Carl C. Schuessler Jr., DHP, DIA, GBDS
Managing Principal / Population Health ManagerMitigate Partners
carl@mitigatepartners.com
404.941.5519
Health Rosetta Advisor since 2017
Carl is the founder and managing principal of Mitigate Partners, a risk-management, cost-containment and benefits consulting firm, which is a partnership of 29 employee benefit consulting and brokerage firms that allows local management within a collaborative environment. Over his three decades in the industry, Carl has pioneered the fiduciary approach to benefits advisory services and developed his proprietary FairCo$t Health Plan, which provides best-in-class benefits at substantially lower costs. A founding Health Rosetta Charter Certified Advisor and accomplished speaker and author, Carl has been nationally recognized for his pursuit of employer-built healthcare to replace the archaic insurer-built system.
DeSoto survived Hurricane Ian due to the leadership sleeping at the hospital for two weeks straight and keeping the doors open. They didn't miss a beat after the massive flooding in Arcadia, FL. Vince Sica, CEO, won the Florida Rural Healthcare Administrator Hero in November 2022 - https://vimeo.com/768670834/8c4e39b5b6. This case study has been featured by Patient Rights Advocate https://www.youtube.com/watch?v=b26Ej9LWYHE&feature=youtube and https://www.youtube.com/watch?v=U24-ltQTaHQ&feature=youtube, and this case study has been shared by us, sometimes with our clients. Here are just a few examples:
–April 27, 2023 – Benjamin Rush Institute – Preserving the Doctor-Patient Relationship.
–December 2, 2022 – I was a guest on the podcast Direct Primary Care Benefits with Brett Shoemaker. Carl Schuessler, Jr., Mitigate Partners Managing Director, talks "Employer-Built Health Plans,” – Episode 12.
–November 10-12, 2022 – 5th DPC Nuts and Bolts To 2.0 – Dallas, TX
–November 2, 2022 – Mitigate Partners' The Gasparilla Inn & Club Case Study and DeSoto Memorial Hospital Case Study are featured in Dave Chase’s new book. “Health Plan Heroes: The CEOs Who Restored the American Dream.” Mitigate Partners’ Case Studies are featured on the following pages – The Gasparilla Inn & Club Case Study (see pages 37-42) and DeSoto Memorial Hospital Case Study (see pages 112-120).
–May 25, 2022 – Becker’s Payer Issues featured Mitigate Partners' Advisor Cristy Gupton and several of Mitigate Partners’ clients, DeSoto Memorial Hospital and Lakeland Automall. “Are Employer-Built Health Plans One of the Best-Kept Secrets in Insurance?”
–April 5–6, 2022 – Florida Rural Health Association (FRHA) 26th Annual Rural Health Educational Summit – Gainesville, FL.
–November 18, 2021 – The Free Market Medical Association Houston Chapter (FMMA) in Houston, TX – Tony Dale, M.D., Founder of Sedera, and Carl Schuessler speak on “Case Studies of Employer-Built Healthcare – How to Actively Manage Your Health Plan.”
–August 5 – 7, 2021 – Free Market Medical Association (FMMA) 2021 Annual Conference – Dallas, TX
–October 28, 2020 – Healthcare Americana Podcast via Zoom; #62 - Carl Schuessler: Embracing Direct Care Benefits
–August 14, 2020 – Florida Rural Health Association Summer Educational Series – Webinar. FRHA Summer Educational Series: “DeSoto Memorial Hospital Case Study of How a Rural Florida Hospital with 157 employees saved $1.2 Million, 54%, in their Healthcare Spend & Improved Clinical Outcomes in One Year.”
–November 15, 2019 – DPC Nuts & Bolts to 4.0 - Orlando, FL. “How DPC Works with Self-Funded Health Plans – A Real Case Study of DeSoto Memorial Hospital, a Rural Hospital.” “DPC 2019 Panel 03 - Case Studies of DPC working with employers.”
- Industry: State Hospital District - Governmental, County
- # of Employees: 220
- Location: Florida
PlanSponsor_Dividend: DeSoto Memorial benefits included:
–Hired first full-time surgeon in county history, with first year savings of $1.2 million, or 54%
–DeSoto was able to reinvest the dividends saved through the health plan into lowering employee contributions and improving plan benefits and member experience, a fundamental component of our FairCo$t Health Plan.
