2025 TGL Interview with Texas Medical Management

  1. What inspired the creation of your solution, and what industry gaps or inefficiencies does it address? 

Texas Medical Management (TMM) was born out of a desire to fix two of the biggest failures in healthcare: the hidden costs of surgery and the inability to identify true surgical quality.

My brother, a surgeon, and I saw how patients and employers are misled by appearances—glittery facilities and brand names—while the real driver of outcomes is almost always the surgeon. Incredibly, quality isn’t measured nor reported. Networks focus on access, not outcomes, and providers only report failure rates rather than patient outcomes.

We built TMM to change that. We use a validated system to vet surgeons and provide a white-glove customer experience.  Since 2018, TMM has collected patient-reported outcomes (PROMs) to monitor quality at the patient level and our patients have rated us 86 on the Net Promoter Score, well above the industry norm of 58.

It’s a fact, Healthcare is confusing; we guide patients with a dedicated team of surgical experts. And we attack unnecessary costs in every episode of care, partnering with quality surgeons to deliver transparent, bundled pricing with no surprise bills at competitive rates. 

In short, we built TMM to bring integrity, transparency, and quality to surgery—for the patient, the purchaser, and the provider.

  1. What are the most common pain points employers face that your solution helps resolve?

Employer health plans face three major challenges in all their healthcare purchasing, access to information on cost, quality and service. Texas Medical Management (TMM) addresses these with all-inclusive pricing, concierge level service and vetted specialists. 

TMM delivers affordable, quality surgeries in partnership with vetted surgeons and accredited facilities. Employers save approximately 50% on surgical costs thanks to our all-inclusive pricing—no surprise bills, ever.  This savings is often shared with plan members through incentives, eliminating member out-of-pocket costs.

For complex procedures that fall outside standard bundles, TMM offers Single Case Agreements (SCAs) nationwide. Managed by our experienced Clinical Operations team, SCAs create cost-effective solutions for high-cost, non-routine surgeries.  These costly hospital surgeries are often budget busters and hit stop loss specs.

TMM also provides personalized care navigation and dedicated account management, supporting employees through every step of the surgical process while reducing the administrative burden.  TMM works collaboratively with employer’s care navigation partners complementing their efforts and increasing scalability.

By offering TMM, employers actively manage costs, improve outcomes, and deliver a meaningful, high-value healthcare benefit that demonstrates care for their workforce.

  1. Why is it crucial for organizations to proactively tackle this issue, and what are the potential financial or operational risks of inaction?

Texas Medical Management (TMM) helps employers enhance the quality of plan member’s choices leading to improved patient outcomes and appropriateness of care.

Surgical care represents a significant portion of employer healthcare spend, accounting for roughly one-third of total plan expenditures. If left unmanaged, surgical procedures can lead to unpredictable costs, poor outcomes, and delayed employee recoveries—all of which strain budgets and productivity.

Texas Medical Management (TMM) helps organizations avoid these pitfalls by vetting surgeons to ensure employees receive high-quality care they deserve, eliminating the guesswork of choosing from a long provider list with no outcome data.

Additionally, TMM’s client services team supports patients throughout their surgical journey, removing administrative burdens and improving the employee experience. This leads to faster recoveries and quicker returns to work—key for preserving workforce continuity and morale.

Proactive employers that adopt a solution like TMM don’t just cut costs—they create a more resilient, efficient, and employee-centered healthcare strategy. Inaction, by contrast, means higher costs, lower quality, and increased operational risk.

  1. Can you provide real-world examples or case studies showcasing measurable success from implementing your solution?

Since 2018, Texas Medical Management (TMM) has collected Patient-Reported Outcome Measures (PROMs) and Net Promoter Scores (NPS) for every patient we serve. This commitment to tracking outcomes has given us a clear picture of the impact our bundled surgical solutions have on patients’ lives.  It also validates TMM’s proprietary surgeon vetting and focus on quality. 

Our data shows TMM patients experience substantial and consistent improvements in key areas:

These results are more than anecdotal—our historical Net Promoter Score (NPS) averages 87, significantly higher than the healthcare industry standard of 58. That score reflects patients’ likelihood to recommend TMM to others and serves as a strong endorsement of both our clinical outcomes and patient experience.

We define quality outcomes as the result of correct diagnosis, appropriate treatment, and successful treatment. Our approach ensures that patients receive the right care at the right time—delivered by vetted specialists at accredited facilities.

In addition to better patient outcomes and experience, TMM delivers significant financial value. Employers typically save up to 50% on surgical costs through our all-inclusive bundled pricing. These cost savings are often shared with employees through incentives, reducing out-of-pocket costs to zero for many plan members.

This level of satisfaction and improvement demonstrates that when surgical care is simplified, and expertly delivered, patients, surgeons and employers win.

  1. How does your solution differentiate itself in a crowded marketplace, and what feedback have you received from early adopters?

