Why I Joined a Health-Tech Startup

After nearly three decades of working within the world of national health insurance carriers, I witnessed firsthand the systemic issues that are plaguing our healthcare system. What was at the core of the problem? Misaligned incentives. Those who provide care, those who predominantly pay for care and those who experience care are all operating within a broken system where costs are soaring, outcomes are often subpar and patients struggle with how to access care and how to navigate their health plan benefits.

Value-based contracting, once heralded as the solution to these issues, proved to be a disappointment in practice. While the concept was sound – incentivizing providers to focus on quality outcomes rather than just volume of services – the execution fell short. In reality, these contracts, which tended to be 1) simple pay- for-performance arrangements in a continued fee-for-service environment, 2) a service line capitation or 3) even worse, a global capitation, lack true alignment with how care is experienced and delivered, especially when it comes to the highest-cost services.

I reached a point in my career where, after observing this broken system and witnessing someone I love struggle to make her way through it, I felt compelled to make a meaningful impact on how healthcare is accessed, financed, delivered and experienced in America.

Enter Oxbridge Health. Fueled by a desire to fundamentally transform healthcare, we're pioneering a new approach centered around patients and episode-based care. Our goal is clear: to realign incentives across the entire healthcare value chain, from providers to employers to patients.

At Oxbridge Health, we're creating Episode Benefit Plans – a groundbreaking new category of health insurance designed to address the shortcomings of traditional models. These plans leverage bundled payments, price transparency and member choice to drive down costs while increasing quality and patient satisfaction.

Our approach starts with a fundamental shift in how we structure provider payments. Traditional fee-for-service models incentivize providers to focus on the quantity rather than the quality of care, leading to fragmented and often unnecessary services. Capitation, one traditional approach to value-based care, shifts too much burden onto primary care physicians to take on risk for services that are really outside of their control. At Oxbridge Health, we're flipping the script. We're pioneering bundled payment structures that align with the true episodic cost of care, enabled by our proprietary algorithms and process expertise.

By transitioning to bundled payments, we're incentivizing providers to prioritize efficiency, coordination and collaboration. Our sophisticated algorithms allow us to accurately identify and track patients within episodes of care, measure provider performance and generate real-time insights to inform decision-making. This not only encourages better patient outcomes but also drives down costs by eliminating unnecessary procedures and reducing the duplication of services.

For employers, our Episode Benefit Plans offer a game-changing proposition: guaranteed fixed costs for the services that drive the largest financial burden. By partnering with Oxbridge Health, employers can confidently predict and control their healthcare spending, freeing up resources to invest in other areas of their business. We literally guarantee it.

And for our members, our plans empower them to take control of their healthcare decisions – with benefit allowances that align to a wide range of care episodes. With price transparency and incentives for choosing cost-effective providers, patients can make informed choices that not only improve their health but also provide them with shared savings from their employers when they select high-quality cost-effective care teams for episodes that are priced below their benefit allowance.

Oxbridge Health is not just another health insurance company – we're a catalyst for change. We're challenging the status quo and leading the charge toward a more sustainable and equitable healthcare system. We believe that by realigning incentives and putting more decision-making into the hands of patients, we can truly transform the healthcare landscape for the better. Oxbridge Health - it just makes sense.

We expect to be in the market with our industry-leading solutions in the second half of 2024. We hope you'll join us on a mission to help heal health care one episode at a time!