by Maria K Todd, MHA PhD
CEO & Founder
Mercury Healthcare International
Health care purchasing coalitions (sometimes referred to as alliances or cooperatives) are established by groups of individual purchasers who wish to use their collective strength to buy the best healthcare benefits at the lowest price. Many healthcare purchasing coalitions have been established nationwide over the years but served only very large organizations. Most were organized as self-governing not-for-profit membership organizations limited to a single region or city.
Mercury Health Travel has established its own health travel purchasing coalition that can be used by freelancers, solopreneurs, small companies and other members.
About the Mercury Health Travel Purchasing Coalition
The Mercury Health Travel Purchasing Coalition was established under the existing Mercury Healthcare International, Inc. corporate umbrella as a service line extension to our existing Mercury Health Travel vertical. It affords group health advantages for solopreneurs, freelancers, and small businesses to discounted health services fees at US and international destinations.
Members gain immediate access to exclusive savings negotiated on behalf of coalition members across the USA and in 120 countries in Asia, Africa, North America, South America, Europe, and Australia. Learn More or Apply to be an Approved Provider.
WHY IT WAS FORMED
The premise is simple to understand, but takes years of network development (that we've already done) to execute. Health care providers offer significant price discounts and administrative efficiencies to large purchasers in exchange for patient volume. But with the purchasing coalition, small business owners and freelancers can use our system. Our network and business model was not designed to do single consumer medical tourism facilitation. In 2014, after months of requests, we decided to create and launch the Mercury Health Travel Purchasing Coalition program as a way to accommodate solopreneurs, freelancers and very small businesses for whom a regular full scale corporate medical travel program was not practical.
Mercury Health Travel Purchasing Coalition was formed so that small business owner and independent freelancers could purchase health travel services at exclusive coalition rates through Mercury's Health Travel Purchasing Coalition for at a lower cost than individual consumers can negotiate medical tourism prices as individuals. Through the coalition, they gain access to expanded choices of Approved Providers at destinations chosen by the coalition members. The concept is similar to a Group Purchasing Organization for solopreneurs, freelancers and very small businesses.
The Role of the Coalition
Health care coalitions seek to contain cost and provide health care quality by enhancing bargaining strength, increasing competition between medical service providers, sharing information on the cost and performance of providers, and on the terms of contracts.
The roles of coalitions vary. Some only collect information. Others may share information and jointly purchase services. A few negotiate PPO networks, prescription drug care programs, and mental health and substance abuse networks.
Mercury Health Travel's Purchasing Coalition
The difference between the Mercury Health Travel program for larger groups (self-funded employers, labor unions and other associations, coalitions and co-ops) and the health travel coalition is that the larger companies set up their own private program, benefit inclusions and limitations, and negotiate directly with healthcare providers for wholesale rates and contract terms with our assistance. The coalition is a group purchasing coop that chooses providers and destinations as a group of otherwise unaffiliated members of the coalition on a smaller scale.
In Mercury Health Travel purchasing coalition, a small solo business owner, freelancer, or small self-funded company (fewer than 50 employees) can join the coalition and access our existing network of medical, dental, and other Approved Providers without the preliminary analysis of their existing group health expenditures and past claims analysis. The cost of entry is low, and the access to services is faster. By forming a coalition, members benefit from the economies of scale.
- Shares information on cost and quality of healthcare providers and destinations
- Endorse high-quality Approved Providers who meet criteria for consideration as an Approved Coalition Provider
- Jointly purchases services and steers volumes to contracted providers similar to a limited scope PPO
- The members designate Approved Providers with whom they wish to do business in select destinations
- Has already arranged a prescription drug discount program
- Treats mental health and substance abuse no differently than medical or dental care
- Collectively negotiates with service providers for reduced fee schedules and other cost controls
- Pool the medical travel financial risk into reinsurance captives organized jointly by the members on a voluntary opt-in basis
- Manages all logistics coordination and case management and reporting for members
- Uses an established TPA (at arm's length) to adjudicate medical travel claims and pay providers for their services.
