Meet free market warriors Colleen Ingraham and Dr. Richard Kube. These two individuals have been working together for several years on various projects, many of which involve medical services. When they met in 2012, Dr. Kube, Founder of Prairie Spine & Pain Institute, was needing someone to assist in accounting and bookkeeping at his medical practice. Colleen Ingraham, President of McMahon Group, took Dr. Kube on as a client. It was soon apparent they shared a passion for business development and were avid problem solvers and strategic planners. A recurrent topic they encountered was rising cost paired with compromised delivery of healthcare. It was clearly not a bright future for patients, physicians, and business owners.
They decided to embark on a new model of healthcare delivery. At that time, buzz terms that are much more common now like “price transparency” and “bundled payments” were not often if ever used. It did not take long to realize that these, as well as other terms in healthcare delivery, had no consistent meaning in the marketplace. Therefore, typical market forces that drive value in other industries did not apply. A consumer needs to know explicitly what they are buying and what it costs in order to shop, compare value, and make an educated decision. Dr. Kube began posting prices online sometime in 2014, but this did not seem enough to be truly impactful. At that point, Colleen began searching for like-minded individuals who could work together to bring consistency to the nomenclature and to allow patients/consumers to shop for healthcare value, e.g. quality care at a reasonable price.
A moment of validation occurred when Colleen arranged a meeting with the founders of the Free Market Medical Association (FMMA). Dr. Keith Smith and Jay Kempton had been successfully using free market principles in the Oklahoma City healthcare industry and were saving local businesses millions of dollars while at the same time allowing quality healthcare providers and facilities to spend their time providing patient care rather than laboring with redundant and often meaningless administrative tasks. This was the big picture model Colleen and Dr. Kube were trying to bring to life here at home in Peoria.
Immediately thereafter, Colleen and Dr. Kube formed the Illinois chapter of the FMMA, and they have not looked back. There are now several medical providers throughout central Illinois (many in Peoria) providing medical services in a truly transparent free market manner. That is coupled with some local businesses also pursuing these options for their employees. Now circa October 2019, there is an emerging free market for healthcare services with an intended hub for patients and providers being Peoria, IL.
We had an opportunity to sit down with both Colleen and Dr. Kube to ask a few questions.
What motivated you to help develop, to engage in, and to facilitate adoption of this new healthcare model?
Dr. Richard Kube: In short, I was getting hit from every direction. As a patient, I was paying over $2000 monthly for my family’s coverage with traditional commercial insurance only to spend thousands more on items they would not cover. We would also get surprised with bills when insurance would later refuse to pay for treatment it previously authorized. As a provider, I found myself spending large amounts of my time on administrative tasks instead of patient care. As a small business owner, the cost of providing healthcare coverage to my employees was skyrocketing. Something had to change.
Colleen Ingraham: As a patient with what I thought was quality healthcare insurance, I was shocked at the types of treatment insurance would deny or later refuse to pay. It is little wonder that medical debt is the leading cause of bankruptcy in the United States and three out of four of those individuals have a qualified health insurance plan. As a business owner and advisor, the costs my clients and I were experiencing were not sustainable. Also, I was astonished at the struggle physician clients faced daily when trying to provide care. The current insurance model creates obstacles and conflicts that often prevent physicians from providing the care they believe their patients need and deserve.
What are some of the ways we in the general public can partake in this model?
Colleen Ingraham: There are a variety of ways a business can engage, and depending upon size and type of business, different models can work for you. Some larger businesses might benefit from an independent third-party administrator who can add free market options to current healthcare plans. This would add access to high value providers and payment models that are almost never included in standard insurance plans, thereby increasing options for employees and savings for the employers. You can use a sharing program like Sedera or implement use of a Direct Primary Care (DPC) physician, especially if you are a smaller company. These options allow very small businesses with a few employees the opportunity to access healthcare benefits at reasonable rates they never thought possible. These options are available right here in Peoria today.
Dr. Richard Kube: As a provider, we understand our costs, and we can provide a single published price for episodes of care so that patients or self-insured business owners do not have any surprises. As a business owner, we implemented use of a DPC, so our employees all have 100 percent of their primary care covered without copay. We also switched over to Sedera for our medical needs. We were able to save money in our business and now, none of our employees need to spend anything towards health insurance premiums. It has been a huge win for our staff and our business.
What impact can you see this having on our community?
Dr. Richard Kube: We already have quality doctors, hospitals, and facilities in our community. Creating a hub for those seeking high quality, high value medical care will keep patients in Peoria, and draw from beyond our local region. I currently have patients from about 14 states and Canada. This will certainly stimulate our local medical industry leading to more jobs and economic growth. For the individual patient, there is greater access and competition which means better care. Additionally, our changes have allowed my own company to put an average of $2,500 annually back into the pockets of every one of our employees which translates to more money for our local economy.
Colleen Ingraham: I advised a small business who just entered this model. They have 14 employees and will save just over $99,000 next year alone. Imagine 14,000 employees in our metro area, a modest number considering our population, shifting into this model. That small degree of market penetration creates the potential for $100 million dollars infused into our economy. Let that number sink in. That is a lot of money that is already spent by local families and businesses but is unfortunately leaving Peoria and going to Chicago or out of state to large insurance companies instead of being kept here for our own households and economic development.
What message would you like our readers to leave with today?
Colleen Ingraham: We have unpacked a lot of topics here today. Based upon conversations I have in our community and with business leaders at Big Table GP, these issues are on a lot of peoples’ minds. Whether you are a doctor, patient, business owner, or hospital, there is opportunity for expansion of healthcare services in our community while simultaneously providing positive economic impact for all participants. We will be discussing many of these topics in greater detail in future issues.
Dr. Richard Kube: Current healthcare trends are not sustainable. For frustrated physicians tired of utilization review, administrators pretending to be doctors, and insurance companies that won’t pay, there is a better way. For our large hospitals and healthcare facilities in the community seeking to be a medical destination, there is a better way. For patients with skyrocketing deductibles and medical bills, there is a better way. For businesses large and small faced with cutting employee benefits vs. terminating staff or closing their doors, there is a better way. I think free market healthcare will play in Peoria.
The McMahon Group and The Illinois Free Market Medical Association are on a mission to educate and empower the patient, the employer and the physician. If you think you cannot afford quality healthcare or are watching your paycheck get eroded by premiums and high deductibles, call us, we have many very affordable options to help you eliminate the stress! If you are an employer struggling with the high cost of providing healthcare benefits, please call us to see how you can save money and keep it here in our local economy. If you are a physician, wondering how you can increase the time you spend providing care to patients and reduce your administrative burden, please call and learn more about how we can all work together to improve the delivery of healthcare, right here in our hometown. Visit ilfmma.org or themcmahongroup.net. Or call 309-453-3963.