Investors – SimpleMed

Winds of change in Healthcare

Employers are increasingly concerned about health care costs, advocating for reforms in pricing transparency, competition, and value-based purchasing.

There’s a consensus among employer groups on the need for systemic changes in health care delivery and pricing.

How do we make money?

Although commercial insurers operate under a model where cost-saving incentives are less pronounced due to the nature of their risk pooling and premium structures, self-insured entities, by contrast, possess a direct economic motivation to minimize health care expenditures, as these costs directly impact their financial outlays
The self insured market comprises 25-30% of the total US Healthcare market.
In 2022, the US spent $4.5 trillion on healthcare
Some of the commonest surgical problems may be offered in the office, the evidence supports safety, the cost reduction is >5-10X

Case Example

In the context of Carpal Tunnel Release procedures, where hospital-based costs can escalate to $10,000, transitioning these surgeries to an office setting could reduce expenses to approximately $2,000, including an adjusted surgeon’s fee to accommodate the in-office environment. This shift results in a potential savings of $8,000 per procedure for self-insured companies.
If we consider an intermediary like Simplemed, which captures a portion of the savings—say, $200 per case—this model could generate $120 million annually, given the 600,000 annual procedures in the U.S.
Extrapolating this scenario across numerous analogous medical procedures highlights a significant economic incentive for self-insured entities to restructure care delivery, potentially unlocking substantial cost efficiencies and revenue streams for facilitators like SimpleMed