Texas Medical Management (TMM) differentiates itself by delivering guaranteed cost, better outcomes, and an unmatched patient experience—a combination few, if any, competitors can offer.

Unlike traditional networks that prioritize access over results, TMM contracts only with vetted surgeons and facilities that meet our strict standards. We track Patient Reported Outcomes (PROMs) and Net Promoter Scores (NPS) to ensure consistent, measurable quality. Since 2018, patients have rated us an NPS of 86, well above the healthcare average of 58.

TMM also sets itself apart through our strong Client Services team, which provides end-to-end care navigation. Patients aren’t left to figure things out on their own—we make the process seamless, from consultation to recovery.

Behind the scenes, our Clinical Operations team collaborates directly with physicians and providers to drive out unnecessary costs while maintaining exceptional quality. This results in surgical bundles that save employers approximately 50%, while improving outcomes.

Early adopters consistently cite our transparency, patient satisfaction, and ease of use as major advantages. TMM isn’t just a surgical benefit—it’s a smarter, more accountable healthcare solution.

  1. Are there specific trends, regulations, or market shifts making this issue more pressing for employers today?

“With rising insurance costs and stricter fiduciary regulations, inaction on surgical cost containment is no longer an option for employers.”

Absolutely. The rising cost of health insurance continues to be one of the biggest challenges employers face, especially as surgical care remains one of the most expensive components of a health plan. This financial pressure is compounded by new regulations, such as price transparency laws and fiduciary requirements under the Consolidated Appropriations Act, which demand that employers take a more active role as plan fiduciaries in managing and justifying healthcare spend.

At the same time, employees are expecting more from their benefits—greater value, simplicity, and better outcomes. This puts employers in a position where inaction isn’t just costly—it can also impact retention and morale.

Solutions like Texas Medical Management are timely because they directly address these pressures with transparent pricing, quality assurance, and proven cost savings.

  1. What key performance indicators (KPIs) or business outcomes should employers expect to improve after adopting your solution?

Employers who partner with Texas Medical Management (TMM) can expect to see meaningful improvements across several critical business metrics:

1. Reduced Healthcare Spend:
 TMM’s bundled surgical pricing model delivers approximately 50% cost savings per procedure vs. network outcomes, helping to significantly lower overall plan costs.

2. Better Employee Experience:
 Employees appreciate the simplicity, support, and transparency of the TMM experience. Employees also get quality care at zero out-of-pocket cost. 

3. Faster Return to Work:
 Our use of vetted, high-performing surgeons and comprehensive care navigation helps reduce complications and downtime—leading to faster recoveries and improved productivity.

4. Better Patient Outcomes (PROMs):
 TMM tracks Patient Reported Outcome Measures (PROMs) to ensure surgeries deliver real, lasting value—an uncommon level of accountability in surgical care.

By improving these KPIs, employers not only control costs—they elevate the employee experience, improve retention, and fulfill fiduciary responsibilities with confidence.

  1. What are some common misconceptions about your industry or solution, and how do you address them?

A major misconception is that less expensive surgery means lower quality. This belief persists among both patients and employers, who often assume that higher cost equals better care. In reality, inflated prices are typically the result of systemic inefficiencies—not superior outcomes. The biggest cost driver in surgery is the site of service, which TMM manages to the most cost efficient, not the one where it can bill the most, like most network hospital contracts. Our simplified model also reduces provider admin costs by more than 30%. At Texas Medical Management (TMM), we partner only with vetted, quality surgeons and track results using Patient Reported Outcome Measures (PROMs) and Net Promoter Scores (NPS) to prove that quality care can be delivered at significantly lower cost.

Another common myth is that offering a more affordable surgical benefit is difficult to implement and manage. After overcoming the initial differences, it’s often one of the most appreciated programs. When employees have a positive experience—marked by quality care, zero out-of-pocket costs, and personal support—they often share it with peers, creating a strong “water cooler” effect that boosts adoption and satisfaction.

To support this, TMM works directly with HR teams to craft effective employee messaging and education. We also attend company-sponsored events in person to ensure employees understand their benefit, ask questions, and feel confident using it when the need arises.

In short, we help employers break through outdated assumptions and deliver a surgical benefit that saves money, improves outcomes, and builds trust.

Condensed, possibly for sidebar:

Breaking Misconceptions: Quality Doesn’t Have to Cost More
 Many believe lower-cost surgery means lower quality—but Texas Medical Management (TMM) proves otherwise. Our simplified model reduces admin costs by 30%. By partnering with vetted surgeons and tracking outcomes through PROMs and NPS, TMM consistently delivers exceptional care at approximately 50% less. To build trust and awareness, TMM works directly with HR teams on employee messaging and even attends company-sponsored events to educate employees in person. Positive experiences drive word-of-mouth—making the “water cooler effect” one of TMM’s most powerful promotional tools.

