Who We Are
Let’s face it – big health insurers use data collected through their Coordination of Benefits (COB) process to know exactly what other insurers are paying your hospital or physician group. Why shouldn’t your organization have access to similar data showing exactly what insurers are paying your competitors?
FlexPoint Health was founded in 2010 knowing that healthcare providers are disadvantaged by the lack of reliable contract rate intelligence available to them. In the past, providers had no choice but to rely on “big data” consultants who provide market data that is sourced from non-current public databases (e.g. CMS) or all-payor claims databases. Providers lack meaningful contract rate data that shows precisely how their rates compare to those of their competition, and that sets them up for failure. FlexPoint’s mission is to provide healthcare providers the data they desperately need to level the playing field with insurers and gain competitive advantage over their competitors.
FlexPoint Health is the only company in the United States providing healthcare providers and provider-owned health plans with their competitors’ actual negotiated reimbursement rates.
Patient Claims Data Derived Exclusively from Your Market
We deliver customized and affordable reimbursement rate reports based on current and prior year claims data procured directly and exclusively from patients in your market.
The Most Current and Precise Data Available in the Industry
Our one-of-a-kind service delivers rate intelligence that is current and precise. We can show you exactly what each insurer is reimbursing each provider in your local market. For the first time, you won’t have to make pricing decisions based on blended averages and old data that all the other consulting firms offer.
Take Control & Dominate at the Negotiating Table
Insurers are good at convincing you that your rates are at par or better than all of the other providers in your market. What data do you have to confirm what they are telling you? We provide you with concrete irrefutable evidence needed to take control of negotiations with insurers. With our data you will be able to negotiate contracts with competitive rates and defensible pricing.
We serve clients throughout the United States. Here is a representation of who we serve:
Non-profit health systems with 20 hospitals or more
Faith-based health systems with 10 hospitals or more
For-profit health systems with 20 hospitals or more
Hospitals with 75-150 beds
Hospitals with 151-500 beds
Hospitals with 500+ beds
Government-controlled, non-federal hospitals
Academic medical centers
We provide our clients with contract rate intelligence for a range of insurers, most commonly these six:
Medical Mutual of Ohio
FlexPoint Health was founded and is operated by leaders with extensive healthcare expertise – managed care contracting, strategic financial planning and modeling, mergers and acquisitions, valuations, due diligence, and advisory.
Learn more about our founders below:
Sean P. McCarihan, CPA
President & CEO
Sean is responsible for product development and oversees company strategy, operations, sales, marketing and business development for FlexPoint. His mission is to give healthcare providers the data they need to gain competitive edge and increase profitability. He is an expert in managed care contracting and payment methodologies. His innovative approaches for accessing claims data have enabled FlexPoint grow its client portfolio to include more than 100 hospitals throughout the country. He is also responsible for management of FlexPoint’s national call center that procures claims documentation directly from patients. He trains and leads our call center team of experts who are disciplined in managed care contracting, coding and mathematics. Prior to founding FlexPoint Health, Sean was an independent healthcare consultant and was also a Manager at PricewaterhouseCoopers – serving at offices in USA and Switzerland. He is a Certified Public Accountant.
Douglas R. McCarihan, CPA
Executive Vice President
Doug is responsible for all aspects of strategic business development and applied mathematics for FlexPoint. He is also President of our Midwest Region client portfolio. Prior to founding FlexPoint Health, Doug was a financial consultant and advisor to a variety of healthcare businesses. His experience with consulting healthcare providers on managed care contracting and revenue forecasting issues lead to his vision for wanting to create FlexPoint. He identified a need for a data delivery service that nobody else was offering. He spent the first 22 years of his career with KPMG, 13 years as Partner. His last position with KPMG, prior to establishing his own independent consulting practice, was Partner- in-Charge of the firm’s financial management consulting practice for the healthcare industry. He is a Certified Public Accountant.