Mishe Health

One week until I share the stage with some of the industry's finest at #RosettaFest!! Join us to learn how a good offensive strategy could be the best defense. We'll be sharing best practices, experiences, and insider tips to help you deliver massive savings, quality care, and a better experience, while protecting your interests. See you there!! Ge Bai Clint Flanagan, MD Julie Selesnick joe L.

We're headed to Washington, DC for Health Rosetta's #RosettaFest!!! September 11-13: An incredible lineup of #healthcare visionaries share the keys to scaling proven fixes for our ailing healthcare system. Don’t miss a chance to hear from Ge Bai, Julie Selesnick, Clint Flanagan, MD, and joe L. on "The Promise of Direct Access: How Employers & Vendors Can Avoid Being Sued While Saving Millions", a panel led by Mishe's CEO, Sidney Haitoff. We are proud sponsors of this star studded event and we can't wait to see you there!

Nikhil Krishnan joked about chat room functionality in the context of value-based care coordination as if it were a pipedream. It was all a dream until a couple of months ago - now it’s real - along with automated value-based care administration. We’ve natively integrated and automated enrollment, authorization, claims, adjudication, repricing & provider reimbursement to remove the bottleneck hindering greater direct-to-employer adoption. Scalable same-day payvider reimbursement is here. This rough demo video shows the functionality in the context of a multi-party surgical bundle ordered and pre-approved (ie codified plan design) by a DPC doc anchoring a level-funded plan. The pre-authorized procedure order triggers automated claims fund withdrawal at predefined direct contract rates stored in the dedicated plan environment in our database. The member chats and shares records with the physician, facility, and anesthesiologist right from the comfort of their personal longitudinal health record in Mishe. The video then cycles through the views from each individual provider’s dashboard where they “redeem” their “voucher” (ie submit their claim) for instant adjudication triggering automated EFT reimbursement. The team’s been HARD at work bringing the value-based surgical bundle administration automation to life. Personally, I've been actively working towards this moment for about 2 years and passively for 10. We're officially a clinically integrated network (CIN) without the admin headaches and look forward to developing unique quality-driven care models with the best clinical advisory board one could ask for. More on this soon. We’re implementing this with surgery centers treating patients from your favorite venture-scale COE companies and look forward to accelerating DTE adoption with the release of our API later this year. The applications for automated value-based care bundles are endless: physical therapy groups, labs/diagnostics (solving for continuity problem), pharmacies, DPC, urgent care, etc. If you’re a clinician who sends or receives referrals, wants to get a better handle on care plan compliance, and/or believes that compensation for care coordination is table stakes, please DM me. If you’re a health system of any kind looking to integrate administration with care coordination to streamline operations, eliminate leakage & boost compliance, please DM me. We look forward to making bundle creation and network enrollment self-serve in the coming months, but for now you’re just a few minutes away when chatting with our 24/7 support team. This is the very tip of the iceberg of what’s to come. James Dimarco Adrienne Moore Ahilan "Siva" Sivaganesan, MD Benjamin Schwartz, MD, MBA Zach Mitchell Chris Severn Peter Pronovost MD, PhD, FCCM Austin F. Cheng, Esq. Benjamin Fenster Sam Moen Adam Hornback Nicholas M. Sean Kelley Keith Smith Duc M. Vo, MHA Ryan Kline Demetrio J. Aguila, III, MD, MA, FACS Lee Dragoonis Jon Van Der Veer, DO, MBA

I’m proud to announce Mishe’s National Omnichannel Affiliate Pharmacy Network. We’re partnering with pharmacies, PBMs, hospitals, and 340B vendors to help employers and individuals access fair pricing on generics and specialty drugs at their convenience. Our proprietary platform integrates navigation, coordination, care management, enrollment, eligibility, authorization, claims, adjudication, clearinghouse, payment, flexible formularies, and transparent pricing to simplify transactions and streamline collaboration (demo video below). We (1) equip clinicians and facilities with cost-plus inventory and the tools to administer their own bundled Hims-like offerings, (2) connect them with employers and individuals in need of fair transparent options, (3) enable Zocdoc-like treatment ordering, (4) augment guidance with real-time decision support furthering quality and reporting, and (5) wrap it all with an omnichannel concierge Apple Store-like engagement and support experience. Supercharging pharmacy benefits takes us one step closer to uniting the entire health plan supply chain. The team has been hard at work shipping game-changing features that power seamless multi-party transactions while driving real-time insights and a level of agency, control and value that we’ve only dreamed of. Pharmacies/PBMs/Health Systems/ACOs/IPAs/MSOs/VBCs, let's mobilize your resources and insert you into the direct-to-employer movement with modern & automated multi-party, multi-service admin, coordination an contracting. Advisors/Employers/TPAs, if you’re looking to save 20-60% while improving health benefits, let’s talk. With love. Ahilan "Siva" Sivaganesan, MD Michael Fang, MD George Brown David H Berger, MD, MHCM Satish Srinivasan Vinay Patel Nick Stefanizzi Ann M. Richardson, MBA Bryson Tombridge Laura Purdy, MD, MBA John McCluskey Raymond Tsai, MD MS Ryan Kline https://lnkd.in/ex63Y5Ny