  1. What advice would you give to employers who are hesitant about making a change in this area?

For brokers advising self-funded businesses, the question isn’t just about offering another benefit—it’s about driving measurable impact. How many programs have you seen that eliminate employee out-of-pocket costs, improve clinical outcomes, and still save the plan sponsor up to 50% compared to traditional network pricing? This model does exactly that.

The challenge? The traditional system resists change because it threatens entrenched revenue streams. But self-funded employers aren’t locked into the same structures—they have the flexibility to innovate. That’s where brokers can lead: by guiding clients toward solutions that prioritize value, transparency, and better patient experiences. 

Quality and experience drive plan success: increasing member engagement and decreasing plan costs. TMM does not charge a PEPM—plans only pay us when they use us.

Real change starts when you help them take that first step.

  1. Please provide direct quotes from leadership, clients, or industry experts to enhance the article’s credibility and depth.

“Our team has partnered with TMM for several years and has seen countless success stories. We’ve found that TMM genuinely prioritizes the patient experience, starting with how they vet surgeons and extending to the way their team engages with plan members. When our clients utilize TMM, we not only have confidence in the fair and transparent pricing, but more importantly, in the unmatched quality and outcomes they deliver.”

Rich Hejny 

Executive Vice President, Partner

CCIG

Texas Medical Management has been an integral partner for our clients.  Not only do we receive access to elite physicians at fair, transparent prices, but we know that the member's well being will be the priority — particularly when the appropriate course of action is NOT to perform surgery. The team at TMM is creative, and finds ways to manufacture great outcomes in ways that traditional care settings simply are not willing or not able to do.

Taylor Rogers 

Executive Vice President, Partner

CCIG 

Patient

All, 

I just wanted to take a moment to share my experience with TMM, specifically, Amie Moore.  Having always been the one to shy away from doctors and their insurances, I was incredibly surprised and grateful for having been placed into this plan via my employer. Everyone, including myself, has had bad experiences with insurance companies. Starting out in this most recent incident, I had no idea of where it was heading and I was quite literally being bounced from one surgeon to another. For reasons outside anyone's control, I went from one specialist to another. But at each step, TMM (Amie) had been in contact with me to arrange vouchers for each one of my visits. As such, I literally walked into the appointment and had the service provided at NO COST to myself. As stressed as I was with the condition that was in, it was amazing to just walk in, have the service performed and walk out.

Taking part in this program, I had learned that some providers simply didn't participate. All that meant for me was that I may have had to drive a little further than I wanted in order to receive the services needed and keep the cost to me at Zero. It was a no brainer. 

I then learned that due to TMM (Amie), I was brought into the care of Dr. Ra'Kerry Rahman. An absolute rockstar! It should be noted that his practice wasn't even part of the TMM network. But somehow, Amie managed to get him onboard and I was lucky enough to become his patient. His staff is stellar and he, himself, is just phenomenal.  I've never been more comfortable going into a surgery.

My procedure (ACDF) is done and I am now healing. But I cannot recommend more highly the use of TMM, Amie's constant assistance, and Dr. Rahman's expertise!

I extend to you all my sincerest thanks and my future recommendations.

Respectfully, 

GT Unterreiner

Patient

“We have about 1200 employees state wide. A couple of months ago I needed rotator cuff surgery. While I could afford to have it done pretty much wherever I wanted to I took advantage of our relationship with TMM and utilized the same Surgeon we send our employees to. Simply because I know how much attention they pay to quality. “

Joe III 

Patient/Client 

TMM’s All-Inclusive Price

All-inclusive healthcare pricing means your provider will charge one price for their services, which includes everything from the initial consultation to any additional tests or treatments necessary. This type of pricing is becoming more and more popular as it offers you predictability and peace of mind when budgeting for their care.

This model is a no-brainer for us at Texas Medical Management (TMM). As a surgical provider, it’s a win-win for our patients and us. TMM approaches healthcare from the patient’s perspective, as opposed to traditional providers, who are more concerned with who is paying the bill. Our goal is to make the experience easier for both patients and providers.

In this post, we’ll explore the benefits of all-inclusive care pricing.

What are the Benefits of All-inclusive Pricing?

For starters, all-inclusive healthcare pricing means you will no longer have to worry about being surprised by unexpected medical bills. With this pricing structure in place, your provider will inform you upfront of all the costs associated with a particular procedure or treatment, before you undergo surgery.

In addition to greater financial transparency, all-inclusive healthcare pricing can lead to significant patient savings. When providers know that they will be reimbursed for the full cost of care, they have little incentive to cut corners or skimp on quality. As a result, you can expect to receive high-quality care without having to pay exorbitant prices. 

Moreover, all-inclusive healthcare pricing can promote competition among providers. By forcing providers to publish their prices and make them available to you, all-inclusive healthcare pricing makes it easier for you to compare rates and choose the most affordable option.

