Decent May 2019 update

Decent updates

Most large U.S. employers self-insure, saving up to 30% on healthcare costs. Decent helps self-employed people band together for similar savings.

We’re solving a big problem for direct primary care (DPC) doctors.

Decent’s wraparound health plans put direct primary care (DPC) at the center: members get unlimited primary care included in their monthly premium. DPC restores the doctor-patient relationship at the heart of healthcare, supporting happier patients, happier doctors, and better and more cost-effective health outcomes. DPC doctors get paid to keep patients healthy, not to pack 10 minute appointments with lab test orders and referrals to specialists. They’ve joined the DPC movement to reject the churn-and-burn fee-for-service model driving healthcare cost escalation in America. And they believe, as we do, that DPC is the future of health.

But today’s DPC doctors have a problem. Most want their members to have insurance as a backup — in case they get hit by a car. But traditional insurance plans include fee-for-service primary care and don’t cover DPC membership. So DPC members have to “pay twice” for their primary care coverage, or go without insurance and risk financial ruin. And for DPC doctors who would prefer to quarterback their members’ care, sending members out alone into the mess of healthcare outside the DPC office feels like putting them on field without a play.

Decent presented our model to 300 DPC doctors at the Hint Summit and got clear validation that it solves their problem. Please watch my presentation here, or below.

After the event I got >50 emails from DPC doctors around the country who want to work together, including Garrison Bliss, the godfather of the DPC movement. Here are some of the things these visionaries had to say:

  • “It was great meeting you Nick. Everyone in the DPC community is sitting on the edge of their seats for you to expand into their area. Let us know if there’s anything we can do to help you and Decent in any way. Thanks again for all your amazing work!”
  • “Great to hear all the amazing things you are doing at Decent, Nick! I enjoyed hearing your passion for making a difference.”
  • “I would be interested in talking further when you get to California. The broker and employer community here expressed tremendous interest in this DPC/wrap model.” … “I’m definitely interested when you get to Arizona.” … “We would of course love to work with you guys to get your product into the Oregon market.” … “MICHIGAN” … “I am in NY. Get it in here!!” … “Please add me to your wait list — especially for Central FL.” … “Get us on the list. We are in Utah” … “Let us know when you are able to move into the Ohio, Kentucky or Indiana markets.” … “Absolutely interested and ready to be a big pitch guy for you here in the Peach State.” … “We would love to have y’all in the DFW area!” … “Excited about the work you are doing. Unlikely that you will ever come to our part of the world — rural Colorado — but keep up the good work.”

We’re solving a big problem for health insurance brokers.

Health insurance brokers sell >80% of individual and group health plans in America, and Decent is partnering with them as our primary sales channel. They are licensed, trusted professionals who help individuals, groups, and companies find the right plans.

But today’s health insurance brokers have a problem. Most don’t have any viable options for self-employed people. Brokers who serve individuals want better and more affordable plans. Brokers who serve groups and companies want plans that will accept independent contractors (1099s). And many of these same groups and companies even want to contribute to 1099s’ monthly premiums to build loyalty and take care of their people. The need is large and growing: by many estimates, more than half of American workers will have worked as independent contractors by 2027.

Decent is the solution brokers can offer for this surging demographic. We have already partnered with 15 brokers, including top online broker KindHealth based in Austin, Texas. One broker already helped a top independent real estate firm in Austin choose our plans as the recommended option for its >500 self-employed real estate agents, and we are in conversations with many other brokers, companies and groups that work with and for self-employed people. When we asked a large group broker if he needed more information to help his team sell our plan, he replied,“I told them we now have a solution for 1099s. What more do they need to know?”

broker flyer

We’re solving a big problem for self-employed people.


Stuff in red boxes is done by our team. Stuff in green by DPC doctors. Stuff in blue by tech partners.

  • Based on feedback from members and brokers, we’re bringing Austin’s must-have facilities and specialists in-network, and launching a new lower-premium bronze-level plan soon. Stay tuned for Pathfinder
  • We paid our first claims. This was a huge milestone— kudos to Mike and the dev team who built our product, to Ryan and Charlie who run operations and CS, and to our launch partners Costco and Hint who helped make this a seamless experience for the members we serve.
  • We have now “seen every part of the roller coaster.” In one year, we’ve received regulatory approval to operate; built a network of physician partners; designed, priced, and marketed a plan; enrolled members and taken payment; provided excellent customer service; and processed claims. Now all we have to do is do it bigger and better! To get a more visual sense of what this means, see below. It’s a lot.
Stuff we do
  • Stuff in red boxes is done by our team. Stuff in green by DPC doctors. Stuff in blue by tech partners.
  • We’re all excited about the future — open enrollment and beyond. With that in mind, I wrote about how Decent will use blockchain. TL;DR: “To align incentives and reward smart choices; to make price and quality data transparent; and to cut waste and take the middlemen out of health insurance. … Decent is a healthcare company using blockchain, not a blockchain healthcare company: in fact, members will be able to use Decent without needing to understand or even think about blockchain.” As always, we use technology in service of our members

Thank you, and how you can help 🙏

  • Please tweet this (personalization is welcome). 🙏
  • Based on market feedback so far, we believe we are in the early stages of building something that will help a lot of people. One broker told us his personal goal is to bring 3,000 1099s onto our plans in the next year from a single deal he’s working on. Another went deep on the advantages of our model and then wrote this in an unsolicited email: “Decent is going to upend, and eventually dominate the health plan market in the USA.” We know we still have a lot of work to do, and we appreciate our community’s support. Thank you. 🙏
  • We anticipate kicking off fundraising in Q4. We’re drawing up a short list of potential Series A leads and would welcome your thoughts. 🙏

Thanks for reading,Nick and the Decent team

Thanks to Molly Moore, Marshall Darr, Suzanne Scharlock, Shine Lee, and Richard Luck.

Welcome to Decent: a new kind of health plan.

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