMMA ShopHealth website allows free market medical professionals to post their pricing online for everyone to see! Don’t see a price for a procedure? Call us! 1-866-906-FMMA Direct Primary Care DPC is an innovative alternative payment model in primary care embraced by patients, physicians, employers, payers and policymakers across the United States. The defining element of DPC is an enduring and trusting relationship between a patient and his or her primary care provider. In DPC unwanted fee-forservice incentives are replaced with a simple flat monthly fee. This empowers the doctor-patient relationship and is the key to achieving superior health outcomes, lower costs and an enhanced patient experience. What’s in it for providers? The buying and selling of goods and services is more stable in a free market. The exchanges in a free market are mutually beneficial to all parties. Any other arrangement begs for at least one party, and sometimes both parties, to be injured. A free market is conducive to competition which benefits the consumer in terms of both price and quality. Whenever the consumer has been disenfranchised in any industry, quality suffers, prices soar and what goods and services are provided are determined from the top down, rarely if ever having any relationship to what the consumers actually need (and want). Physicians operating in a free market environment find happier patients, none of whom feel as if they are being pressured to see a particular doctor, but rather exercising their choice. This provides for a healthier patient-physician relationship, fewer bureaucratic hassles, typically better pay and better outcomes. Third Party Administrator (TPA) Processes the claims and helps manage the benefit Plan for a self-funded employer. A TPA’s responsibilities include maintaining eligibility, adjudicating and paying claims, client customer service, provider customer service, utilization management, etc., plus arranging for services such as stop loss coverage, provider network access, a pharmacy benefit management company, and case management. A TPA also assists the employer with employee education. Quality Many people believe that their insurance company or PPO network is looking at a Provider’s quality when they are contracting. This is not the case. The insurer is only looking at whether the provider has the correct credentialing and will accept their agreement. When a provider decides to post bundled, cash pricing and embrace the free market, they are putting their name behind that price. According to Dr. Keith Smith of the Surgery Center of Oklahoma, when a facility knows that they must use the same price for all patients regardless of outcomes, and that the bundled price is their entire compensation, providers are forced to be very efficient. Reducing complications and surgery times increases the profit for the facility. It is in their best interest to only offer the procedures that they are very proficient at performing.
Price is not a product. Care is the product. Selling access to pricing is anti-free market.
Subscription to Free Market Healthcare Solutions (FMHS) magazine Contribution & Advertising in FMHS Publicly post your prices in the FMMA #ShopHealth pricing tool Educational Tools & Information Seminars Webinars Free copy of Dave Chase’s newest book: CEO’s Guide to Restoring the American Dream
Free job postings on FreeMarketMedicineJobs.com In partnership with
Join the Healthcare Revolution Today