How Does TMM Use All-inclusive Care Pricing?

We make all-inclusive pricing practical by bundling together services. By charging a flat fee for access to care, patients can save money on their overall healthcare costs. We achieve this without compromising on the quality of care.

When you see us for a surgical procedure, you will be billed for your entire episode of care, from when care began to when you are discharged, whether it is days or weeks later. 

Inclusive Healthcare Available in Texas

At Texas Medical Management, we publish our surgery prices on our website because we believe that healthcare requires transparency. We keep our prices low by ensuring that everybody pays the same price. There are no special discounts with companies or others. Simple and straightforward, as we believe healthcare should be.

Schedule an appointment with us today.

Transparent Pricing in the Healthcare Industry

Healthcare pricing can be hard to compare or even understand. But with recent efforts to increase pricing transparency, healthcare providers can now offer patients more accurate information on how much they are paying for their care. 

Texas Medical Management (TMM) has been offering transparent healthcare pricing since day one. We are committed to providing patient-centered care at reasonable prices.  We also have a roster of board-certified surgeons who provide knee surgery, tonsillectomy, hysterectomy, hernia surgery, and other services.

This blog article will look at transparent healthcare pricing, discussing why it is important and its implications for you.

What is the State of Health Care Pricing?

Healthcare costs are rising at an alarming rate. As a result, many Americans are beginning to question the current state of healthcare pricing and transparency. After all, how can we be expected to pay for something when we don’t even know how much it costs?

Unfortunately, insurance companies are one of healthcare’s biggest obstacles to transparent pricing. That’s because they typically reimburse hospitals based on a negotiated rate, meaning that patients have no way of knowing how much their care actually costs.

Furthermore, pharmaceutical companies have full autonomy when it comes to setting prices for prescription drugs, while some hospitals and other providers charge whatever they deem necessary. These and other factors contribute to the high healthcare pricing in the US.

Medical providers have an ethical and moral obligation to provide transparency for their patients. Patients are at a severe disadvantage in a system where prices are hidden. They need to find out if they are being charged a fair price for their care. Making prices transparent is a way to ensure that everyone involved in the healthcare system is acting in the best interest of the patient.

What are the Benefits Of Price Transparency?

In addition to being the right thing to do, pricing transparency has many benefits. When prices are transparent, patients can make informed decisions about their care. They can compare and shop around to find the best value for their needs.

Transparency in healthcare pricing also leads to competition, which can help drive down costs. When hospitals and other providers know that their prices will be compared side-by-side, they are incentivized to keep their prices competitive.

Finally, pricing transparency helps build trust between patients and providers. When you know that you are being charged a fair price, you are more likely to be satisfied with your care and less likely to feel like you are being taken advantage of.

Texas Medical Management offers bundled pricing, in which all the costs associated with a particular procedure (including surgeons’ fees, lab tests, etc.) are bundled together and paid upfront. This lets you know exactly how much you will be paying before surgery.

Transparent Health Care Pricing for Surgeries Available in Texas

Are you interested in getting a cash pay surgery that promises no surprise fees? Consult the team at Texas Medical Management. You may view our surgery prices online or call us at (512) 967-6238 for a direct quote. 

Book an appointment with us today.

The Benefits of a Bundled Cash Pay Surgery

The high cost of healthcare is a big problem for American families, and spending on health care is generally their most significant financial worry.

While most assume this is only a problem for the uninsured, that is often not the case. Almost one-third of insured Americans are concerned about their monthly health insurance cost; 44% are worried about their deductible before their health insurance kicks in.

There are a growing number of Americans who have opted out of insurance coverage by using a Health Share or by paying cash for healthcare needs. If you are among these brave souls, welcome to Free Market Healthcare. As you probably have found out, finding healthcare providers who offer quality surgery at transparent prices is not as easy as you might have imagined. A good place to start is always Google! If you would like a place to look through all your free market healthcare options, visit the Free Market Medical Association website: FMMA.org. In either case, you will find Texas Medical Management (TMM) listed. Alternatively, you can access our online price list to see our surgeons and facility partners at TexasMedicalManagement.com

Getting surgery can be expensive and scary. We often feel like there is an absence of available information when trying to shop for healthcare services. The most important information consumers need to know when deciding when and where to get surgery is the price and quality of healthcare delivered. Lucky for you, we keep track of both!

Quality is hard to come by in medicine, particularly surgery. According to BLIS, a company that underwrites surgical complications insurance, there is an extremely high correlation between the quality of the surgeon and the patient outcome: 0.94. With that in mind, TMM’s primary focus is in surgeon selection as our team has decades of expertise between them. It’s the most important thing we do for consumers.

Price is also incredibly difficult to know in advance. Our healthcare system is very opaque in terms of consumer pricing due to the cozy relationships that exist between medical device companies, big pharma, and health insurance companies, which as a group make up large healthcare systems. TMM has led the effort in transparently bundling prices, which give you an all-inclusive price for your care episode. We make it easy to compare the total cost to you between different surgical providers.

