Out-Of-Pocket

Out-Of-Pocket

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Plain-English, humorous deep dives on healthcare business and trends, with education and industry analysis.

The Curious Case of Professional Employer Organizations | Out-Of-Pocket
NewsMar 23, 2026

The Curious Case of Professional Employer Organizations | Out-Of-Pocket

Professional Employer Organizations (PEOs) act as co‑employers, taking over payroll, HR, and benefits for small businesses. By aggregating thousands of workers, they secure large‑group health‑insurance rates that would be unavailable to individual firms. Clients pay a flat fee of roughly...

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Licensing and Credentialing Nonsense with Assured | Out-Of-Pocket
NewsMar 23, 2026

Licensing and Credentialing Nonsense with Assured | Out-Of-Pocket

Assured offers a software platform that combines AI‑driven automation with credentialing experts to streamline provider licensing, credentialing, and payer enrollment across multiple states. The service automates data collection, screen‑scrapes portals, and manages follow‑up, charging a base SaaS fee plus usage‑based...

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Out-Of-Pocket’s 2025 Predictions | Out-Of-Pocket
NewsMar 11, 2026

Out-Of-Pocket’s 2025 Predictions | Out-Of-Pocket

Out‑Of‑Pocket’s 2025 outlook forecasts a turning point for several health‑care segments. Obesity drugs such as GLP‑1s are expected to become cost‑effective as pricing pressure and outcomes‑based contracts expand access. AI models will split, with healthcare‑specific versions emphasizing explainability, security and...

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23andMe, a Healthcare Fund Idea, and the NHS | Out-Of-Pocket
NewsMar 11, 2026

23andMe, a Healthcare Fund Idea, and the NHS | Out-Of-Pocket

Digital‑health founders struggle with traditional venture financing, prompting a proposed three‑stage fund that blends early equity with royalty‑based repayment to limit dilution. The author suggests 23andMe should merge with or create a biobank to leverage its high‑participation genetic data for...

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Sleep Health Is Getting Interesting | Out-Of-Pocket
NewsMar 11, 2026

Sleep Health Is Getting Interesting | Out-Of-Pocket

The sleep health market is merging consumer wearables with clinical diagnostics, creating a surge in demand for at‑home screening and management tools. New devices—from Oura rings to at‑home apnea kits—provide continuous biomarkers that flag issues before formal polysomnography. Telemedicine platforms...

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Citizen Fraud Detection, Self-Experimentation, and OOP Updates | Out-Of-Pocket
NewsMar 11, 2026

Citizen Fraud Detection, Self-Experimentation, and OOP Updates | Out-Of-Pocket

The post announces three upcoming healthcare courses—payor contracting, LLM applications, and a US healthcare crash course—each with limited enrollment beginning in December and January. It critiques the stagnant fraud‑waste‑abuse detection market, citing data access barriers and weak incentives, and proposes...

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Weird Health Insurance Concepts | Out-Of-Pocket
NewsMar 11, 2026

Weird Health Insurance Concepts | Out-Of-Pocket

The article explains three emerging health‑insurance tactics—intercompany eliminations, copay accumulators/maximizers, and reference‑based pricing—that reshape cost flows and patient liabilities. Intercompany eliminations let insurers count payments to owned providers toward medical loss‑ratio requirements, effectively boosting margins. Copay accumulators prevent manufacturer coupons...

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Open Source in Healthcare Is An Opportunity | Out-Of-Pocket
NewsMar 6, 2026

Open Source in Healthcare Is An Opportunity | Out-Of-Pocket

The author argues that open‑source software, a proven engine of innovation, is finally ready to disrupt the heavily proprietary healthcare IT landscape. By exposing code, licenses and community governance, open source can break the pay‑wall model that dominates clinical workflows...

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Real Talk if You’re Looking for a Job at a Health Tech Startup | Out-Of-Pocket
NewsFeb 11, 2026

Real Talk if You’re Looking for a Job at a Health Tech Startup | Out-Of-Pocket

The article offers candid advice for professionals targeting health‑tech startup jobs, emphasizing the trade‑off between flashy titles and actual compensation. It stresses the need for candidates to be opinionated, self‑aware of their performance level, and to leverage AI tools for...

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