Becker’s Healthcare Podcast Strengthening Independent Medicine and Rethinking Employer Health Benefits with Scott Hurst
Mar 13, 2026
Scott Hurst, CEO of PPNHCo, leads a 600-provider IPA and is launching a multiple employer welfare arrangement to lower costs. He explains how MIWAs work and why employers should consider contracting directly with independent networks. He talks about preserving independent medicine through operational alignment and scaling, and urges careful, accountable adoption of AI in healthcare.
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IPA Built Scale To Support Independent Practices
- Scott Hurst runs a 600-provider IPA offering contracting, delegated credentialing, group purchasing, value-based care ops, and a MIWA health plan.
- The MIWA began three years ago with ~50 participants and grew to ~250 by 2026 to lower insurance cost pressure on practices.
Set Up A MIWA To Lower Practice Insurance Costs
- Do pursue a Multiple Employer Welfare Arrangement (MIWA) to offer fully insured plans for member offices, staff, and families.
- Hurst worked with lawyers and the Texas Department of Insurance and grew enrollment from ~50 to ~250 participants in three years.
Payer Rates Favor Systems Over Independent Doctors
- Payers pay vertically integrated systems dramatically more than independent physicians, creating a shameful disparity that shifts costs to employers.
- Hurst observed in Dallas-Fort Worth that major employers are often self-insured and unaware their costs rise because dollars flow to system overhead, not physician pay.