MedMerge

Independence is not failing.
It is under-structured.

MedMerge is the coordination infrastructure for independent medical practices, integrating risk, capital, employer access, and operational intelligence without requiring consolidation or loss of ownership.

Currently coordinating independent groups across multiple states.

1,000
Facilities
$4.2B
Aggregate Premium
$1.6B
Aggregate Payroll
$840M
Captured Float

Consolidation is not a talent issue. It is a structure issue.

Dimension Alone Coordinated
Tax Identity 1 Tax ID 10,000 Tax IDs
Purchasing Power No leverage Aggregated purchasing
Insurance Pricing Retail pricing Institutional pricing
Risk Capital No float Captured risk capital
Employer Access Excluded from direct contracts Coordinated network contracting
Operational Data Practice-level visibility Collective intelligence

If selling is your only strategic option, your structure is incomplete. The gap is not clinical. It is not operational. It is structural.

Without coordinated infrastructure, selling becomes rational.

That is not a failure of will. It is a failure of structure.

Institutional systems compound. Independent groups operating alone do not. Every year without coordinated infrastructure widens the gap.

1,000
Facilities
Independent practices coordinated under a single infrastructure layer
$4.2B
Aggregate Premium
Total premium volume creating institutional purchasing power
$1.6B
Aggregate Payroll
Coordinated employment infrastructure across the collective
$840M
Captured Float
At retail scale, margin compresses. At coordinated scale, margin compounds.

Modeled at 1,000-facility scale.

Most independent groups believe they are losing to hospitals. In reality, they are losing to structure.

They sell because infrastructure pressure erodes negotiating leverage, capital reserves, and employer access over time. Independent groups remain independent when four conditions are met.

I
Risk Coordination

Pooled risk across hundreds of practices creates actuarial credibility and captive insurance economics that no individual practice can access alone.

II
Capital Retention

Premium dollars, underwriting surplus, and float returns stay within the physician collective rather than transferring to commercial carriers.

III
Direct Employer Access

Independent practices contract directly with employers as a coordinated network, bypassing intermediaries and competing with hospital systems for covered lives.

IV
Operational Intelligence

AI-driven analytics across the collective surface patterns in claims, utilization, and cost that individual practices cannot see or act on independently.

Without these, consolidation becomes rational. With these, independence becomes competitive. MedMerge restores structural leverage.

Tier 1
Operations
  • Compresses administrative work across coordinated practices
  • Standardizes execution without requiring centralized control
Tier 2
Intelligence
  • Surfaces patterns in claims, utilization, and cost across the collective
  • Reveals service-line economics invisible to individual practices
Tier 3
Strategy
  • Scenario modeling for payer cuts, labor shocks, and rate compression
  • Direct employer pricing models that bypass intermediary networks

A typical independent medical facility with 50 employees. Their annual insurance and benefits expenditure reveals a structural disadvantage that compounds every year.

Expense Category Independent MedMerge
Employee Health Benefits $750,000 $525,000
Medical Malpractice $400,000 $280,000
Property & Casualty $200,000 $140,000
Workers Compensation $100,000 $70,000
Cyber, D&O, EPLI, Other $150,000 $105,000
Total Annual Spend $1,600,000 $1,120,000

Based on typical independent practice vs. coordinated purchasing economics. Actual savings vary by specialty, geography, and claims history.

Model your practice ↓

Your premium is someone else's investment portfolio.

When you pay an insurance premium, that money enters a pool. The carrier pays claims, covers expenses, and keeps the profit. But there is a fourth dynamic most people never consider: the float.

The float is the pool of premium dollars sitting between collection and claim payment. While it waits, the carrier invests it. Warren Buffett built Berkshire Hathaway on this principle. Every practice that pays premiums is funding someone else's float.

MedMerge redirects the float back to the physicians who created it.

Where Your Premium Goes
You pay annually $1,600,000
Carrier pays claims 65%
Carrier keeps the rest 35%
What you retain $0
With MedMerge, you retain $320,000+

How do your practice's economics change under coordinated structure?

Enter your total annual insurance & benefits spend

Include employee benefits, malpractice, P&C, workers comp, and all other lines.

10-Year Total Paid
Premiums paid to commercial carriers over a decade
Carrier Profit Captured
Estimated profit + float returns earned on your money
Annual Savings with MedMerge
Rate savings + retained captive surplus
10-Year Value Recaptured
Total savings + surplus + float returns retained
That could fund

Operating coordination structures across independent physician groups nationwide.

Executive
Dutch Rojas Founder
Chuck Foster Head of Operations
John Behles, JD General Counsel
Physician Partners
James McAtee, MD Physician Partner
Hank Doering, MD, FACS Physician Partner
Trevor Gaskill, MD, MBA Physician Partner
Paul Slosar, MD, MHCDS Physician Partner
Seven-figure annual capital redirection demonstrated across hospital and multi-physician group settings. Institutional economics achieved at independent scale. Structure replaced retail exposure. Practices retained full ownership, full autonomy, and full clinical independence. Currently coordinating independent groups across Louisiana, Oklahoma, Kansas, and Arizona.
Q1 2026 — 14 new facilities onboarded across 4 states

Determine whether your structure is durable.

Your personalized Practice Economics Report shows exactly where your premium dollars go, and what changes when they stay.

Confidential. Personalized. No obligation.

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