Opening

Dr. Jack Lewin introduces Geoff Teed and sets the stage.
Dr. Greg Daniel is introduced as a co-presenter, bringing deep practice management and capital expertise.
Deep gratitude to Dean Shomaker, Kelley Withy, the JABSOM team, the Hawai‘i Physician & Nurse Crisis Task Force, and the Hawai‘i Primary Care Association for their invaluable advice and counsel.
Heartfelt thanks to the physicians and advanced practice providers we've had the privilege of meeting—your insights helped shape this initiative in a way that truly resonates with and earns the trust of your peers.
Framing for audience:
Let’s Begin: This isn’t theory, it’s a boots-on-the-ground playbook for physicians and advanced practice providers. Not corporate fluff. Not another middleman scheme.

Core Promise

We’re honored and privileged to share with you today.

Hawaii’s first Practice Mutual: a cooperative model where physicians and advanced practice providers themselves are the payer.
No Prior Authorization. No Coding. Physicians and Advanced Practice Providers set the rules… not insurers.
Full authority, full control, zero leakage of profit. Every dollar reinvested locally.

Why This Matters in Hawaii

Imagine practicing medicine without prior auth drag or denial mills.
Imagine community-based triage and care coordination, powered by AI, keeping patients out of the hospital when safe.
Imagine clinicians actually working at top of license, while friction disappears.

Vision of 2027

Imagine practicing medicine without prior auth drag or denial mills.
Imagine community-based triage and care coordination, powered by AI, keeping patients out of the hospital when safe.
Imagine clinicians actually working at top of license, while friction disappears.

The Broken Flow of Money

Today: Physicians and Advanced Practice Providers make 90% of care decisions but control only 3.5% of spend.
Billions siphoned by insurers, hospitals, and private equity.
Hawaii loses twice: talent leaves, and capital leaks.

Our Model’s Flow of Money

Physicians and Advanced Practice Providers own 100% of the governing entity.
Global capitation authority—you manage total cost of care.
MSO takes a capped admin fee (3.5%)—not a penny of shared savings.
Surplus flows to physician/APP income, patient care, and reinvestment. nd capital leaks.

Payment Model

Physicians and Advanced Practice Providers receive prospective Part B-level payments upfront—cash flow is protected.
All claims and outlier exposures are pooled, not carried by individuals.
Surplus is shared: fair, transparent, reinvested locally.

Differentiators

Physician/APP-owned, governed TCOC entity.
No prior authorization. No coding. Lower admin burden. Lower malpractice.
Independent MSO = end-to-end wraparound support while physicians and advanced practice providers remain in control.

The Impact

Better medicine: fewer avoidable hospitalizations, stronger gap closure, higher patient satisfaction.
Lower professional liability costs through captive formation and collective purchasing power.
Stop-loss protection + resource pooling eliminates individual downside exposure.
Higher practice revenue with less friction and more support.

The MSO Role

AI-powered backbone: denial recovery, cleanup, predictive analytics.
End-to-end wraparound support: care coordination, gap closure, social services, risk adjustment, compliance.
No clinician coding burden—we handle it.
You focus on medicine. We handle the rest.

Scale

Target: 15,000 lives at launch → 65,000 lives by 2026.

~$750M benchmark → ~$100M Physician/APP net revenue.

Hawaii becomes national proof-of-concept. The model others learn from.

What’s Next

Join Us

Not Agilon, Pearl, or MDX. Not PE. Not-insurer owned. No outside investors siphoning profits.
It’s a Community Physician/APP-driven Mutual—transparent, accountable, with a Clinician Bill of Rights baked in.
Call to Action: Scan the QR code → join the founding group → help lead the change.

Backed by PARADIGM PROVIDER PARTNERS, INC.

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