THE PROBLEM

BIG HOSPITALS

Hospitals are great for emergency care of life-threatening conditions, child birth, neo-natal, and the unexpected.  (Unless, of course, you are near an outpatient urgent care facility).  Otherwise, if you are planning an elective procedure, need diagnostic imaging, or lab work, the hospital is your most expensive option.  In fact, hospitals have special rate tables with Medicare and private insurance companies to inflate the cost of their services to pay for the increased overhead of hospital operation.

LOXLEY SOLUTION:

  • We strive to manage and direct non-emergent, elective care through appropriate “sites” of care. This could be telemedicine, primary care, urgent care, and ambulatory outpatient surgical centers.  On average, all these options have a lower cost, lower infection rates, and better outcomes than hospitals.
  • We work to build relationships with primary care providers who are not employed by large hospital ecosystems, resulting in unbiased care.
  • We encourage pre-negotiated charges (via Sympl Care Marketplace) or contracts with payors that reference reasonable rates for each episode of care (Reference Based Reimbursement).
  • We’ve created the Sympl Care Marketplace, for Michigan providers who agree to publish their cost for specific episodes of care. Patients who use this have no patient responsibility, zero.
  • We will always fight for full-transparency of Big Hospital-owned insurance companies (HMOs) and require the plan sponsor owns all data prior to contracting.

BIG INSURANCE

Rx BENEFT MANAGERS (PBMs)

DISRUPT STATUS QUO
TAKE YOUR HEALTHPLAN BACK

Health insurance premium “trend” is a historical lookback that is then projected forward.  This creates a self-fulfilling prophecy, resulting in an auto-increase for your insurance company and the healthcare providers they pay.  It has been accepted as norm for years. Fight the urge to accept this as fact.