Rent Seeking PPOs

Do we need to pay a premium to access healthcare services? By premium, I mean do we place a financial value on the mere access of healthcare services? If we take this prima facie, how much margin is fair and who decides?

 In the largely opaque supply chain of healthcare in the U.S., we’ve developed the roles of (quite large) middle-men to facilitate everyday transactions. One of the most ubiquitous would be the advent of the PPO or Preferred Provider Organization. The idea that a third party would sit in between the patient and doctor to facilitate the cost of that care and the movement of money. PPOs develop contracts, hidden from view of the consumer, presumably at the benefit of the patient and employers that are by-large the funders of healthcare in the U.S. As we’ve moved away from the indemnity contracts of old, we’ve lost sight of what healthcare services should cost thus, allowing PPOs to tout incredible discounts off of prices that have ballooned to extraordinary levels.

For what good is a 60% discount if the retail price was inflated 6x or even 10x cost?

Alas, this is where PPOs have evolved and remain today. It is classic rent-seeking behavior. There is nothing productive about the PPO. They have made no improvements to the level of care provided nor have they simplified the flow of funds between the two parties. Yet due to their predominance in the marketplace and perceived brand-value, very little are they questioned or held accountable.

If the United States is to survive economically, disintermediation of the healthcare supply chain is the only solution. The good news is that common-sense solutions already exist and forward-thinking employers like Rosen Hotels, Walmart, and the state of Montana have been doing it for years with tremendous success. These companies are spending nearly half the cost on health care as everyone else which means more money back into R&D, restored wages, restored pensions and 401(k)s, and investment back into local communities.

We’re on a journey, along with Health Rosetta and the certified pros across the country, to restore wages and hope. We hope you join us.

You Can't Fix What You Don't See

Has your company tried, over and over again, to solve ever increasing health care costs?  “Yes, of course we have, but nothing seems to work!” is a common answer. “We bid out our employee health insurance every year through multiple brokers, we reduce benefits to offset rate increases, and we even light a candle 24 hours before year-end renewal!”

DisruptHR 2.0 STL

We are thrilled to announce that Adam Berkowitz has been selected to present at next week's DisruptHR event at Helium Comedy Club in St. Louis. DisruptHR is a high-energy idea forum designed to inform and empower executives, business leaders, people in the human resources field and anyone really, who is passionate about humans in the workplace. 

DisruptHR STL

Our topic: Restoring the American Dream: Delivering World Class Benefits to Your Employees at Half the Cost. Here's the catch...we have just 5 minutes and 20 slides to present our topic and slides will transition automatically every 15 seconds. This is sure to make for an entertaining evening. 

If you are a business leader, a CEO, a technologist, a community leader, an HR professional, or someone who is simply passionate about new ideas in the workplace then DisruptHR is the place to be! 

Come out to support, heckle, have a drink, and laugh with us. Thank you to all of my Health Rosetta cohorts for helping build out this content. This is going to be a fun event and a great networking opportunity. Tickets can be purchased here - be sure to get one before they sell out!


Proudly Partnering with MOCPA to Deliver Healthcare Purchasing Solutions

Simpara Founder and President, Adam Berkowitz, has formed an official partnership with the Missouri Society of Certified Public Accountants and their benefits team to deliver modern healthcare purchasing solutions for member CPAs and their respective businesses across the state.

3 Game-Changing Transparency Tools for Healthcare Consumers

3 Game-Changing Transparency Tools for Healthcare Consumers

Have you ever inquired about the cost of a medical procedure or medication in advance of receiving it? What about price shopping to make sure you are receiving good value for your money? It has become standard to compare airline costs and rental cars or even drive the extra mile to save five cents on gas but when it comes to expensive tests like MRIs, we know that most people will go directly the hospital - usually the most expensive option.

Business Owners: Is Your Employees' Financial Health Harming Your Business?

Business Owners: Is Your Employees' Financial Health Harming Your Business?

According to a recent study, about 50% of employees are ‘concerned, anxious or fearful about their current financial well being’ and over 40% of employees are ‘looking to their employer for financial support’. Are your employees among those who are uneasy about their finances? Whether you like it or not, they’re looking to you for help. Even if your workforce is highly educated they still might have little to no personal financial acumen.