The thinking behind what we're building — an integrated payvidor that both pays for and delivers care, growing into a level-funded plan — and the free offer that comes with it, for a small group of brokers. Coordinated care comes first; everything else follows from it.
The big carriers compete on network size and rate cards — never on how care actually happens. Meanwhile employers with 50+ lives absorb 30–40% renewals on fully-insured, BUCA-style plans that quietly fail them: no real visibility into spend, no leverage, and a member experience that leaves employees to fend for themselves. The status quo isn't working, and everyone in the room knows it. The question is what actually replaces it.
The industry frames everything around networks. We think the real divide is whether anyone is coordinating a member's care — or whether that burden has quietly become the member's problem. Four ideas drive the build.
Care built on one connected relationship — a physician and a team sharing a single picture of the member. Coordination is the foundation, not a point solution stapled onto a PPO.
One place a member starts for anything health-related — a symptom, a referral, a new diagnosis. The plan routes and resolves it, instead of handing out a directory and a phone number.
Navigating a fragmented system — the calls, prior auths, follow-ups, dead ends — is the plan's job, not the member's. That's what members feel, and it's what changes utilization.
Sandbar stays on the member's side across the entire clinical journey — routine care, a serious diagnosis, a second opinion — not just the parts that are easy to automate.
One well-known model proved that integrating and coordinating care drives better outcomes at lower cost — but it can leave members feeling locked into a single system. Another proved that smart financial incentives steer people toward better choices — but it can leave them navigating an app and second-guessing their own doctor. Sandbar takes the strengths of both: a named doctor as your front door, plus a benefit design that keeps care inside a tier-one model — without locking anyone into one facility.
Every piece exists somewhere in the market already. The integration is what doesn't — and it's why coordinated care actually holds together here.
Different architecture, not better features. Every piece exists elsewhere — the integration does not.
It starts with the primary care relationship. A Sandbar PCP who knows the member steers referrals to the right, cost-effective specialists at the right time — instead of members picking blind and landing on the most expensive option by default. Fewer avoidable procedures, fewer ER visits, fewer dollars leaking out of the plan. The big carriers compete on rate cards; coordinated care wins on utilization. Get the care model right first, and the economics follow.
The pilot is the care-delivery half. The other half is the payer: Sandbar is built as a payvider — one entity that both delivers care and pays for it, growing into a level-funded, integrated plan. Get the care model right first, and the economics follow from it.
Concierge primary care and coordinated navigation — the clinical relationship that changes utilization.
A level-funded, integrated plan that builds on the same foundation — so care and coverage answer to one team.
The care comes first; the plan follows from it.
Built in the DMV. Funded for the build. Worth a 30-minute conversation.