“The less we have to spend on the plan, the more we are able to put back into salaries, back into maybe additional benefits or [toward] increasing benefits.” –Lois Hilton, HR Director, DeSoto Memorial
- TPA: Aither
- PBM: Ventegra
- Stoploss: Skyward
- PrimaryCare: XXXX
- Individual Stewardship: Yes to both - 1/1/19 DeSoto also added a medical advocacy program which identifies the right appropriate doctor and/or provider and directs members to those providers with top quality outcomes at the appropriate price and at the right time of the member’s medical journey. This advocacy program not only eliminates waste inherent in the system, but it also improves the experience of the member while reducing overall costs.
- Other Solutions: Chronic Kidney Disease Mgmt / Defined Benefit Pricing Strategy / Custom network partner / active data mining / cancer navigation / transplant carveouts COE / imaging solutions, etc.
Gasparilla survived Hurricane Ian primarily due to the company’s leadership. With its plan innovations, Gasparilla has put back into salaries, and back into additional benefits or increasing benefits year over year–including adding direct primary care (DPC) in July 2023 (they basically had a direct contract with a private clinic down the street). Click here to see this 37 second video of their 7/1/23 Benefit Education Meetings we just competed led by myself, Doctors, & Pharmacists, and others were present to educate the members - https://youtu.be/psmjak-Ldyo / This case study has been featured by Patient Rights Advocate https://www.youtube.com/watch?v=LqChEXHoujw&feature=youtu.be and https://www.youtube.com/watch?v=u4bpD7c0UsU.....and this case study has been shared by us and sometimes our clients are with us - here are just a few of them: • December 2, 2022 – I was a guest on the podcast – Direct Primary Care Benefits with Brett Shoemaker – click here to listen – Carl Schuessler, Jr., Mitigate Partners Managing Director, talks "EMPLOYER BUILT" Health Plans – Episode 12 / • November 2, 2022 – Mitigate Partners' The Gasparilla Inn & Club Case Study and DeSoto Memorial Hospital Case Study are featured in Dave Chase’s new book – click here for FREE COPY – Health Plan Heroes - The CEO's Who Restored The American Dream. Mitigate Partners’ Case Studies are featured on the following pages – The Gasparilla Inn & Club Case Study (see pages 37-42) and DeSoto Memorial Hospital Case Study (see pages 112-120). / • June 6–7, 2022 – Hosted the 3rd Annual Mitigate Partners Summit called DEMYSTIFYING HEALTHCARE COSTS - Controlling Costs is not a Spectator Sport! How to Crawl, Walk, Run, and Fly in Boca Grande, FL – Boca Grande, FL at The Gasparilla Inn & Club – Mitigate Partners held an Employer Day and Mitigators attended along with our FairCo$t Health Plan Partners – click here to see our promo video – Mitigate Partners June 6, 2022 Demystifying Healthcare Costs Promotional Video at The Gasparilla Inn. / • February 9 ,2022 – Maverick Magazine in their Winter 2022 Issue featured our client, The Gasparilla Inn & Club’s story in an article called Working With a Benefits Champion. / • October 18, 2021 – Physician Outlook Magazine – Mitigating Matters Volume 7 2021 – This Physician Outlook Magazine issue was dedicated to recognizing the healthcare heroes like Carl Schuessler, Co-Founder and Managing Principal of Mitigate Partners, and the Mitigate Partners colleagues that are doing the “behind-
the-scenes’’ work that makes healthcare affordable. This issue covers the Mitigate Partners’ June 7-8 event – Demystifying Healthcare Costs – Controlling Costs is Not a Spectator Sport! How to Crawl, Walk, Run, and Fly in Boca Grande, Florida at The Gasparilla Inn & Club. Many of the Mitigate Partners’ speakers wrote featured articles in this issue.