TMM offers bundled surgeries in many different fields, including orthopedics, general surgery, ENT, gynecological surgery, reconstructive surgery, pain management, and many more. This post will explore free-market surgery and its benefits.

What Exactly is Free Market Surgery?

Free-market surgery is when skilled surgeons and innovative business partners work together to give patients the best care possible at fair, bundled, and transparent costs. It is a model that stresses straightforward package pricing, transparency, and improved patient outcomes.

No unexpected costs with free market surgery

TMM and other free-market surgery providers combine all of the costs of a surgical episode into a single pricing that is displayed on our website. No unexpected invoices or other nonsense with upfront pricing.

The Type of Facility is Important

Hospitals are prohibitively expensive venues to seek medical attention. Hospitals are the best places to go when you require a high degree of care due to trauma, cancer, or an infectious condition because of their integrated health system and around-the-clock nursing. That doesn’t mean they are the best choice for surgery on bunions, gallbladder removal, or a complete knee replacement.

An outpatient surgical facility (ASC) is almost always a safer and significantly less expensive venue to get your care. TMM helps surgeons better understand hospital and ASC costs, driving better value decisions. ASCs are intended to be both safer and more cost-effective. They are safer because they restrict surgeries on individuals who are infected with infectious diseases.

They also do everything they can to make the process faster and cheaper for you by getting rid of any extra costs. They will make the greatest use of their highly qualified and experienced surgeons and other staff members while ensuring that the equipment and supplies meet the surgeon’s demands.

Insurance Companies Raise the Cost of Healthcare

Most people don’t know that surgical providers spend an average of 30% of their income billing and collecting from insurance companies. The process is often complex and necessitates using an IT department and a coding office to navigate successfully. To make matters worse, insurance companies only pay in part or refuse payment about 20% of the time.

The additional costs of billing and collecting late payments add to surgical providers’ financial burden. As a result, TMM does not need its provider partners to participate in complicated billing and collection processes. We pay provider partners quickly, typically three to four times faster than large insurance companies. TMM’s supplier partners offer low prices to clients by eliminating this expense of doing business. Because of how much money this saves, many procedures now cost less than insurance deductibles or out-of-pocket maximums.

Transparency in Billing is Practiced by Free Market Surgical Providers

Texas Medical Management and other free-market surgical providers post most of our pricing on our websites or can give surgical prices over the phone promptly. These rates are bundled, meaning they cover all of the costs of the surgical episode, including the surgeon consultation, surgery, and post-operative care.

That is, you will pay a predetermined and agreed-upon sum. Transparency exists in the free market, and its supporters urge you to compare their rates to those of others. Patient value competition (patient outcomes vs cost of treatment) is a good thing that will enhance care across the country.

Better Results, More Peace of Mind

We approach healthcare differently than most traditional physicians, who tend to be more concerned with who is paying than with the patient.

Our objective is to make the experience easier for both patients and doctors. This allows both patients and clinicians to concentrate on what matters most: the patient’s diagnosis and treatment, commonly known as the patient’s health result.

We care so deeply about patient outcomes that we collect patient-reported outcomes for every patient we treat. Because healthcare requires more openness and transparency, our rates are published on our website.

You not only see our pricing but also know that you pay the same price as everyone else. There are no special discounts with businesses or others.
Surgery is complicated, but understanding how much it will cost and how to pay for it does not have to be.

Transparent Surgery Costs in Texas

If you want surgery without surprise bills or hidden fees, look no further. Texas Medical Management partners with board-certified surgeons, facilities, and other providers to deliver affordable surgery in a wide range of specialties such as orthopedic surgery, general surgery, ENT surgery, gynecological surgery, spine surgery, and more.

Book your online appointment today.

Beginner’s Guide to Free Market Surgery

In preparation for surgery, your focus should be on improving your health, restoring function and reducing your pain.  Cost should not be your greatest worry, but often it is.  Furthermore, its nearly impossible to find data on surgeon quality and the true cost of surgery.  Costs are often astronomical and only after the surgery do you find out the bad news.  This situation has led to tragic circumstances.  According to a West Health-Gallup Survey, one in 8 Americans has to resort to borrowing to afford health care. The survey also shows that 65 million citizens reported a health issue but didn’t seek medical treatment due to cost.

When it comes to paying for your surgery, it’s important that you understand your options. Free-market surgery providers are one of the newer options and are gaining traction in the marketplace for their transparency, bundled prices and quality surgeons.  Bundled prices allow you to compare prices across different surgical providers and transparency means you don’t need to worry about surprise or unexpected bills. 

