Keepwell Health Union

A nonprofit healthcare cooperative

Concept Memo

Executive Summary

Keepwell Health Union is a nonprofit healthcare cooperative designed to deliver comprehensive, preventative, and navigated care at a significantly lower cost than traditional employer-sponsored health insurance. The cooperative model aligns incentives around patient outcomes, cost containment, and long-term health rather than claims volume and billing complexity.

By combining primary care, care coordination, negotiated specialty access, and catastrophic coverage through reinsurance, Keepwell aims to reduce employer healthcare spend while improving access, continuity, and patient trust.

The initial phase will launch a single clinic serving a defined member population through anchor employers and organizations, proving the model before expanding.

The Problem

Healthcare in the United States is expensive, fragmented, and administratively hostile to both patients and employers.

Employers face:

• Rising premiums with no corresponding improvement in outcomes
• Lack of transparency into what they are paying for
• Absenteeism and productivity loss driven by unmanaged care

Patients experience:

• Difficulty accessing primary care
• Fragmented specialist referrals
• Confusion navigating insurance, billing, and treatment plans
• Delayed care that escalates into emergencies

The current system optimizes for billing events rather than health.

The Opportunity

Most healthcare costs are driven by:

• Poor preventative care
• Unmanaged chronic conditions
• Avoidable emergency room usage
• Lack of care coordination

A cooperative model that focuses on:

• Early intervention
• Continuous primary care
• Active care navigation
• Clear incentives aligned with outcomes

can dramatically reduce costs while improving quality of care.

This model already works in limited forms (direct primary care, union clinics, integrated health systems), but remains inaccessible to most employers and communities.

Keepwell Health Union exists to bridge that gap.

The Keepwell Model

Keepwell Health Union operates as a membership-based cooperative.

Core components:

• Primary Care Access Same-day or next-day appointments, extended visit times, and continuity with providers.

• Care Navigation Dedicated staff assist members with referrals, scheduling, billing issues, and treatment follow-through.

• Preventative & Chronic Care Focus Proactive management of conditions such as diabetes, hypertension, and mental health.

• Specialty & Hospital Access Negotiated rates with local specialists and hospital systems.

• Catastrophic Coverage via Reinsurance External coverage protects against high-cost events such as surgery, trauma, or extended hospitalization.

Members pay a predictable monthly fee, dramatically lower than traditional premiums, while catastrophic risk is managed separately.

Why a Cooperative

A cooperative structure:

• Aligns incentives between patients, employers, and providers
• Prevents profit extraction from care delivery
• Allows surplus revenue to be reinvested into services, staffing, and expansion
• Builds trust through transparency and member governance

This structure prioritizes health outcomes over shareholder returns.

Initial Launch Plan

Phase 1: Pilot Clinic

• One physical clinic location
• Initial capacity: 500–1,000 members
• Staffed with primary care providers, care navigators, and administrative support

Anchor Partners

• One or more mid-sized employers, unions, or community organizations
• Committed enrollment provides predictable revenue and validates demand

Target Outcomes

• Reduced ER utilization
• Improved chronic care markers
• High member satisfaction
• Lower total cost per member compared to traditional plans

Funding Needs

Initial funding will support:

• Legal and regulatory setup
• Clinic lease and build-out
• Staffing and operations for first 12–18 months
• Data collection and outcomes measurement

Seed funding target: $250,000 – $500,000

This funding enables proof of concept and positions the organization for foundation grants and public funding.

Sustainability & Growth

Long-term sustainability comes from:

• Employer and member monthly fees
• Scaled enrollment
• Grants for expansion, not core operations
• Public and municipal partnerships

As membership grows, per-member costs decrease, allowing reinvestment into additional services and locations.

Why Now

Healthcare costs continue to rise faster than wages and inflation. Employers are actively searching for alternatives. Patients are losing trust in existing systems. Policymakers are increasingly open to preventative and cooperative models.

Keepwell Health Union is positioned to demonstrate a viable, humane alternative—starting locally and scaling responsibly.

Conclusion

Keepwell Health Union is not an experiment in technology or insurance arbitrage. It is a structural correction: putting care, navigation, and prevention back at the center of healthcare delivery.

With modest seed funding and committed partners, this model can deliver immediate impact and long-term systemic change.