Questions we hear from practices like yours.
What MedMerge Is
What is MedMerge?
MedMerge gives independent medical practices the benefits, payroll, and HR infrastructure of a large employer. Lower healthcare costs, self-funded benefits, claims transparency, and access to the Friends & Family network where your employees get care at cost. One platform, one point of contact.
You keep your practice, your name, and every clinical and operating decision. Nothing changes for your patients. What changes is what you pay for benefits and how much control you have over the plan.
Why do independent practices pay more for benefits?
Because they are small. Not because they are inefficient.
A 12-person practice and a 12,000-person health system buy the same things: health benefits, workers' compensation, payroll, HR. According to industry surveys, large employers typically pay 25 to 40% less for substantially the same coverage. Large employers self-fund and control where their employees get care. Small practices buy fully insured coverage at retail and send their employees into a network priced for someone else's margin.
We call this the Independence Tax. It is structural, it compounds every year, and it is the economic pressure that pushes practices toward private equity or hospital employment. MedMerge gives independent practices the cost structure of a large employer without asking them to sell, merge, or give up ownership.
How does the structure work?
Your employees join the MedMerge employing entity alongside every other member practice. That is what puts a small practice inside a large group and unlocks self-funded benefits regardless of size.
You keep complete operational control: hiring, firing, scheduling, compensation, clinical decisions, and how you run the business. MedMerge handles the infrastructure underneath: benefits administration, payroll, tax filings, HR compliance.
Do I lose control of my practice?
No. MedMerge does not take equity, does not take a board seat, and does not touch clinical operations. You decide staffing, scheduling, compensation, clinical protocols, payer strategy, and how you run the business.
What size practice can use MedMerge?
Any independent medical practice from one employee up. There is no minimum. The platform is designed for practices under 150 employees, though we work with larger groups as well.
How It Lowers Costs
What is the difference between fully insured and self-funded?
Control.
In a fully insured plan, a carrier sets your rates, writes your plan design, decides your network, and tells you very little about where the money went. Every renewal is a number you did not choose and cannot challenge.
In a self-funded plan, the plan pays claims directly. Plan design is built for the people on it. Claims reporting shows where care is going and what it costs. Large employers have run this way for decades. Small practices were locked out because they could not carry the risk alone. MedMerge is how an independent practice makes that move.
What is the domestic network?
Your own people receive care at your own facility. The plan pays your actual cost of delivery, and your employee pays nothing out of pocket.
Two things happen at once. Plan expense drops, because the plan pays cost instead of retail. And the care, the relationship, and the revenue stay inside your practice instead of going to a competitor or a hospital system.
What is the Friends & Family network?
When a plan member receives care at another member practice, the plan pays that practice its actual cost of delivery, not the retail rate. A knee injection billed at $900 retail that costs $275 to deliver is paid at $275. No copay, no deductible, no coinsurance.
These are structural savings, not negotiated discounts. Every practice that joins adds services the network can deliver at cost. The more specialties inside the network, the more care stays inside it, and the lower plan expense goes for everyone.
Where is the network available?
The platform serves practices nationwide. The domestic network is available everywhere, because it is your own practice. The Friends & Family network is live in four markets: Phoenix, Dallas, Manhattan (Kansas), and Tulsa.
Can members still see doctors outside the network?
Yes. The domestic and Friends & Family networks are the lowest-cost option, not the only option. Care outside them is covered under the plan's standard terms.
What happens if we have a catastrophic claim?
Your practice does not carry it alone. Claims are paid from the plan, not from your practice's operating account. Above a set threshold, specific stop-loss coverage pays the excess. Aggregate stop-loss caps total plan claims for the year.
Does MedMerge include dental, vision, life, and disability?
Yes. Dental, vision, life, and disability coverage are all included alongside your medical benefits. Your employees get a complete benefits package through a single platform.
Cost and Service Levels
How much does MedMerge cost?
Pricing depends on your employee count, the claims profile of your workforce, and the service tier you choose. Every quote is built on your actual numbers, side by side with what you pay today.
The comparison that matters is total cost: what you spend now on premiums, payroll services, HR, and compliance, against what you spend inside MedMerge. Contact us for a practice-specific quote.
What is included in every tier?
Every tier includes the single employer structure, self-funded health benefits, access to the domestic and Friends & Family networks, payroll processing and tax filing, and employment compliance. Tiers differ in how much HR and talent support comes with it.
Do I need Tier 3 to get healthcare benefits?
No. The benefits are identical in every tier. Tiers change the HR service level, not the coverage your people receive.
Implementation
When can we join?
Anytime. Fully insured plans are written month to month, so you do not have to wait for a renewal date to leave your carrier.
How long does implementation take?
90 days. That covers benefits underwriting, payroll and HR setup, open enrollment, and the move of your employees to the MedMerge employing entity.
What happens to our current benefits plan?
It ends on the day MedMerge coverage begins, timed so there is no gap in coverage. If you are fully insured today, the transition is clean: you give your carrier notice, your old coverage stops, MedMerge starts.
What changes for our employees?
Less than you would expect. Their manager, their schedule, their job, and their paycheck timing stay the same. What changes: their W-2 comes from the MedMerge employing entity, they complete standard new-employer paperwork, and they enroll in new benefits during an open enrollment we run with them. They also gain care with no out-of-pocket cost at your practice and across the Friends & Family network.
What if we want to leave MedMerge?
You can. Your employees transfer back to your practice's direct employment, and we coordinate payroll, benefits continuation, and records so the transition does not interrupt anyone's paycheck or coverage.
Definitions
Single Employer Platform
A structure where your staff joins a single employing entity for purposes of payroll, tax filings, and benefits administration. Your practice keeps full operational control over hiring, firing, scheduling, compensation, and clinical decisions.
Fully Insured Plan
A health plan where you pay a fixed premium to an insurance carrier. The carrier assumes the risk, sets the rates, designs the plan, and keeps any surplus if claims come in low. You have limited visibility into claims data and no control over plan design.
Self-Funded Plan
A health plan where the employer funds claims directly rather than paying premiums to a carrier. The employer controls plan design, owns claims data, and benefits from lower plan costs when claims are managed well. Stop-loss insurance protects against catastrophic claims.
Stop-Loss Insurance
Coverage that protects a self-funded plan against unexpectedly high claims. Specific stop-loss covers individual claims above a set threshold. Aggregate stop-loss caps total plan claims for the year.
Domestic Network
Your own practice serving your own employees. The plan pays your actual cost of delivery. Your employee pays nothing out of pocket. Plan expense drops and the care stays in-house.
Friends & Family Network
The network of MedMerge member practices. When a plan member receives care at another member practice, the plan pays that practice's actual cost of delivery, not the retail rate. No copays, no deductibles, no coinsurance for services inside the network.
Still have questions?
Request a demo and we will walk through how MedMerge works for your practice.