At Texas Medical Management (TMM), we offer bundled surgeries in many specialties including orthopedic, general surgery, ENT, gynecological surgery, spine surgery, urology, ophthalmology, reconstruction surgery, pain and much more. In this article, we’ll look at free-market surgery and how it benefits you.

What is Free Market Surgery? 

Free-market surgery refers to a collaboration between quality surgeons and innovative business partners to deliver the best care at affordable, bundled and transparent prices for patients. It’s a model that prioritizes simple bundled pricing, transparency quality, and better patient outcomes.

No Surprise Bills With Free Market Surgery

Free market surgery providers, like TMM, bundle all the costs of a surgical episode into one price that is published on their website.  Upfront pricing means no surprise bills or other shenanigans,

The Type of Facility is Important

Hospitals are very expensive places to receive care.  When you are faced with trauma, cancer or an infectious disease and need a high level of care, hospitals are the best place to go with their staff of highly trained specialists and around the clock nursing.  That does not mean they are the best place for your bunion surgery or your gallbladder removal or even your total knee replacement surgery. An outpatient surgical center (ASC) is nearly always a safer and a far more cost effective place to get your care. Ultimately, your surgeon will make the decision that is best for your condition. TMM helps surgeons understand the costs at both hospitals and ASC so that they are better able to make these important value decisions.  ASCs are designed to be safer and more cost effective.  They are safer because they do not allow operations to occur on patients who are sick with an infectious disease.  They are more cost effective because they are only open during normal business hours and do not need to hire a staff of highly trained specialists.  They also strive to make the process more efficient and cost-effective for you by eliminating all unnecessary expenses. They will make the best use of their highly trained and experienced surgeons and other staff members while ensuring that the equipment and supplies suit the surgeon’s needs.

Large Insurance Companies Make Healthcare Expensive

You may be wondering why a surgical provider, like TMM, offers only cash pricing and does not accept traditional large insurance company plans. What most people don’t know is that surgical providers spend on average 30% of their revenue to bill and collect from insurance companies.  The process is overly complex and requires an IT department and office of coders to properly navigate.  To top it off, insurance companies partially pay or deny payment nearly 20% of the time.  The extra cost to bill and collect and poor payment add up to a huge cost burden on surgical providers.  For this reason TMM does not ask its provider partners to engage in complex billing and collection routines and pays its provider partners fast, often 3-4 times faster than large insurance companies. By cutting out this cost of business, TMM’s provider partners offer great pricing that is passed along to its customers like you. This cost savings is so great that the cost of many procedures is less than insurance plan deductibles or out of pocket maximums.  If you have traditional health insurance or a Health Savings Account, you should check out free market surgery pricing.  It might surprise you that you can go ‘out of your insurance network’ and save $1000s.  If you have a health share or even no insurance, free market surgical providers are a good choice. 

Free Market Surgical Providers are Transparent with Their Billing

Texas Medical Management and other free-market surgical providers publish most of their prices on their websites or can quickly quote surgical prices over the phone. These prices are bundled, meaning that all the costs of surgical episode, from surgeon consultation, surgery and post-opeative care is included in the price.  That means you get a price that is fixed and agreed upon ahead of time.   Transparency is real in the free market and its adherents want you to compare their prices to others.  Competition on patient value (patient outcomes / the cost of care) is a good thing and will improve care across the land.

Unfortunately, most hospitals are unwilling or unable to quote prices and when they do, the quote is far higher than the free market surgical provider. Furthermore, it is unlikely they will provide a breakdown of the costs as this could lead to more questions. Opacity in pricing and quality has served these titans well and they will only reluctantly agree to do things differently.  Use your better judgement when choosing your care providers.  Would you choose to buy a house or a car from companies unwilling or unable to give you straightforward easy to understand prices? Then don’t do it with your surgical providers, do your diligences and find free market surgical providers like TMM.

Free Market Surgery in Texas

Texas Medical Management has been an advocate and practitioner of the free-market surgery model even before we officially opened our doors. We believe that disclosing prices from the get-go empowers patients with the kind of knowledge they need to make sound decisions.  When healthcare providers compete for patients business by providing high-quality patient outcomes at fair, transparent prices, patients win.

If you’ve been told by your doctor you might need surgery or you’ve been putting off having that old injury looked at by a surgeon, you ought to take a look at TMM’s fair and competitive surgical prices. We offer over 400 bundles or all-inclusive offerings tailored to your specific needs. Book your consultation online today. 

How We Help You to Avoid Surprise Bills

As healthcare costs continue to rise, patients are increasingly being hit with surprise medical bills. These are bills for services that they thought they had accounted for in their search for prices for care but turned out they hadn’t accounted for all the costs of their care. This can happen if you need surgery and you ask your surgeon how much it will cost. Your surgeon’s office will tell you a price, let’s say it’s $2.000. But what you don’t know, until you receive the ‘surprise bills’, is there are other costs for a surgery: facility, anesthesia, pathology, surgical assistant among others. And all of these services are generally offered by separate companies, meaning you get at least two additional bills besides your surgeon’s.

