It’s time to start over.

Most of your health happens outside the exam room. Traditionally, the healthcare doesn’t show up proactively to keep you healthy, but shows up when something goes wrong.

Knowing where to seek care, and when, is a full-time job. Whether it’s finding doctors and coordinating referrals, or a lack of transparency and entering repetitive information into outdated systems, the system creates friction and erodes trust.

And getting even that part has become a job. Find the doctor. Get the appointment. Chase the referral. Line up the specialists. Tell your story again. Decode the bill. Fight the denial. Wait. Start over.

Each of them sees a piece of you. None of them sees the whole.

Friction and erosion of trust lead to care gaps and high-costs for us all.

Our system does exactly what it was built to do, which is pay for sickness, one claim at a time.

Your health plan is paying for care in a system it doesn’t operate, and makes decisions based on cost and risk-reduction, not long-term health outcomes.

Most physicians are paid by the visit, which means 15-minute appointments and long wait times, making it impossible to invest in prevention, follow-up, and long-term health.

Everyone in it is squeezed. Nobody in it has the space to think about the whole of you.

Who suffers because of this misalignment? Members and employers.

It does exactly what it was built to do. It was built to pay for sickness, one claim at a time.

Hospitals have budgets to make. Plans have margins to hold. Both are doing their job. And every handoff between them is a place someone gets paid, and a place you get lost.

Forty years of fixing it hasn’t fixed it, because there’s nothing to fix. It works. It just wasn’t built around you.

Incremental changes bring incremental progress. We are redesigning the system from first principles in a moment that calls for cost-reduction and improved access to high-quality care. Insurers have tried purchasing doctors offices to fix this problem, but it falls short because practices continue their old habits. Provider groups have built health plans that leverage a legacy set of incentives that lack consumer design. Starting from scratch means we don’t inherit anyone else’s incentives, so the care and the plan work together from day one.

A system is a set of parts working toward one goal. In a health system, the goal is the health of the people in it, and the money and the medicine point the same way.

You can’t get there by adjusting what’s here. You have to build it.

Every part of it. The doctor, the plan, the network, the building, the person who answers the phone.

All of it with one goal: you’re healthier, and it costs less. Not by making you pay more of it.

The moment something feels wrong, a hand reaches for a phone. We’re building the thing it reaches for.

Awesome care, and you get it. Not better care for some and cheaper care for the rest.

Trust. Care that is personalized and easy-to-access leads to more care decisions flowing through Mainstay, helping to reduce costs.

More than care. Members need more than just care they love, but an advocate to help them navigate and simplify the system.

Easy path is the right path. Financially rewarding care that is coordinated, which nudges members to high-value care, while enabling flexibility for members who self-navigate.

Building every part of a health system took a century and a fortune. The only way to have one was to already be one.

That’s changed. A small team with the right tools can now build every part, and make the parts work as one. Not a little faster. Differently.

Most of the industry is using this moment to help the old system run a little better. We think that’s backwards. The only real way to use it is to build the new one.

It’s still hard. It will still take years, and patience. But for the first time, it’s doable.

This is a ten-year problem. So we’re built on a ten-year clock.