Side-by-side
The old way charges the sick.
The new way pays them.
For a century, the legacy stack — the old conglomerate insurers, their captive PBMs, the rented-out EHR vendors, the clinic billing middlemen — has built one thing brilliantly: extraction. They charge to bill. Charge to chart. Charge to know what's in your own body. Then they sell that knowledge — to advertisers, to drug-makers, to data brokers — and you never see a cent. Conceptual Health is built the opposite way. Patients earn. Clinicians keep what they bill. Researchers pay patients for data. The platform is free, forever. Below, every line of how the two systems differ — in money, data, and time.
The old way
The legacy stack
Insurer-owned PBMs · 1980s EHR vendors · billing middlemen · ad-funded patient portals · data brokers
The new way
Conceptual Health®
One free patient app · one free EHR · one wallet · one ledger · one Master Equation · paid back to the patient
Section 1 — money
Where every $1 of healthcare spending actually goes.
In the U.S., national health expenditure is ~$4.9 trillion. About a third of that never touches care — it's eaten by administration, billing arbitration, network haggling, and pharmacy-benefit spread. We mapped both stacks below.
The legacy stack
Of every $1 a patient or employer pays in:
Patient receives in cash, rebates, or rewards: $0.00. Their de-identified data — labs, claims, prescriptions — is sold ~7×, generating an industry estimated at $13.6B/yr the patient sees none of.
Conceptual Health
Of every $1 a patient or employer pays in:
Patient earns from data licensing (HCC) on top: median $340 / yr for active members who consent. The patient is paid, not the broker.
Section 2 — line by line
Eighteen lines on the bill. Look at every one.
The old stack hides its extractions in opacity — line items only the billing department sees. We laid them out, plain.
| Issue | The legacy stack | Conceptual Health® |
|---|---|---|
| Patient cost to use the chart | Hidden in premiums & copays. Portal "free" only because it's funded by ads or claims revenue. | $0 forever. No premium, no ad, no upsell. Funded by ledger fees and research licensing. |
| Provider cost to use the EHR | $300–$1,500 / provider / month. Multi-year contracts. Per-module fees for orders, billing, e-prescribing. | $0 / provider / month. Every module included. No seat math, no implementation fee. |
| Patient earnings for healthy behavior | $0. Maybe a 5% discount on a gym voucher. | HCR for every verified action. Walk, sleep, vaccinate, fill an Rx, attend an appointment — paid at the ladder rate. |
| Who owns the patient's data | Health system or insurer. Patient gets a 30-day "right of access" — often by mailed CD-ROM. | Patient owns the DataVault. Cryptographic keys, per-record consent, revocable any time. |
| Who profits when the data is sold | Data broker. EHR vendor. Insurer's analytics arm. Patient: $0. | Patient — paid in HCC for every approved query. Researcher pays patient directly. |
| Prior authorization | Insurer-owned. 14-day median turnaround. ~6 hours / week / clinician on PA paperwork. | AI-drafted PA packet. Submitted electronically. Audit trail attached. Median 8 minutes of clinician time. |
| Pharmacy pricing | PBM-controlled spread. List $400 → patient sees $80 → PBM pockets $310 in rebates & spread. | Conceptual pharmacy at-cost mail-order. List shown. Spread shown. Refill paid in part by HCR. |
| Number of patient logins | Average insured U.S. adult: 12 portals across plans, providers, labs, pharmacy, vision, dental. | One. The Guardian Orb app. Household members under one roof. |
| AI scribe / ambient note | $200–$700 / provider / month from a third-party scribe vendor — billed on top of EHR. | Included. 3-minute encounter note. Reviewed before sign-off. Provider keeps the audio if they want to. |
| Telehealth visits | $60–$120 per visit out-of-pocket if not covered. Separate vendor login. Recording usually disabled. | Built in. Cost set by clinic. Recording opt-in. Encounter writes back to the chart automatically. |
| Health score visible to patient | None. Dozens of disconnected lab values, no synthesis. Patient guesses. | CH score — single 0–100 number across 8 axes, 137 signals. Methodology public, every contribution shown. |
| Billing transparency | EOB arrives weeks later, in cryptic codes. 1 in 4 bills contain an error in the patient's disfavor. | Itemized in plain language at point-of-service. Auto-coded by AI, signed by clinician, written to chain. |
| Surprise / out-of-network billing | Common. Network haggling between insurer and provider; patient absorbs the gap. | Impossible by design. Network rules and fees are part of the encounter quote, not a post-hoc adjustment. |
| Identity, recovery, KYC | Knowledge-based questions ("name the street you grew up on") + a fax. Common breach surface. | Identity Vault: device-bound passkeys, multi-method recovery, household guardian fallback. |
| Pet care | A separate veterinary EHR. A separate vet portal. The dog's labs never touch the household's chart. | Pets are first-class members of the household. Vet, eye, dental — same kit, same chart, same login. |
| Provider time on documentation | ~2 hours of charting for every 1 hour of patient care. Pajama-time epidemic. | ~6 minutes per encounter. AI scribe drafts; clinician reviews and signs. |
| Audit & oversight | Internal compliance, audited by the same auditor every year. Subpoenas not disclosed. | Every model change, override, breach, and subpoena published in the public Trust Center. |
| Exit cost | Custom export. Often weeks. Often partial. Often charged. | One click. FHIR, CDA, CSV, PDF. Free. The patient is the export. |
Section 3 — what the patient earns
A year of being a healthy patient.
