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San Antonio FMMA Discusses Creating a Free Market Surgery Center

November 02, 20219 min read

After the Free Market Medical Association's 2021 Annual Conference in Plano, Texas, the local chapter leaders of the San Antonio FMMA were inspired to hold their next quarterly meeting Creating a Free Market Surgery Center in San Antonio, Texas. On October 27, 2021, the chapter gathered together to discuss how to promote affordable, competitive prices for elective surgeries in exchange for a hybrid structure or cash pay from willing consumers. The solution was found in bridging a hybrid surgery center and other cash facilities together with Benefits Advisors.

With about 50 attendees, San Antonio FMMA members (buyers, sellers, vendors, and now facilities with cash pay) came together to hear about facilities that are or aim to operate under a free market model. Chapter Leaders Dr. Roger Moczygemba of Direct Med Clinic and Shankar Poncelet, CEO of Shankx Web Development, introduced the keynote speakers of the evening. Dr. Aamir Ehsan from CorePath Laboratories (accompanied by Executive VP of Business Operations, Curtis Loos), Randy Reynolds and Michelle Patino representing HealthCrest Surgical Partners introduced the new Huebner Ambulatory Surgery Center, and Health Benefits Advisor, Allison De Paoli from Altiqe Consulting helped to tie it all together.

Takeaways From FMMA

  1. Using reference labs for low-cost pathology (e.g., sampling tissue, bone marrow, urine, blood for diagnosis) is vital to bringing down the cost of healthcare. After all, 80% of Clinical Decisions Are Made On Pathology Findings (Lab Results). As a "one-stop-shop," CorePath is saving surgeons/specialists thousands of dollars, which allows them to offer more affordable rates to their patients.

  2. Bundled pricing for elective surgeries and procedures may not be the status quo, but it is saving lives. Most Americans are deferring their care for fear of the cost of screenings and surgeries. Huebner Ambulatory Surgery Center is not only charging fair and transparent prices, they cover a full spectrum of 10 different specialties, are in-network for all major payers, and they are proving that a hybrid model can work.

  3. Knowledgeable Benefits Advisors and brokers or consultants who participate in the free market can change the way we shop for healthcare. Allison De Paoli is a broker, consultant and CEO of Altiqe who offers full control of the price chain by plans that bundle goods and services such as medication, hospital visits, etc. Benefits Advisors who help to promote transparency and cost control align with the FMMA. This ultimately helps employers and people to save money.

Price Transparency and Spearheading a Movement

San Antonio Free Market Medical Association chapter leaders, Dr. Roger Moczygemba and Shankar Poncelet shared opening remarks before the speakers. Poncelet began by reflecting on how at one point, transparent pricing seemed only theoretical. However, this movement has gained momentum, and it seems more tangible than it did at the beginning. CEO of Shankx Web Development LLC, Poncelet and his marketing team helped make this event possible.

Shankar Poncelet explains the Pillars of the Free Market Medical Association and the practical use of specialists and surgery centers that operate under the free market model of healthcare.

CEO of Shankx Web Development, Poncelet said, "We don't want to destroy medicine. We want to bring back what it originally meant to be. Which is doctors, physicians, surgeons, nurses, pharmacists and anyone else I am forgetting. Give them the chance again to really offer healthcare at an affordable rate and in accessible ways. That is something we can absolutely achieve through American ingenuity, which is truly what FMMA is in my opinion. My role is to get to know all of you and simplify the message a little bit so that the general public can benefit from all this valuable information."

Dr. Roger Moczygemba of Direct Med Clinic - San Antonio introducing the speakers of Creating a Free Market Surgery Center at Club at Sonterra.

As a very passionate consumer advocate, Dr. Roger Moczygemba is eager to partner with specialists who can help keep consumer costs low while maintaining quality. In 2020, his company saved a single employer over $1.7 million dollars in avoided workers’ compensations claims. By contracting directly with the employer, his clinic was able to cut down unnecessary costs and eliminate the waste by offering direct access to healthcare.

​CEO of Direct Med Clinic, Dr. Moczygemba said, "The whole purpose of what we’re doing here is to try to create affordable and accessible healthcare. Which is kind of hard to find these days. But you know when you step back and break it down into individual components...It gets really expensive when we get too many third parties involved. Especially if they get a little too greedy. So if we break it down to the basics that’s what we’re doing here. So we just want to take that to the new level now from doctor, patient, company, clinic to getting more specialists involved...we want this to work and we have some key players here in this room tonight and all of these meetings to make this work."

CorePath Laboratories: Clinical Pathology for Testing, Clinics, and Consultation

Dr. Aamir Ehsan of CorePath Laboratories facing projector.

Founder, CEO and Medical Director of CorePath, Dr. Ehsan shared insights about pathology labs and their role in the free market system of healthcare. As one of the few laboratories in the world offering cancer cytogenetics (i.e., testing samples of tissue, bone marrow, etc.), molecular genetics, and multicolor flow cytometry (e.g., imaging) in one place, CorePath is unique.  The Bone Marrow Clinic, for example, by CorePath Laboratories, not only supplies providers with the kits, equipment, and technicians, but the consultation of their highly-trained, board-certified hematopathologists. This means providers are able to partner with subject matter experts in delivering care to consumers. Understanding that cancer involves time-sensitive reporting, follow-up is critical, and because CorePath provides in-house labs, they are able to deliver results that are timely and accurate. Providing in-house labs is also a key component to maintaining low-costs, passing the savings on to the end consumer without sacrificing quality of care. The lower costs of preferred specialists is due to using a reference lab.

CorePath seeks to discover physicians and providers that are entrepreneurs. They wish to collaborate with universities and the FMMA. Lastly, they are challenging the status quo by saving people thousands of dollars on pathology.