The Coalition Members:
- Designate preferred providers and destinations with whom Mercury Health Travel will open group purchasing contract negotiations
- Design their own benefit packages and make their own decisions to offer any benefit - most find they don't have to change their benefit plans
- Authorize Mercury Health Travel to contract and inspect providers on their behalf
- Set their own cost-sharing requirements
- Assume the financial risk for their health costs
- Agree to prepay quoted case rate estimated charges directly to providers prior to patient arrival
- Enjoy advantages such as collective bargaining power, lower administrative costs through economies of scale
- Enjoy efficiencies in educating employees about medical travel program benefits and an easy access health travel logistics portal
- Benefit from the Coalition's ability to maximize employees' benefit choices in access to care, choices of destination and more
- Trustees of each participating fund make the final decision concerning benefits offered and providers chosen by their fund.
- Trustees are not permitted to delegate their fiduciary responsibilities
- May use their HSA debit cards (if their accounts have adequate funds deposited) to pay for their includible healthcare expenses.
- Small self-insured corporations engage with the TPA affiliated (at arm's length) with Mercury Health Travel, if necessary.
- Solopreneurs, freelancers and non-incorporated individuals pay providers directly, in advance, for transparent estimated costs. This approach pares down handling fees and other administrative costs.
- May specify minimum group size in order to access preferred rates
- May offer different discounts to fund financial incentives that steer plan participants towards using their services
- May adjust discounts up or down based on the number of employees that participate in the program
- May invite certain members for hosted site inspections and tours to their destination and facilities and to meet with local providers
Direct contracting is way of buying health care that is gaining in popularity. Purchasers, such as self-insured employers and coalitions, buy services directly from providers, such as physicians and hospitals, or contract directly with an integrated provider network or health delivery system. Proponents of direct contracting believe that eliminating involvement of insurers, ASOs and PPOs can lower administrative costs and eliminate the profits that are built into insurers' premiums. The same proponents also believe that direct contracting gives more control to the health care providers and buyers resulting in lower costs and better outcomes marketplace approach. We believe it also enhances the brand loyalty relationships between buyer and sellers - but most small business owners, freelancers, and contractors have always been marginalized in these relationships.
Mercury Health Travel began contracting with healthcare and ancillary providers in 2003. In 2010, it filed for and was granted a trademark registration for a new term of art to define its "globally integrated health delivery system®" and now negotiates for any and all health services. Mercury Health Travel contracts with inspected and approved "centers of excellence" across the USA and in 120 countries for specific services, such as cancer treatment, open heart surgery joint replacements and more. Negotiating jointly for a subset of benefits allows member funds to begin working together on individual contracts. In 2014, we launched the coalition on a beta test basis. Now we're ready to move forward and scale the program.
Why not post a Price Estimator tool?
Many websites offer healthcare price estimator tools, but the accuracy is unreliable. Many draw in a consumer with a lowball price and then surprise consumers with increases. If we catch a provider doing that without informed consent and even one valid complaint, the provider will be expelled from the network for cause. Many price estimator tools are poorly maintained or never updated despite the best intentions.
Reason to Join: As a member of the Mercury Health Travel Purchasing Coalition, you gain immediate access to the largest network of Approved Health Professionals and Facilities in 120 countries willing to discount fees to coalition members.
Membership: Annual Dues
|Small Business (1-3)||$695|
|Small Business (4-10)||$1795|
|Small Business (11-20)||$3495|
Immediate access to:
- Exclusive rates at Approved Facilities and Providers
- Pharmacy discount card - over 65,000 U.S. pharmacies
- Discounts on Comprehensive Annual Checkups
- Discounted Airfares (Up to 60% off Intl. Bus Class)
- Discounted Accommodations
- Discounted Wellness / Medi-Spa Packages
- Discounted Vacation Packages and Tours
- Care and Travel Coordination Services, Worldwide
- Discounted hearing aids and home medical equipment
- Subscription to Medical Tourism Destinations of Distinction
Additional value added benefits:
- Free admission to Mercury Health Travel Purchasing Coalition annual member conference
- Member roundtables / regular meetings and webinars
- Network with your purchasing peers
- Print and electronic resources
- Voice - You decide on new network providers
- Legislative updates on medical and dental travel
- Health benefit purchaser intelligence
- An extensive healthcare delivery network - worldwide
- Value-based purchasing and bundled, transparent pricing
- Magazine and e-newsletter classified ad space to promote your business /services among coalition members
- Membership extends to family members under the master membership
- Lifestyle Risk Wellness Calculator App
Annual Member Conference:
July 2017 - Denver, Colorado (No charge to members)
If we can't save you at least the cost of your annual membership over the course of the year, we'll refund the difference or apply the difference as an offset off subsequent year's membership.
