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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. Why shouldn’t your hospital 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. Until now, providers have been forced to rely on market information based on average payment rates, outdated, and full of holes. In almost no other industry are companies so blinded to the data behind how they compete. 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 once and for all.

Our Offering

FlexPoint Health is the only company in the United States providing healthcare providers 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 other data vendors 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 control negotiations with insurers.  With our data you will be able to negotiate contracts with competitive rates and defensible pricing.

Our Clients

We serve clients throughout the United States. Here is a representation of who we serve:

Health Systems

  • Non-profit health systems with 20 hospitals or more

    6

  • Faith-based health systems with 10 hospitals or more

    5

  • For-profit health systems with 20 hospitals or more

    3

Hospitals

  • Hospitals with 75-150 beds

    8

  • Hospitals with 151-500 beds

    36

  • Hospitals with 500+ beds

    23

  • Children’s hospitals

    3

  • Faith-based hospitals

    25

  • Government-controlled, non-federal hospitals

    5

  • Academic medical centers

    9

We provide our clients with contract rate intelligence for a range of insurers, most commonly these six:

  • Aetna
  • Blue Cross
  • CIGNA
  • Humana
  • Medical Mutual of Ohio
  • United Healthcare

Our Leadership

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 and served as President of Healthcare Financial Management Association (HFMA) – Northeast Ohio chapter from ’92-’93.