Unfortunately, many healthcare providers only disclose their fees and don’t educate the patient about the other costs associated with their care.  One 2016 study found that 20% of patients who sought medical attention at an ER within their health insurance networks incurred an average surprise bill of $622.55! In most cases, everyone except the hospital is out of network so you’ll get billed by the Emergency Medicine group, pathology, imaging, and more. 

To eliminate this insanity and reduce the extra burdens placed on patients,, Texas Medical Management created a new model where all the care a patient needs is bundled into one price. To do this, TMM contracts with all the other providers involved for a mutually agreed upon fee and pays them so the patients never receive a ‘surprise bill’.  TMM sees healthcare from the patient’s point of view, differently than most traditional providers who often seem more concerned with who is paying than the patient. Our vision is to simplify the experience for patients and providers alike. This allows both patients and providers to focus on what’s most important, the patient’s diagnosis and treatment, also known as a patient’s health outcome. We feel so strongly about patient outcomes that we measure patient reported outcomes on every patient we care for.  Our prices are published on our website because we believe that healthcare needs a dose of transparency. Not only do you see our prices, but you know you pay the same price as everyone else.  No specially negotiated discounts with companies or others.  Straight and simple, just like we think healthcare ought to be.  Surgery is complicated, but knowing how much it costs in advance and paying for it,  doesn’t have to be.  

How Do We Help You to Avoid Surprise Bills?

At Texas Medical Management we believe in being upfront and honest with you about your costs so that you can budget and plan for your surgery. Therefore, you need not worry about getting a huge bill you weren’t expecting.  Our price includes everything you need for a surgical procedure: surgeon (pre-op, surgery and post-op), facility, anesthesia, assistant surgeon, pathology, implants, sterile supplies, and specialized equipment.

Our surgical expertise gives us knowledge on how to identify quality providers and partner with them to reduce unnecessary or low-value costs.  We employ the following strategies to reduce costs and add value:

Quality Surgeons

As one would expect, the people who most often work with surgeons see the results and will have the most objective opinion about quality outcomes.  For that reason, surgeons, surgical nurses, surgical techs and anesthesiologists are by far the best source of information on the quality of any one surgeon. There is no substitute for first-hand knowledge.   For that reason, our team is led by an orthopedic surgeon with 25 years of experience, his clinical lead is a surgical nurse with 20 years experience and our board is composed entirely of highly regarded surgeons in several different specialties.   Our team’s decades of experience in surgery serve them well when vetting surgeons who want to partner with us.  The vetting process involves speaking with several providers in the surgeon’s community, especially those who have first hand experience working with them, and personal interviews with the surgeon candidate.  Once a surgeon has been approved, the board formally votes to admit them to our panel of highly qualified, mid-career, subspeciality focused surgeons.  Our experience in surgery has taught us that a good surgeon is often the difference between a good outcome and a bad one.  In fact, data indicates that the quality of the surgeon predicts the quality of the outcome 94% of the time.

Time-driven Activity-based Costing

This method allows us to attach a value to every minute spent during your procedure, aftercare and other aspects related to your operation. With these calculations, we are better able to pinpoint opportunities to be more resourceful. As a result, one of our main focus areas is determining the most appropriate site of service for your care. The cost of delivering care in a physician’s office, ambulatory surgery center, hospital outpatient department, surgical hospital and acute care hospital vary 100 fold.  That means you might pay $500 for a physician office fee vs $5,000 for an ambulatory surgery center vs $50,000 for an acute care hospital fee. If you need the more expensive, complex site of care, that’s what your surgeon will recommend.  In all cases, the surgeon will select the site that best fits your needs and doesn’t waste your money. We work with our physician partners to ensure you are in the most appropriate facility for the care you need. 

Bundled Payments

Another way we remove the guesswork for our patients is through bundled prices. These present you with a single, comprehensive price that covers all of the services you use during your surgery and aftercare.

With bundled payments, we do the hard work of understanding who your surgeon needs to be involved and what care they deliver to achieve the best outcome for you. To that end, we contract with all of the providers a surgeon tells us to in advance and establish that we will pay them a fair fee and fast, often within a week of your surgery. 

One way we save lots of money is by avoiding the complexities and costs associated with traditional insurance. You may not know this but surgeons spend 30% of their revenue to bill and collect from insurance companies.  By eliminating costs like this from our care model, providers and patients benefit. This helps us to keep our costs low, which in turn makes our surgery prices competitive.

Cost-Effective Facilities

We’ve partnered with accredited surgical facilities that deliver quality and cost-effective care. The value and the price of course translate to lower costs for you. 

While we commend other healthcare providers for finally taking a step in the right direction by giving patients the level of transparency that they deserve, they still have a long way to go in mastering the concept of value-based care. For us, it is all about being patient-centered. We’re committed to providing the best possible care for you, at a price you can afford.