/ • October 1, 2021 – Maverick Magazine turn to pages 50-51 – featured Mitigate Partners in their coverage of the Free Market Medical Association (FMMA) 2021 Annual Conference in Dallas, TX – Our own Cristy Gupton and myself were featured
alongside our courageous client The Gasparilla Inn & Club with their visionaries - Glenn Price, CFO and Benefits Champion Extraordinaire Elizabeth Schrock, CEBS
/ • August 5 – 7, 2021 – Free Market Medical Association (FMMA) 2021 Annual Conference – Dallas, TX The Red Pill of Employer Health Plans - Successes and Challenges of Actively Managing your health plan with The Gasparilla Inn & Club Case Study / • June 24, 2021 – We were featured in Grit Daily – Mitigate Partners’ Employer Day Empowered Participants to Challenge the Healthcare System written about
Mitigate Partners’ DEMYSTIFYING HEALTHCARE COSTS - Controlling Costs is not a Spectator Sport! How to Crawl, Walk, Run, and Fly in Boca Grande, FL at The Gasparilla Inn & Club where we held an Employer Day on June 7th - Mitigators attended along with our Health Plan Partners. / • June 7 – 8, 2021 – Hosted the 2nd Annual Mitigate Partners Summit called DEMYSTIFYING HEALTHCARE COSTS - Controlling Costs is not a Spectator Sport! How to Crawl, Walk, Run, and Fly in Boca Grande, FL at The Gasparilla Inn & Club where we held an Employer Day and Mitigators attended along with our FairCo$t Health Plan Partners. / • October 18, 2019 – Health Rosetta Employer-led Webinar featuring The Gasparilla Inn & Club – Glenn Price, CFO, and Liz Hernandez, Benefits Champion, at Gasparilla Inn, along with Carl Schuessler, Benefits Advisor at Mitigate Partners. Click this link and scroll down to find The Gasparilla Inn https://members.healthrosetta.org/employer-webinars/. / • Late 2020 – Gasparilla Inn Case Study featured in Dave Chase’s new book – Relocalizing Health: The Future of Health Care is Local, Open and Independent / • February 9, 2020 – Gasparilla Inn Case Study featured in Dave Chase’s new book – REHUMANIZING Health Plans THAT RESTORE HEALTH, HOPE and WELL-BEING IN OUR COMMUNITIES
- Industry: Hospitality (seasonal)
- # of Employees: 450
- Location: Florida
The Gasparilla Inn & Club has put back into salaries, back into maybe additional benefits or increasing benefits which they have done year over year including adding DPC effective 7/1/23; even though, they basically had a direct contract with a private clinic down the street. Click here to see this 37 second video of their 7/1/23 Benefit Education Meetings we just competed led by myself, Doctors, & Pharmacists, and others were present to educate the members - https://youtu.be/psmjak-Ldyo / We created the Benefits Champion position with Liz Schrock, CEBS on 7/1/16. Benefit improvements are Rich plan design eliminates deductibles & coinsurance Copays ONLY / No network restrictions = go wherever you want in the U.S. / Direct Contracted with 4 hospitals within a 50-mile radius to eliminate any balance billing issues, and even had the hospital CEO’s attend and speak at our yearly Benefit Education meetings. / Negotiated with a Community Pharmacy for FREE prescriptions delivery to the Inn / All services performed and done in a physician’s office are covered by the appropriate office visit copay. Member has no extra cost responsibility outside of Physician or Admission copays when tests or surgeries are performed i.e. no “ologists’ charges” i.e. anesthesiologists, radiologists, pathologists – all “surprise billing” is eliminated / Preventative Colonoscopy (polyps may be removed at that visit) 100% coverage (part of ACA) – colonoscopy that may have started as the preventative visit covered at 100% no matter what such as polyps identified and removed. Normally, once the polyps discovered, what began as preventative turns into a diagnostic code that becomes a billed charge to the member. The entire event covered at 100% no matter what happens. / Implemented a Direct CASH Pay program provides discounts down to 70% of Medicare. Paid to the Hospital (no later) than the day of service. Custom Negotiation - up front and eliminates any balance billing Issues. Member can receive up to 50% of the savings, up to cap of $1,000 for Outpatient and a cap of $1,500 for Inpatient by using this service. / Provided Education Meetings in Group Setting to transform their employees from HealthCare Users to HealthCare Consumers. Each year since 2015, we conducted 4+ education meetings for them b/c of the unique nature of their employee shifts. / They have used our employee helpline and advocacy services – quality and cost research
Employer contribution remained at 75% of the coverage election which also includes dental and vision increased salaries
- TPA: PBA
- PBM: Araya
- Stoploss: Skyward since 7/1/16
- PrimaryCare: Yes, had a clinic on island but decided to still add DPC this year 7/1/23 DPC - Epiphany Health Direct Primary Care - Dr. Lee Gross, Dr. Bill crouch
- Individual Stewardship: Yes to both - 7/1/16 Gasparilla also added a medical advocacy program which identifies the right appropriate doctor and/or provider and directs members to those providers with top-quality outcomes at the appropriate price and at the right time of the member’s medical journey. This advocacy program not only eliminates waste inherent in the system, but also improves the experience of the member while reducing overall costs.
- Other Solutions: Chronic Kidney Disease Mgmt / Defined Benefit Pricing Strategy / Custom network partner / active data mining / cancer navigation / transplant carveouts COE / imaging solutions, etc.