Disrupting Health Insurance: Larry Hightower Opens the Healthcare Pricing Black Box
On Disruption Interruption, Larry Hightower, Founder and CEO of Vxtra Health, explains why self-insured employers need a clearer view of healthcare pricing and how locally coordinated purchasing can give employers and physicians a greater role in providing care.
TAMPA BAY, Fla., Oct. 15, 2026 /PRNewswire/ -- Sixty-seven percent of covered workers were enrolled in self-funded health plans in 2025, according to KFF, meaning employers directly pay some or all their workers' medical costs. New federal Transparency in Coverage rules finalized on October 5 are intended to make healthcare pricing information more standardized, accurate, and accessible, including for employers analyzing healthcare markets. Larry Hightower, Founder and CEO of Vxtra Health, joins host Karla Jo Helms (KJ) on the Disruption Interruption Podcast to explain what greater visibility could mean for employers funding their own health plans. "If you're self-insured, it's your money from end to end," Hightower says.
Healthcare Spending Remains Difficult to Trace
Self-insured employers finance their workers' claims but may still rely on insurance companies and administrators for the networks and systems that process them. Hightower says employers historically struggled to access information about their own healthcare spending. "You literally, as an employer, could not get your own data," he says. "You put all your money into a bank, and once a month they tell you what your balance is."
Employers need more than access to pricing data. Hightower says the challenge has also been the systems behind it: employers historically struggled to obtain their own healthcare information, while legacy technology across insurers, third-party administrators and pharmacy benefit managers was not built to manage and deliver that data in real time.
With more pricing information available, Hightower argues that employers can compare cash prices, Medicare reimbursement rates, and negotiated commercial rates when evaluating elective care. "When you blow the black box open, you have data that allows you to have a different conversation," he says.
From Price Visibility to Local Buying Power
Hightower built Vxtra Health to help self-insured employers use healthcare spending data to coordinate how care is purchased and managed locally. The company focuses on employers with roughly 100 to 1,000 employees in secondary markets, creating local networks that connect employers more directly with physicians and patients. The model is designed to bring people making care decisions closer to the health plan itself. "We spend our time going back to the root cause. Get the right doctors and the right patients with the right network together, and let them administer that plan."
Physicians need visibility into the economics surrounding the care they provide. They may carry the clinical responsibility, pre-authorization burden, and malpractice liability for a case without seeing how much of the employer's healthcare spending goes elsewhere in the transaction. Giving physicians that information, Hightower argues, can help them question those arrangements and take an active role in how the health plan operates. "We don't argue. We just say, 'Let's look at the data,'" he says.
Hightower sees the next step as giving employers in the same community more influence by buying as a local market rather than one company at a time. By creating geographic density, he says, employers can bring physicians and other healthcare participants to the table around a plan designed for that community. "Make the market. It's a mindset change," Hightower says. "Don't buy standing alone. Aggregate with your fellow employers in your local community to create your own local health plan."
Links
Disrupting Health Insurance: Exposing the Black Box and Taking Back Control with Larry Hightower
Disruption Interruption is the podcast where you will hear from today's biggest Industry Disruptors. Learn what motivated them to bring about innovation and how they overcame opposition to adoption.
LinkedIn: https://www.linkedin.com/in/larry-hightower-0b63b712/
Company Website: https://vxtrahealth.com/
About Disruption Interruption™
Disruption is happening on an unprecedented scale, impacting all manner of industries — MedTech, Finance, IT, eCommerce, shipping, logistics, and more — and COVID has moved their timelines up a full decade or more. But WHO are these disruptors and when did they say, "THAT'S IT! I'VE HAD IT!"? Time to Disrupt and Interrupt with host Karla Jo "KJ" Helms, veteran communications disruptor. KJ interviews bad asses who are disrupting their industries and altering economic networks that have become antiquated with an establishment resistant to progress. She delves into uncovering secrets from industry rebels and quiet revolutionaries that uncover common traits — and not-so-common — that are changing our economic markets… and lives. Visit the world's key pioneers that persist to success, despite arrows in their backs at www.disruption-interruption.com.
About Larry Hightower
Larry Hightower is Founder and CEO of Vxtra Health, a healthcare company focused on helping self-insured employers build more transparent, locally organized health plans. His career has centered on healthcare, physician relationships, insurance, and new care-delivery models. Through Vxtra Health, Hightower is working to connect employers more directly with physicians, improve visibility into healthcare spending, and give local markets more control over how care is purchased and delivered.
About Karla Jo Helms
Karla Jo Helms is the Chief Evangelist and Anti-PR® Strategist for JOTO PR Disruptors™. Karla Jo learned firsthand how unforgiving business can be when millions of dollars are on the line — and how the control of public opinion often determines whether one company is happily chosen, or another is brutally rejected. Being an alumnus of crisis management, Karla Jo has worked with litigation attorneys, private investigators, and the media to help restore companies of goodwill into the good graces of public opinion — Karla Jo operates on the ethic of getting it right the first time, not relying on second chances and doing what it takes to excel. Helms speaks globally on public relations, how the PR industry itself has lost its way, and how, in the right hands, corporations can harness the power of Anti-PR to drive markets and impact market perception.
References
- KFF. (2025, October 22). 2025 employer health benefits survey. kff.org/health-costs/2025-employer-health-benefits-survey/ KFF
- U.S. Department of Health and Human Services. (2026, October 5). New regulations make it easier to find, compare, and report healthcare pricing and coverage information. hhs.gov/press-room/cms-finalizes-healthcare-price-transparency-rules.html
Media Inquiries:
Karla Jo Helms
JOTO PR™
727-777-4629
SOURCE Disruption Interruption
Share this article