Transparent Surgery Costs in Texas

If you are interested in a surgical procedure without surprise bills or hidden fees then look no further. Texas Medical Management partners with board-certified surgeons, facilities and other providers to offer competitive surgery prices across a broad range of specialties including orthopedic surgery, general surgery, ENT surgery, gynecological surgery, spine surgery and more. Book your online appointment today.

Need Surgery? Then You Need Help Finding Quality Surgeons

The decision to seek surgical treatment is not an easy one to make. There are so many things to consider – the quality of the surgeon and facility, the duration of the procedure, the recovery process, pain and, if you can find it, the cost of the surgery,  just to name a few. At the top of your list of concerns should be the overall quality of the surgeon. Unfortunately, this information is not readily available, at least not to the untrained eye.

Obviously, not all surgery providers are created equal. According to BLIS, a company that underwrites surgical complications insurance, surgeons are by far the most important person in achieving a quality surgical outcome. How much? It’s not even close! The quality of the surgeon is 30X more important than the next most important person, the anesthesiologist.  And quality can have a big impact.  According to an analysis by Consumers’ Checkbook, the mortality rate among patients who underwent heart valve and bypass surgery was 11%  for poorly rated surgeons versus 3% for their most sought-after colleagues.

The problem is, that it’s not easy to find data on surgeon quality.  And what you might find is based on Medicare claims which are often skewed towards surgeons who operate on Medicare age patients.  Then what is the best way to find quality surgeons?  It turns out the best way to find out this information is to ask other surgeons and anesthesiologists.  As you might guess, not many people have access to these people.  So where do you turn?

At Texas Medical Management (TMM), our surgeon CEO and board peer-select, board-certified surgeons to give you the best outcomes possible.  Below we dive into what all this means technically.  What you should know is that quality is at the center of everything we do.  And to that end, we don’t stop with the selection process.  We continuously monitor our surgeons for quality by collecting Patient-Reported Outcomes from every patient: first, prior to their consultation with the surgeon; next, at 120 days; and lastly, at 365 days.  Our surgeons love this type of feedback which they do not get from anyone including insurance companies.  

We understand that getting a surgical procedure requires careful thought. In this article, we will highlight some indicators of a good surgeon.

A Qualified and Experienced Surgeon

Our surgeon CEO and board lead the selection and vetting of all our surgeons.  Because of their quality and reputation, we also pay our surgeons several times more than insurance companies.  Rewarding surgeons for their quality is important to us. Here are a few basic data points that can help you select a good surgeon: 

An Accredited Facility for Surgical Procedures

Surgery is a team sport and the facility is important to the degree that it has the proper equipment and people to assist the surgeon.  Most facilities obtain accreditation to validate their capabilities with regard to following well-established processes and hiring and training the right personnel.:

Transparent Surgery Prices

Unfortunately, healthcare pricing is far from transparent even today. As you shop around for the best price, you will find it difficult for any one person to give you a price for their part, much less an all-inclusive price.  Healthcare is a fragmented industry; in most cases, the surgeon, facility and anesthesia are in separate organizations and each bill for their services.  Additionally, there are often people in the ‘operating room’ you are not aware of until you start to receive their bills.  In this category are surgical assistants, pathology or surgery monitoring personnel.   As of January 1, 2022, by law, all facilities must provide you with a ‘good-faith’ estimate of the cost of your procedure.  However, that is only for the facility; you still need to ask for the same information from your surgeon and anesthesiologist.  

Due to the nature of insurance and how they contract with healthcare providers like surgeons, most providers are not prepared to calculate and give you pricing for surgeries or episodes of care.  Thankfully, there is positive movement in this direction with the No Surprises Act and other legislation passed since 2019 requiring transparency in pricing.  In the meantime, patients should always ask for a ‘bundled price’ which is another way of saying ‘all-inclusive’.  If you want to be sure you are getting an ‘all-inclusive’ price for your surgery, call us at Texas Medical Management.  We publish 100+ bundled surgeries on our website, TexasMedicalManagement.com, and we have another 300+ bundles we have created with our quality surgeon and facility partners.   There are other providers around the country who publish their bundled surgery prices, one place to find them is the Free Market Medical Association website, FMMA.org.  

Surgeons in Texas

Finding board-certified surgeons and accredited facilities is not hard to do, as most surgeons practicing and surgery facilities fulfill those requirements.  That begs the question, how do you find the quality providers in a crowded marketplace?  The answer – come to Texas Medical Management where our surgeon CEO and board of directors have vetted and personally interviewed each and every surgeon and facility prior to partnering with our company.  We offer competitive surgery prices for quality services for orthopedic, general surgery, ENT, gynecological surgery, spine surgery, urology, ophthalmology, reconstruction surgery, pain and much more. Schedule an appointment with us today.