We did it!!! Real prices for hospital services!! Thrilled to be partnered with Downstate Health Sciences University to drive meaningful change for patients!!

Estimates are bullsh**. We need real contract discount pricing that enables access. Being an informed consumer is great, but it means nothing if we can't easily take action on the information. Pricing information in hospital and payer MRFs represents information, not access. The MRF info won't help people like Valerie June (story below) avoid inflated bills, even if it's presented in a consumer-friendly format. For most, the only way to access deeply discounted rates is through their insurance network. Absent a predefined contractual agreement, providers are legally required to make "reasonable attempts to collect" the chargemaster rate before applying discounts. The spectrum of provider risk tolerance around this topic varies. Education around this topic is close to nil. Prompt pay cash discounts are usually good for 20% off, but anything more than that risks being seen as a "dual fee". Dual Fee Schedules are explicitly allowed in some states, prohibited in most large states, and the regulation is unclear in the rest. The insurance lobby pushed these restrictions to ensure they'd always get the best price and maintain their control over the industry. Lower prices in exchange for aggregated demand is a fair trade, and PPO networks represented the foundation of cost containment when managed care was introduced in the late 80s-early 90s. Today, in a world where insurance often means higher prices, medical debt, and bankruptcy - despite 90% of the country having insurance - what once represented free market protection now subjects the masses to undue harm. We can no longer trust insurance carriers to negotiate and pay for services on our behalf. They've shown to be terrible at both and the incentives are clearly misaligned. Employers and patients pay 10x cost to middlemen while providers are left with scraps (see J&J lawsuit), all because there's a disconnect between care providers and care sponsors. With more than 50% of the country on HDHPs and more than 10% of the country uninsured, we the people have become our own care sponsors. Self-insured employers like Mark Cuban have realized their power and are starting to contract with hospitals and providers on behalf of their employees. We need more entities like Mishe Health doing this on our behalf. We need our own 100% pass-through network to contract with care providers to ensure we get the best rates. When it comes to aggregated demand, 200 million people should be enough to justify better prices. Now that we have the tools in place, it's time for the people to take back healthcare. Ge Bai Josh Archambault Doug Aldeen David Balat Kevin Morra

⚖ Considering your healthcare options? With Mishe, it's a clear choice! Guaranteed discounts, no surprises, and seamless appointment scheduling – why settle for less? ✨ #MisheHealth #HealthcareChoice #InnovateYourWellness

Meet Dr. Hunt, our outstanding orthopedic surgeon and sports medicine expert. Graduated from Kentucky College of Osteopathic Medicine, and did residency in Orthopedic Surgery at St Anthony Hospital in Oklahoma City. Specializing in Orthopedic Surgery and Sports Medicine, Dr. Hunt founded OrthoLinks Orthopedics in Tampa, FL, known for transparent pricing and top-notch orthopedic care. #HealthcareLeader #PriceTransparency #KentuckyMedicine

🌟 Spotlight on Dr. Vinay Patel, PharmD 🌟 A distinguished graduate of the University of Florida College of Pharmacy, he's revolutionizing healthcare with expertise in pharmacy benefits and clinical services. As CEO of MakoRx, an innovative direct pharmacy, Dr. Patel breaks down silos, bringing medications to patients close to cost. As a former board member at the North Carolina Association of Pharmacists, he pioneered pharmacist-provided wellness visits and groundbreaking prescription pricing models. Celebrate his dedication to positive change in healthcare! 👏 #HealthcareInnovation #PharmacyLeaders #PositiveChange #MakoRx

⚕✨ If your current doctor isn't on board, it's time to join the wellness revolution. Refer them to Mishe and let's revolutionize healthcare together! #ReferYourDoc #HealthcareRevolution #MisheHealth #WellnessJourney #ReferralProgram