Reference-Based Pricing without the balance bills

Providers in Flume Community welcome our members at fair pricing because we created a better reimbursement relationship

Flume Community™ is

The Right Doctors

We build Flume Community™ dynamically for every employer - starting by intaking our clients' claim history along with Provider Nominations to understand where members actually want to go. We then use key quality data points to select providers we want to invite into Flume Community™

True Pricing

Traditional PPO networks price contracts as a % discount from an arbitrary charge master - making costs unpredictable

All Flume Community™ provider contracts are priced as a reference to publicly-known Medicare reimbursement rates, ensuring pricing is always fair and known

Great Outcomes

Flume Community™ breaks down barriers in healthcare and aligns incentives for providers, members and employers to enable better outcomes
  • Providers get fast (72 hr) reimbursement with no collection risk
  • Employers transact at fair, known pricing
  • Members access care with confidence at a price they can afford

Members

Nominate your doctors to join Flume Community™ & future visits could be low-cost or no-cost for you

Go to nomination form

Providers

Join to start seeing patients with 72 hour reimbursement and $0 collections

join flume community

How does it work?

1

Decided you need to see a doctor? Call the Flume Concierge to get started

2

We will route you to local providers who are contracted in Flume Community™ for the requested specialty (we can help you book and preauthorize at this stage)

3

Show up for your appointment, hand over your Flume Health member ID. All you owe is the small copay listed on the card

4

Appointment complete

5

No more bills - we handle the balance.
Seriously that's it

Why Did We Create Flume Community™?

High cost does not equal high quality

Often providers with the best outcomes are specialized, smaller practices that perform the same procedures frequently

By contrast, hospitals are generalist facilities with massive overhead costs - meaning visits are more expensive and quality does not correlate

Members have a massive financial responsibility, too many choices, and little-to-no information. Flume Community™ makes care decisions simple by selecting for high value, and rewarding patients with a waived deductible

Data Source: Medivi by 6Degrees Health

Great providers want to focus on medicine

Providers today face an unreasonably high cost of doing business, billing via complex claims and a need to collect more from patients - some have even resorted to suing their patients

In some hospitals, the billing and collection staff now outnumber nurses

A fair reimbursement arrangement means providers can  focus on care, rather than administration

Data Source: Bureau of Labor Statistics, National Center for Health Statistics, and the Census Bureau analyzed by athenahealth

Cost shifting has made benefits unaffordable

High-cost, opaque insurance PPO networks have driven up the cost of care - forcing employers to decrease benefits (increased premiums & deductibles)

By selecting the providers who price fairly and have proven to improve outcomes, employers can finally afford to share savings back with members

So proactive healthcare becomes affordable again

Data Source: Kaiser Family Foundation, 2019 Employer Health Benefits Survey, Figure 7.8