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Rx for Pricing Transparency

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Photography by Patrick Clinton

There’s Amazon for shopping. There’s Airbnb for vacations. There’s Priceline, Expedia and Travelocity for trips. Wouldn’t it be nice if there were a similar easy-to-use experience for shopping health care?

That’s the need that MediXall.com of Fort Lauderdale is trying to address, says President Michael Swartz. The company allows consumers to use their smartphones, tablets or computers to check out health care providers and related service providers.

It’s ramping up by providing information about imaging centers. In South Florida, prices for MRIs, PET scans, CT scans, X-rays and other diagnostic imaging services can vary widely—without any real difference in the quality of outcomes as well, Swartz says. MRIs can range from $400 to more than $3,000 for the same imaging.

Patients are starting to get more savvy about shopping around rather than just going to a center a doctor recommends, especially when they have high deductibles, Swartz says. MediXall cites National Center for Health Statistics data that shows more than 48 percent of the state’s population between ages 18 and 64 were uninsured in 2017 or were struggling with a high-deductible insurance policy, leaving patients paying cash for medical imaging services that they cannot evaluate or comparison-shop, because of lack of available information.

For those lacking a health insurance provider who has a list of providers, finding a database of providers can be a challenge. That’s one of the roles MediXall wants to fill.

MediXall is looking at partnering with employers who have self-insurance programs. It could help employees manage costs before they hit their deductibles, Swartz says. That fits in a scenario with many employers who offer a combination of high-deductible plans and health savings accounts.

MediXall is all about pricing transparency in the health care field. The industry has had issues with gag clauses that inhibit pricing disclosure, which is starting to get legislative attention.

For example, President Donald Trump in October signed two bills that prohibit gag orders on pharmacists. The issue was contracts preventing pharmacists from disclosing that an equally effective but less-expensive drug option was available to patients.

Swartz, who was a co-founder of Viridian Capital Advisors and served as a senior analyst from 2013 to ’15, has tweaked his approach since MediXall had a soft launch in March. Initially, the approach was to target a broad array of health care providers. The company gained an insider’s view on how pricing works and became acquainted with CoreChoice, whose specialty networks include imaging.

Swartz realized he could tap into networks with thousands of providers instead of bringing in providers one by one. Providers also would already be fully credentialed, because health plans required that for reimbursements.

MediXall formed a strategic partnership with CoreChoice.

“Just as Amazon did with books, we decided to initially launch with diagnostic imaging,” Swartz said. That was rolled out in September.

Swartz is looking to parallel that next by negotiating with lab service companies and physical therapy networks. He’s also talking with dental and vision providers. He expects the company to grow rapidly from its 15-employee head count.

He has also launched MediXallRx, which gives patients a discount pharmacy card. MediXall has partnered with a company that has relationships with a pharmacy benefit manager, which negotiates prices for specific prescriptions. The card is accepted at 60,000 pharmacies, including Publix, Walmart and CVS, he says.

For providers, Swartz has launched MediXall Finance Group, which provides customized solutions, such as patient financing and securing accounts receivable.

MediXall’s parent, MediXall Group, is publicly traded over the counter with the symbol MDXL, which Swartz sees as a way to provide transparency for investors and providers. Shares were recently trading near $2.75 with low volume. Swartz hopes to eventually be listed on NASDAQ when the business model is proven.

MediXall is backed by venture capital company TBG Holdings, which is in the same office as MediXall. Sister companies include R3 Accounting, which helps small cap companies structure their capital, and Crossroads Capital Finance Group, which helps clients with financing.♦

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Drew Limsky

Drew Limsky

Editor-in-Chief

BIOGRAPHY

Drew Limsky joined Lifestyle Media Group in August 2020 as Editor-in-Chief of South Florida Business & Wealth. His first issue of SFBW, October 2020, heralded a reimagined structure, with new content categories and a slew of fresh visual themes. “As sort of a cross between Forbes and Robb Report, with a dash of GQ and Vogue,” Limsky says, “SFBW reflects South Florida’s increasingly sophisticated and dynamic business and cultural landscape.”

Limsky, an avid traveler, swimmer and film buff who holds a law degree and Ph.D. from New York University, likes to say, “I’m a doctor, but I can’t operate—except on your brand.” He wrote his dissertation on the nonfiction work of Joan Didion. Prior to that, Limsky received his B.A. in English, summa cum laude, from Emory University and earned his M.A. in literature at American University in connection with a Masters Scholar Award fellowship.

Limsky came to SFBW at the apex of a storied career in journalism and publishing that includes six previous lead editorial roles, including for some of the world’s best-known brands. He served as global editor-in-chief of Lexus magazine, founding editor-in-chief of custom lifestyle magazines for Cadillac and Holland America Line, and was the founding editor-in-chief of Modern Luxury Interiors South Florida. He also was the executive editor for B2B magazines for Acura and Honda Financial Services, and he served as travel editor for Conde Nast. Magazines under Limsky’s editorship have garnered more than 75 industry awards.

He has also written for many of the country’s top newspapers and magazines, including The New York Times, Washington Post, Los Angeles Times, Miami Herald, Boston Globe, USA Today, Worth, Robb Report, Afar, Time Out New York, National Geographic Traveler, Men’s Journal, Ritz-Carlton, Elite Traveler, Florida Design, Metropolis and Architectural Digest Mexico. His other clients have included Four Seasons, Acqualina Resort & Residences, Yahoo!, American Airlines, Wynn, Douglas Elliman and Corcoran. As an adjunct assistant professor, Limsky has taught journalism, film and creative writing at the City University of New York, Pace University, American University and other colleges.