Everything
for David

Before Direct Care Alliance, David Balat ran hospitals. He kept hearing the same thing from benefit advisors. You cannot get a direct contract with a hospital. It cannot be done. He heard it enough times to ask a different question. What if both sides want the same thing and are just using different words for it? That question is where this company started. He told the story on the record last week, in front of the Texas House Select Committee on Health Care Affordability. Twenty nine seconds, in his own words.

On 1 September the Texas House Select Committee on Health Care Affordability heard from six panels. Doctors. Insurers. Hospitals. Drug companies. Direct contracting. And other solutions. Direct contracting got a panel of its own. Not a mention inside somebody else's hour. Its own place on the agenda, in front of a committee whose whole job is what care costs in Texas. Our Founder and Board Chairman, David Balat, was on that panel.

Here is what our Founder told the Texas House on 1 September, in plain terms. A big surgery or a course of cancer treatment is almost never one provider. There is a hospital. A surgeon. An anesthesiologist. A pathologist. An oncologist. A radiologist. Usually more. Normally that turns into a pile of separate bills, and nobody can tell the patient what any of it will cost. Direct Care Alliance turns those pieces into one episode of care with one all in price. A price, not an estimate. No prior authorization needed. The price is agreed in advance. When an employer offers DCA and the patient chooses it, that patient pays nothing out of pocket for the episode. No deductible. No coinsurance. No bill afterward. They can focus on getting well.

We did not ask the State of Texas to change anyone's coverage. We asked for something much smaller. Texas is not only a policymaker. It is also a very large employer that pays its own health claims. So we asked the committee to consider a test. A defined group of people. A defined period of time. Starting where the money is most concentrated, which is cancer and expensive hospital care. Then measure it. Compare what the State would otherwise have spent against what it actually spent. Ask the patients whether somebody helped them through it. Then let the data decide. No new agency. No mandate. No change to anyone's coverage.

The Texas House Select Committee on Health Care Affordability has published the record of its 1 September hearing. Panel Five is the one on direct contracting. If you want to hear how this model gets explained to the people who write the rules, rather than how it gets pitched, it is worth the time. Link in the first comment.