Surgical Procedures With Transparent Pricing: Huebner Ambulatory Surgery Center

 Senior VP of HealthCrest surgical partners, Randy Reynolds shared his presentation virtually via Zoom. Reynolds works with the Huebner Ambulatory Surgery Center in San Antonio at an easy to access location. Their surgical facilities have been open since July of 2019 with affordable care and cash pay options for medical bills

For many consumers, the quality of care begins with accessibility. The larger medical expenses for most Americans are typically a result of hospitalizations, surgeries, emergency room visits, and MRIs. However, Huebner Ambulatory Surgery Center  is an outpatient facility that provides elective procedures similar to traditional hospitals but without the high costs and fake prices where cash rates differ drastically from insurance. The facility charges individual patients with competitive, all-inclusive prices with a hybrid form of payment. This means that both private insurance and cash payments are acceptable forms for the health care services rendered.

Surgical facilities do not typically have a price list with affordable prices at an all-inclusive price, but Huebner Surgery Center bundles procedures and prices. Not only are they accessible because of the cost of healthcare, but also because of the location. Working with insurance companies, the surgical center makes sure that transparent pricing is still at the core of their surgical procedures.

Their providers have extensive experience and they have 4 fully equipped operating rooms. Their patients have the ability to stay overnight. They offer a scope of services and cover a full spectrum of 10 different specialties.

Reynolds said, ”San Antonio is a large [top 10] city in the there’s a lot of opportunities for cases to be done at a low-cost provider...I think opportunities are endless. We do have an advantage over some of the other surgery centers because we are independent...our contracts aren’t as rich and I think you would find our pricing reasonable. We would work with you to take care of your patients.”

How are you more cost effective and compare to others?

Reynolds said,"We get paid about a third what the hospital systems do on commercial. We get paid 52 cents on the dollar for Medicare. I would say probably any ASC that's hospital affiliated is leveraging their contracts so they're probably getting close to twice as much as we are. As Michelle [Patino] said, we are still making money but we have to run very efficiently and Michelle does a great job with that...we got a staff that loves to work at Huebner ASC and they love to take care of the patients. We have very high patient satisfaction scores. We are very focused on quality. Just because we are the low-cost provider, that doesn't mean that the patient is going to get less quality or care because that's not how we do business."

Raising the Bar: Building a Better Health Plan

Allison De Paoli stands in front of projector

Allison De Paoli is a health insurance advisor, health insurance broker, consultant, founder and CEO at Altiqe. As a veteran of the insurance industry, her expertise and knowledge show through being able to help employers budget effectively to save money while also ensuring their employees have access to the care they need. However, just because she’s a veteran of the industry doesn’t mean that she sticks to the status quo. She breaks the mold with her strong focus on transparency and through the way she’s changing the insurance game.

At this meeting, De Paoli discussed how to build a better health plan as an employer and her answer to tackling the modern problems faced by employers and employees alike. One of the biggest problems that she brought up was “The Moral Imperative”, a fitting name for the unnecessary waste and fraud found in our current healthcare system that is benefitting everyone but who it needs to benefit: the everyday consumer. However, De Paoli has the creativity and wisdom to create the solutions necessary to fix these problems. An example of one of her solutions was through utilizing an alternative sourcing partner for your specialty and brand-name medications, which, as De Paoli phrased it, “puts real dollars back in the pockets of your employees”, since these medications come at zero out-of-pocket cost. Read more about Allison here.

De Paoli said,”If we are going to survive, we need to all evolve and adapt. The US healthcare system is coming apart in what I do is one thing. I unbundle and rebuild health plans. What we try to do, and sometimes, we build the bridge as we go: Provide solutions that are completely transparent and allow an employer complete control.” 

Special Guests Attend Free Market Medical Association Meeting

Some San Antonio FMMA members pose for a group photo. From left to right: Shankar Poncelet, Susan Kaars-Sypesteyn of Nola's Brunch & Beignets, Allison De Paoli of Altiqe Consulting, Constable Kat Brown of Bexar County Precinct #4, Honorable Bexar County Clerk Lucy-Adame Clark, Antréa Ferguson of Shankx Web Development, and Tim Kaufeldt of Laso Health.

Change isn't possible without the assistance of healthcare providers and policy makers. The San Antonio FMMA is building a bridge to policy makers. The special guests who joined the meeting included Constable Katherine Brown of Bexar County Precinct #4 and Honorable Bexar County Clerk Lucy Adame-Clark.

Constable Brown shared that she fought ovarian and breast cancer and how informative the meeting was. She understands very well how costs for cancer treatment can quickly escalate for those who do not have ease of access to healthcare or are not in a single-payer system like the military.

Constable Brown said,"This information that you guys shared with me tonight is very helpful. It’s going to be a contributing factor in terms of the people that I speak to and correspond with.”


San Antonio FMMA in-person meetings and online events were not possible without sponsors. The sponsors include Altiqe Consulting, CorePath Laboratories, Shankx Web Development, and Direct Med Clinic. For more information about sponsoring future events or inquiries, email Shankar Poncelet from Shankx Web Development at ​

picture of group

From left to right: Constable Katherine Brown, Antréa Ferguson, Dr. Altamirano of Casa Salud Family Medicine Clinic, Michael Davies, Shankar Poncelet, Susan Kaars-Sepesteyn, Allison de Paoli, Honorable Lucy-Adame Clark, Bexar County Clerk, Tim Kaufeldt, Ansley Partosa, Teresa "Tess" Vardeman, Dr. Aamir Ehsan, Dusadee "Pink" Martin, Sherri Gary-Johnson, Kellie Pickett, 

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Shankar Poncelet

Shankar Poncelet serves as the co-leader of the San Antonio Free Market Medical Association. He is the proprietor of SHANKX, a branding agency.

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