For many Americans, November brings an annual ritual: choosing health insurance for the year ahead. Open enrollment arrives, premiums can rise, deductibles can feel out of reach and the list of doctors covered by a plan may seem increasingly narrow.
While Washington continues to debate the future of the Affordable Care Act and healthcare spending, some of the most interesting changes in how Americans access and pay for care are happening closer to home, in doctors’ offices, corporate boardrooms and technology companies — rethinking how care is delivered.
In Grand Rapids, one example of that shift is taking shape at Root Functional Medicine, a healthcare company founded in 2022 by family physician Dr. Erica Armstrong, who serves as its founder and CEO. The company is expanding its downtown presence while developing RootOS, its proprietary technology platform designed to support a functional-medicine approach to healthcare.
The idea reflects a broader shift in healthcare: Some physicians and employers are looking for ways to make care more transparent, accessible and proactive rather than waiting for changes to the traditional insurance system.
For patients, that can mean knowing what a service costs before receiving it. For employers, it can mean looking for ways to address health problems earlier and potentially reduce the cost of care over time.
Rethinking the Middleman
The traditional healthcare system can be difficult to navigate because the person receiving care isn’t always the person paying for it. A patient might schedule a blood test without knowing what it will ultimately cost, while insurers and providers negotiate rates behind the scenes.
That disconnect can make it difficult to comparison-shop for healthcare in the same way consumers do for other services.
Direct-care models attempt to change that equation by putting the relationship — and often the price — more directly between the patient and provider.
The approach is particularly relevant to self-funded employers, which pay their employees’ healthcare claims directly rather than purchasing a traditional insurance plan that shifts that financial risk to an insurer. These employers may still use an insurance company or third-party administrator to process claims and provide access to a provider network, but when medical costs rise, the financial impact ultimately lands on the employer.
That gives companies an incentive to explore approaches that could improve care while managing costs.
Root’s recent expansion offers a local example. The company recently closed a Series A funding round led by HealthX Ventures, a Wisconsin-based digital-health venture capital firm. Root is also expanding its downtown Grand Rapids headquarters to 3,920 square feet at 120 Ionia Avenue SW, where it plans to house a team of around 16 employees.
The company combines advanced laboratory testing with care from physicians and registered dietitians, using its RootOS software platform to support its approach. Root describes its model as “root cause health benefits” and says it works with self-funded employers across the country.
The company’s approach is rooted in functional medicine, which seeks to look beyond individual symptoms and consider factors such as nutrition, metabolic health, lifestyle and other aspects of a patient’s overall health.
Root also emphasizes upfront pricing. The company says its “Root Cause Panel,” a diagnostic package, can cost about $2,100 through conventional channels but is available for $225 through Root’s model. Root attributes the difference to direct purchasing, negotiated laboratory costs and reduced administrative overhead.
For patients accustomed to medical bills that can be difficult to decipher, the appeal is straightforward: knowing what a service costs before agreeing to it.
For employers, the potential impact is broader. Root says its model is designed to help employers reduce healthcare costs, improve employee health and provide a benefit employees will use. Those claims are part of a growing interest among self-funded employers in approaches that seek to address health problems earlier rather than simply paying for care after they become more serious.
A More Proactive Approach
The larger idea behind models like Root’s isn’t simply that healthcare should cost less. It’s that the incentives surrounding care could change.
Much of the U.S. healthcare system operates through a complex web of insurers, providers, employers, patients and third-party administrators. Root is betting that technology and a more proactive approach can simplify part of that equation while giving patients and employers more information about the care they receive.
That philosophy is central to Armstrong’s vision for Root.
“As a physician, author, and entrepreneur, my focus is on creating the future of healthcare: one where care is proactive, personalized, and powered by both human connection and technology,” said Armstrong. “Between this recent capital investment and our expanded offices and team, I believe we can solve what conventional healthcare leaves unsolved: chronic disease, fragmented care, and the absence of true prevention.”
It’s an ambitious proposition in a healthcare system as complicated as America’s. No single clinic, employer or technology platform can solve every problem. Insurance remains central to the way millions of Americans receive care, and the economics of medicine are shaped by everything from pharmaceutical pricing to hospital consolidation.
But change doesn’t necessarily have to begin with a sweeping federal overhaul.
It can start with a conversation about whether it’s better for patients to see a price before a test is ordered. And whether a system built around prevention might ultimately be better for patients and providers alike. The question is increasingly personal: What if the best healthcare is the kind that helps us need less of it?
