Innovative Payment Models & Plan Designs: Decentralization, Transparent Pricing, and Episodes of Care w/ Steve Wiggins

<p><em>“I’d like to leave an infrastructure behind that is better than the one I encountered when I came in, because we're stifling innovation, we're stifling creativity, we’re stifling advance.”</em></p><p>How can decentralization and transparent pricing reshape American healthcare? In this episode of <em>Moving to Value</em>, the MTVA Board sits down with <a href="https://www.linkedin.com/in/steve-wiggins-925389a9" rel="noopener noreferrer nofollow"><u>Steve Wiggins</u></a>, a healthcare entrepreneur with 40 years of experience at the intersection of healthcare and technology. Steve has founded and led multiple companies driving innovations in payment models and care management—and today, he’s on a mission to transform the system with his latest ventures: <a href="https://www.oxbridgehealth.com/" rel="noopener noreferrer nofollow"><u>Oxbridge Health</u></a> and <a href="https://opennetworks.org/" rel="noopener noreferrer nofollow"><u>OpenNetworks</u></a>.</p><p>Steve’s involvement in healthcare began in college, when his best friend suffered a life-changing injury that left him paralyzed. Since then, he has dedicated his career to creating solutions that improve access, affordability, and outcomes. </p><p>Steve shares how innovative plan designs and payment models based on episodes of care can break the cycle of rising costs and realign payment with how patients experience healthcare. He also explores how policies like the <a href="https://www.cms.gov/newsroom/fact-sheets/transparency-coverage-final-rule-fact-sheet-cms-9915-f" rel="noopener noreferrer nofollow"><u>Transparency in Coverage Rule</u></a> and the <a href="https://www.cms.gov/nosurprises" rel="noopener noreferrer nofollow"><u>No Surprises Act </u></a>are pushing the industry toward greater transparency.</p><p><em>“To me, if you’ve been in my seat, you look at this and you say, ‘This is the beginning of a profound change. It’s all going to be different.’” </em></p><p>With Oxbridge Health, he introduces “Episode Benefit Plans,” which use <a href="https://hbr.org/webinar/2016/06/the-case-for-bundled-payments-in-health-care" rel="noopener noreferrer nofollow"><u>bundled payments</u></a> to lower costs while preserving broad provider choice. Open Networks is pioneering America’s first health network cooperative—leveraging pricing transparency and data to offer patients predictability on their out-of-pocket costs.</p><p>————————————</p><p>As a 501(c)(3) nonprofit, we rely on support from our grassr