The same care costs 2 to 20 times more across town. Nobody can see it. We can.
Nine findings. The deeper you dig, the more it just makes sense.
Costs grow at twice the rate of inflation.
Healthcare costs have compounded at roughly 2× general inflation for decades. The consequence is personal: healthcare bills are the number-one cause of personal bankruptcy in America.
Consolidation raised prices 40–50% — with no quality gain.
Hospital and physician-group consolidation pushed prices up dramatically. Quality didn't follow. Market power did.
Transparency alone isn't enough.
The tools show fee schedules — thousands of incomprehensible line items — not all-in prices for an actual course of care. Only 2% of patients use them.
The same care costs 2–20× more across town. Quality correlation: zero.
Within one metro, for the same risk-adjusted episode, the gaps are multiples, not percentages — and higher cost is not correlated with better quality.
Oxbridge analysis of 8.2 million risk-adjusted commercial episodes, 135 episode types, four Texas metropolitan areas (working paper, June 2026).
It's the only industry that refuses firm, upfront prices for plannable services.
You'd never buy a car, hire an attorney, or fix a roof on an open-ended estimate settled months after the work. In healthcare, that's the standard arrangement.
The episode is the unit where the variance lives.
So it's the unit where cost can be measured, priced, guaranteed, and managed. Assemble the full journey into one unit and the invisible becomes a number.
Proven at national scale.
Remedy Partners managed over $7B per year in Medicare bundled payments — the largest such program in U.S. history. Medicare itself is moving to episode accountability with the CMS TEAM model.
One team. 45+ years. 12+ companies. The same problem.
You're not alone.
Medicare is already running episode-based payment at national scale. The Transforming Episode Accountability Model (TEAM) is live today — hospitals and physician groups across the country are signing up for bundled episode accountability.
And in 2028, CMS launches the CARA program (CMS-Administered Risk Arrangements) — a new, massive nationwide initiative integrating bundled payments into the ACO framework. Providers are already planning for it. We will be in the middle of it.
Episode-based payment isn't experimental. It's where the entire system is headed.
Episode Advantage Health Plans fill the competition vacuum.
Patients become market participants — comparing real, guaranteed prices before care. Efficient physicians get rewarded with informed volume. Competition starts doing what competition does everywhere else.