At E Powered Benefits, Emma Fox is creating a new kind of healthcare plan

Emma Fox was just 21 years old when she was taken to the ER after a hit-and-run car accident. She was pregnant and found herself stuck with medical bills she couldn't pay off. Twelve years later, she was forced to file for medical bankruptcy. 

Fox, who grew up in the U.K., couldn't comprehend the U.S. healthcare system, despite working for a U.S. insurance carrier at the time — and if it was difficult for Fox to understand, then she knew something was really wrong. 

"While I was working at that insurance carrier, I thought I could change things from the inside," says Fox. "But I finally turned my back on carriers because that system devastated my life. I couldn't forgive what happened. I now know I have to create a parallel system to the current one because the current one is not fixable."

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In 2018, Fox co-founded E Powered Benefits, a health plan management company set on reimagining what healthcare looks like in America. As the managing partner, Fox ensures employers and employees save money on care by taking carriers out of the equation. 

E Powered Benefits offers employers a direct primary care plan, where members of the plans go to a few specific primary care offices in their locale for free before being referred for further care. Fox is a huge proponent of this plan because primary care doctors can act as a gateway to other doctors through referrals; members do not have a traditional network, where a limited number of providers are covered. 

Doctors bill a third-party administrator who handles claims and other administrative services for self-funded plans — the insurance carrier is no longer the middle man, underlines Fox. E Powered's plan prices are set by either Medicare commercial data or treatment rates provided by hospitals, thanks to the Hospital Price Transparency Rule.

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"To a member, the only thing that is really different is that you don't really have a network," she says. "The third-party administrator acts like the insurance company."

But unlike insurers, the third party isn't incentivized to see patients foot a larger bill; they only see compensation for their services, emphasizes Fox. 

Notably, Fox has consistently reduced costs for employers by 40% or more. Fox's company is incentivized to lower prices as much as possible, and she wouldn't have it any other way.

"One of the unique things we do is get paid based on our performance," says Fox. "We say to our clients, 'If we reduce your costs by 30%, would you be willing to pay us a performance bonus?' No one has ever said no, and we have met that goal for every single one of our clients."

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Fox hopes to bring E Powered's solutions beyond their direct clients. She founded the YOU Powered Symposium, an annual event that brings together benefit advisers, clinicians, media outlets and industry stakeholders to discuss how to make a better healthcare system for employers and employees alike. 

Between launching an industry association this August called the Association for Healthcare Advisors, and beginning to sketch out a health plan that would cater to underserved communities, Fox has no intention of slowing down. It's an uphill battle, but the little things make her feel like she's on the right path. 

"I took my 12-year-old son to the symposium," says Fox. "[He later] wrote a book of poetry and one of the questions he answered was, 'What's the most amazing thing you've seen your mom do?' His answer was 'running a healthcare conference.' And that made all those hours and effort so worth it."