What gets paid back.
Modeled on a typical engaged member: 12 visits, 4 lab draws, 1 imaging study, 220 days of Orb-tracked vitals, and a consenting share of de-identified data with researchers.
Patient annual earnings — the old stack vs. Conceptual Health
Median engaged patient. USD-equivalent, audited monthly. Methodology footnote ↓
Section 4 — where the data goes
In the old stack, your data ships seven times. None of those trips comes back to you.
Below: where a single lab result travels in the legacy system vs. how it travels in Conceptual Health. Same lab. Same patient. Different fate.
One lab result. Two universes.
Section 5 — time
The other tax: your hours.
Money is one extraction. Time is the second. We measured both ends — patient and clinician.
The legacy stack — annual time cost
Conceptual Health — annual time cost
Section 6 — for the clinician
A solo clinician's annual stack: $28,440 in the old way, $0 with us.
Modeled on a primary-care physician with one MA, ~1,800 patient visits / year, average payer mix.
| Line item | The legacy stack | Conceptual Health |
|---|---|---|
| EHR seat (1 provider, 1 MA) | $10,800 | $0 |
| e-Prescribing & EPCS module | $1,440 | $0 |
| Lab interface fees | $1,200 | $0 |
| Imaging interface fees | $960 | $0 |
| Patient portal (white-label vendor) | $2,400 | $0 |
| Telehealth platform | $1,800 | $0 |
| AI scribe / ambient note | $4,800 | $0 |
| Billing service / clearinghouse | $3,600 | $0 |
| Prior-auth labor (1.0 FTE × 0.15) | $1,440 | $0 |
| Total annual platform cost | $28,440 | $0 |
On top of zero platform cost, every Network Clinic earns mining rewards in HCC for the de-identified data they generate — read the mining program →
Section 7 — the five extractions
The old stack runs on five quiet extractions.
None of them is illegal. None of them is announced. All of them compound.
EXTRACTION 01
The premium skim
Insurer overhead and dividend before a dollar reaches care. Quietly capped by MLR rules — but only quietly.
14¢ on every $1 in
EXTRACTION 02
The PBM spread
The price your insurer pays for a drug, minus what your pharmacy receives, minus what the manufacturer keeps. The gap is the spread.
7¢ on every $1 in
EXTRACTION 03
The EHR tax
Per-seat licensing, per-module fees, per-interface fees, per-patient hosting fees — billed to the clinic, passed to you.
3¢ on every $1 in
EXTRACTION 04
The data resale
De-identified prescription, claim, and lab records sold and re-sold across an industry the patient is never told exists.
$13.6B / yr industry — patient share: $0
EXTRACTION 05
The time tax
Hours the patient and clinician give up — to portals, to forms, to prior auth, to clarification calls — that the bill never refunds.
38h patient · 2:1 charting
Conceptual Health has none of these. Not by promise — by architecture. The Master Equation is open. The ledger is on-chain. The treasury wallet is glass. The only revenue is research licensing, and the patient is paid first.
Switch your chart.
It costs nothing. It pays you back.
Free for patients. Free for clinics. Free for providers. Forever.
Methodology
Old-stack figures are modeled from CMS National Health Expenditure data, JAMA studies on U.S. healthcare administrative costs (Himmelstein & Woolhandler 2020), peer-reviewed PBM-spread analyses, KLAS/Becker's reporting on EHR pricing, and the AMA's pajama-time studies of clinician documentation burden. The $13.6B health-data resale market figure is a 2024 industry-analyst estimate. The "engaged member" earnings model is documented in coin.health · about and audited monthly. We do not name specific vendors here because the pattern is industry-wide; specific vendor disclosures are surfaced in our Trust Center and quarterly Transparency Report. "Integrity in all we do."