[mjamilkowski]

I’m sorry to hear about the bad reaction you had to the vaccine and then the terrible experience you had with the care system. You are correct, individuals do need to have better understanding and connection to the cost of care, and the cost dialog is convoluted and lacking transparency for a long list of reasons. We are operating within the system but are looking to change it. What we can change is how you, as an individual, receive value from your insurance company. The most obvious way is to be protected against the super high cost of some catastrophic circumstance, like a massive heart attack or surgery. But another way to receive value is through incentives and rewards that support you in your pursuit of wellness, whatever that means to you, as well as making it easy for you to get access to things that are of interest to you that individuals or smaller employers do not typically get access to because there are no economies of scale to encourage these vendors to offer their products and services to the retail public. I understand and appreciate your pain as a self-employed or small group.

[mgkimsal]

> We are operating within the system but are looking to change it. What we can change is how you, as an individual, receive value from your insurance company

But only if this is something an employer pays for.

I understand it's a big problem, and you'd like to make changes to the system. I wish you good luck in your efforts :)

[mjamilkowski]

We are embedding several programs into the benefit plan and still charging a lower price. We think its the best solution to the employer demanding positive ROI on the disease management and telehealth based solutions

[mgkimsal]

> We think its the best solution to the employer demanding positive ROI on the disease management and telehealth based solutions

Just rereading this one line - again, I'm pretty sure your motives are noble, and perhaps you can move the needle a bit. But... why should employers be demanding positive ROI on something that isn't their core business? "Employers" as a whole, having to learn about various 'insurance' options and dedicated people to help guard their investments in Human Resources - something about this troubles me greatly. It's... as if... unless I'm somehow 'good enough' to warrant the protection/benefit of a 'good employer'... I'm less than worthy of good health, or access to necessary care. And... once that employer has no more use for my services (or someone else can provide them cheaper)... I'm essentially on the scrap heap (someplace we'll all be, metaphorically, at some point, sometimes through no fault of our own).

Again, I wish you the best of luck, but "employer provided health insurance" is just something that really is past its sell-by date, even if you can squeeze out some savings for employers and provide some good for the select few special/lucky enough to be employed by a company so forward-thinking as to engage your services.

[IG_Semmelweiss]

You nailed it on the head.

Employer based insurance is at the core a monstrosity. I hope these founders make a dent in cost but ultimately i dont see how any ROI will translate to lower industry costs, especially since outcomes-based billing is just another more confusing way to ration care and squeeze independent doctors to work for larger systems that can do the accounting.

And squeeze the little guys, and everyone else ends up paying ASC or Hospital pricing.

The only real solution is to actively get rid of employer based insurance and to break down barriers to independence practice.

I dont see how this startup does either, unfortunately.

[mjamilkowski]

Hi Mark here - Just to be clear we are not using ROI, but rather clinical impact. The expectation being that the expense of encouraging better care through facilitating coordination, clinical teaming, and incentives addresses issues of access, transparency, and engagement/compliance. We are looking to change the healthcare experience from being confusing, disjointed, costly, and wasteful.

As for employer-based insurance, it is the market that more than 50% of all people get their insurance from currently [1]. Is it the best way to make sure people get access to care? No, its just a convenient way to pool risk, and there are significant tax and regulatory support structures in place to prop it up. No private enterprise is going to change this and it is unreasonable to expect that outside of massive political and regulatory changes. And when that revolution happens, our technology and infrastructure will be able to continue delivering the same positive benefits to the disaggregated community because quite frankly we are agnostic to whether 50,000 people are insured by us through 250 employers or as individuals - we are still treating the issues being faced by the people in the community.

[1] KFF Data https://bit.ly/3IFQkoB