This model is not unprecedented — several operating or in-progress facilities already validate pieces of it.
- Physician-owned OKC hospital/ER: handles admissions and ER; outpatient services are competitively priced; contracts with commercial insurance but not Medicare, which simplifies operations considerably. Its main friction point: Medicare patients who show up at the ER are effectively treated for free and transferred if admission is needed — a live example of the EMTALA/uncompensated-care question.
- Emerging South Carolina project: a physician-owned surgery center, DPC practice, and specialist group launching just outside Charlotte, NC, close to a major airport and a dense regional pool of DPC physicians and self-funded employers. A hospital component is a planned next phase.
- Direct-contracting employer movement: an established playbook of benefits advisors steering self-funded employer plans to cash-pay surgical centers — exactly what this plan's surgery and imaging lines could plug directly into.