CONCORD, N.H. (AP) — Self-insured businesses looking to cut out the middleman when it comes to health care have a new way to solicit bids directly from doctors or hospitals.
Created by a doctor, a lawyer and a former benefits manager, Open Health Market is an online matchmaker of sorts: Employers submit requests for proposals for a category of medical services and procedures — knee surgeries, for example, or cardiac care. Health care providers then submit competing bids, which are then evaluated by the employer.
If an employer accepts a bid, the savings could then be passed along to employees in the form of incentives to go with the new provider, such as a waived deductible, said Don Crandlemire, the Concord lawyer who created the site along with Dr. Leonard Fromer of Los Angeles and Peter Hayes, former benefits manager at Scarborough, Maine-based Hannaford Bros. supermarkets.
Crandlemire and his partners won't get involved in structuring any deals; they just handle the introductions. The employer decides whether to pursue negotiations with any of the bidders.
"It brings buyers and sellers closer," he said. "The further apart a buyer and seller are in a market, the more inefficient that market is."
Nearly 60 percent of U.S. workers who have health insurance are covered by employer-funded plans, according to the Kaiser Family Foundation. In general, workers in large companies are more likely to be in a self-funded plan: 93 percent of covered workers in firms with 5,000 or more workers are in self-funded plans. Under such an arrangement, an employer assumes responsibility for the costs of employees' medical claims, typically contracting with an insurer or third-party administrator to administer the claims.
Holly Ramer
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