Request Coalition Membership Application
Comments from Members
I've known Maria Todd since high school. I joined because I fix guitars from a small shop on the side of my little house. Care is scarce around where I live. My lame ass insurance network limits where I can get care even though I have to pay the first $6500 each year out of my pocket. Now I buy my healthcare where I want and pay less. The pharmacy discount saved me more than my membership on one prescription. What she's developed for freelancers and small business owners is pure genius. Thanks Ria. Ya done good! Join with confidence!
In addition to medical, prescription drug, vision and dental, dialysis, executive checkups, as the coalition expands, members will be offered opportunities to access other benefits including, but not limited to:
- Fiduciary liability insurance (for self-funded companies)
- Accidental death and disbursement (AD&D) coverage, travel insurance, foreign and domestic medical travel complications insurance
- Voluntary insurance benefit programs
- Employee Assistance Programs (EAPs) and telehealth counseling
- Eating disorder center (partial hospitalization program)
- Discounted amenities such as car rental discounts, hotel discounts, auto leasing deals and fitness club memberships; and
- Chronic disease management programs
- Exclusive marketplace coalition discounts (ride sharing, meal sharing, accommodation sharing, and more)
PROVIDERS - OFFER YOUR SERVICES TO MEMBERS OF THE COALITION
In recent years, a growing number of commercial companies have initiated and marketed Health Discount Plans to the general public. Commonly, these discount plans include features such as the following:
- An modest enrollment from $12 to $25 or $45 per month.
- Access to a wide variety of health services including doctor and clinic visits, specialist visits and treatment, hospital services, prescription medications and medical devices, all at reduced rates. Some include dental, vision and alternative health services.
- The freedom to pick and choose among thousands of different providers in a distinct geographic market
- Discounts ranging from 5 percent to 90 percent on various services.
- No - "just show your card" with no waiting for reimbursement from an insurance company.
- No medical exam is necessary to join or access services; pre-existing conditions are treated like any other recent onset condition.
- The sponsors and proponents of such plans describe them as filling an important gap in the health market. For those families with some health insurance coverage, the discount cards can provide a kind of supplement, especially for non-covered services like eye glasses, or the option of seeing another practitioner that may not be included in insurance plans.
For some who are uninsured or have large annual deductibles, these discount plans plans are viewed as a financial cushion, giving members access to discounted health care, with discounts that more like large employer might enjoy. Healthcare providers interested in coalition should contact our provider relations director. We'll send you an application by return email. If you qualify, you'll be sent a contract.
- The mission of the coalition is to set criteria to approve healthcare providers who wish to gain access to the Coalition's marketplace of independent and small business buyers.
- Fee schedules. What you charge and the discount you offer is your prerogative. This is not an extension of any insurer or PPO. You set the prices or discounts you want to offer to the coalition members. Update your discounts or add services at any time with 30 days advance notice to the Coalition office.
- Payments. Members pay providers in advance for services. Members are identified by their valid membership card. All financial transactions are direct with coalition members. Discounts are not stacked on top of existing PPO or other contractual relationships you may already have. Fees are independent of any pre-arranged health plan or insurance coverage the coalition member may have. If a coaliton member wishes to file a claim with their insurer for any benefits due them, that's their prerogative. For this they'll need a properly coded (ICD10/CPT/HCPCS) receipt for their payment to you.
- A complete membership kit for new providers includes images of the membership card, program rules that Coalition members are expected to follow, and other important program details.
- A dedicated toll free number is available to verify membership.
This is not health insurance, and it is not a PPO.