About our Founder:

Quantum Care, LLC was founded by Michael Lynch in 2005 and was designed with one specific purpose in mind: to help HMOs and other risk bearing entities to be more cost-effective without sacrificing quality.

Lynch was a former regulator, previously having oversight of the Florida Department of Insurance's HMO Section. He continued a private sector career with Humana and served that company in a Regional Capacity as the Head of Financial Analysis for Humana's Southeast Region. Additionally, Lynch headed Contracting and Provider Relations Departments for Humana's South Florida Market. Lynch was VP of Network Operations and Business Development at Coral Gables-based CarePlus Health Plan, creating a unique contracting strategy that led to CarePlus being sold for approx. $450 million. Lynch assisted other MCOs in pre-sale value creation and was involved in more than $1 billion in health plan sales transactions in a 4 year time span. Lynch has been active in the development of single specialty network solutions and has developed an extensive client list that spans multiple markets including, South Florida, Southern California, and New York.

 

WHY Quantum Care, LLC:

Lynch had seen, first hand, that HMOs are "jacks of all trades and masters of none." With that in mind, Lynch set out with an old-fashioned "stick to the knitting philosophy:" Let's target niche areas that financially expose risk-bearing entities and create solutions that are more robust than what HMOs have created in-house. High cost, high trend areas oftentimes go under-addressed by the HMOs.

In other instances, Lynch had observed that costs are buried in a mound of financial data and health plans have cost overrun issues for which they remain unaware (see our Transparent RBM page for examples).

Lastly, Lynch had noticed that a trend exists in Managed Care Organizations: ALL WORK IS PERFORMED IN SILOS. Contracting personnel think that they know their job. Finance personnel think that they know their job too. However, there are few folks in the industry who can pinpoint a financial problem and develop the appropriate solution to make the adverse situation go away through creative contracting. Even more enlightening is the fact that several folks in contracting contract with entities that ARE NOT LEGAL ENTITIES (see our Network Compliance page for more details). Such contracting activities, often associated with MSOs and single specialty networks, place the HMO at severe financial risk in terms of potential membership loss and massive fines.

So, nestled in a quiet corner of Pembroke Pines, FL, Quantum Care, LLC exists. We work hard to make life easier for risk-bearing entities. Let us show you how we can help!