Mark Sanchez: The general gist is to make it a little easier for people to see a doctor, better access, maybe better affordability. Now we heard all about this back in July, the one big, beautiful bill, tax and spending bill. Congress passed it. President signed it. And buried in there is language concerning health savings accounts, which have been around 20 plus years, people have them often through their employer. The employer maybe puts some money in there, you can put some money in there, it's tax free, you can use it for medical expenses.
Now today, we have this new model for primary care practices, commonly known as direct primary care. These are medical practices that generally do not take health insurance. They don't. Instead, they use a subscription or membership model. You pay maybe $50, $75 a month. You get a membership to this practice. You need to see a doctor. They'll generally get you in the same day or within a day. The doctor's spending longer times with patients. That's important for folks with a chronic medical condition to help manage that condition. Generally, for your membership fee, you get unlimited visits annually. You'll get some lab services if you need a blood draw. And if you need a referral, they'll refer you to that specialist and then that's when your health insurance kicks in and you can pay for that with your health insurance.
Why? Because over the last 20 years, we've seen a lot of employers migrate to high-deductible health plans. In fact, most folks today are enrolled in high-deductible health plans of $5,000 or more dollars, five, six, seven, 8,000 or more for a family plan. So generally, when you go to the doctor for that checkup or you get up and you have a sinus infection or the kid's got something going on, you're paying for that visit out of pocket. Now, if you enroll and buy a membership to one of these direct primary care practices, starting January 1, you can use the money in your HSA to pay that membership fee. Up to $150 a month, you can dip into your HSA for that direct primary care, or $300 a month for a family.
So, it's a new model, this direct primary care. It's been around a little bit, but it's relatively new to this region. In the last two to three years, we've seen a number of medical practices kind of emerge using this model. There's Exponential Health that I use as an example in the story this week in Crain’s Grand Rapids Business. There's MI Health Partners. There's a men's health and a women's health practice on the east side of town. We've seen Plum Health out of Detroit expand offices and is looking to kind of put a base here in Grand Rapids with an office. So, this direct primary care model is really beginning to gain traction. And the expectation with the change in the federal law come January 1 that allows you to use your HSA money to pay these memberships. There's a lot of expectations that this model is going to take off and really accelerate in growth and more people are going to migrate to this because again, the idea is its better care, better access, better care management for uh chronic illnesses. And you're already paying for that visit out of pocket and now you can use your HSA money.
Patrick Center: We're talking with Crain's Grand Rapids Business staff writer, Mark Sanchez. Fifth Third Bank and Comerica are merging. A $10.9 billion deal.
Mark Sanchez: They announced this deal last week. The latest bank merger that could cause a little bit of market disruption. It's, as he said, a 10 plus billion-dollar deal between Comerica Bank and Fifth Third Bank. And yes, both banks are based elsewhere. Fifth Third's in Ohio, Comerica. formerly based in Detroit years ago, moved headquarters down to Texas. And these are two big banks coming together.
For this marketplace, we'll see the fallout from this. There's some expectations that Fifth Third Bank may have to divest some branches. We saw that a few years ago when Huntington Bank bought TFC Financial and the Federal Reserve before it approved the deal said, no, you got too much market concentration. You need to divest some of those offices.
And one of the things, and what we kind of wrote about this when it came out last week to kind of put a local take on it is a few years back, Fifth Third was no longer the leading bank in the marketplace based on deposit market share. You can go back generations, back to the Old Kent days and then Fifth Third after that deal 25 or so years ago. Fifth Third Bank for a long time was the number one bank in the Grand Rapids area marketplace. After Huntington bought TCF a few years ago, that changed and Huntington became number one. So, for Fifth Third, once this deal comes through and it acquires Comerica, which has a number of offices here in the marketplace, Fifth Third will once again be on the top of the list for market share leaders.
Patrick Center: Big story last week, but everybody is still talking about it. And that is Acrisure cutting 400 jobs and replacing those jobs with automation and you know the automation, everybody knows the acronym with AI, artificial intelligence.
Mark Sanchez: Yeah. Think of this as the parallel in conversations and emails I've gotten in my inbox in the last week. Think of this in terms of 40-plus years ago when we started seeing automation and robots started showing up on factory floors, especially the auto plants here in Michigan. And yup, they supplanted a lot of jobs, but manufacturing's pretty productive. So, Acrisure, as we've watched this corporation over a decade-plus make numerous acquisitions and grow into a now on track to be about a $5 billion corporation this year. It's a global insurance brokerage and fintech, announced the other day last week that it's eliminating 400 jobs in the accounting area. It's basically the artificial intelligence platform that has been developed over the years.
Acrisure bought an AI platform from a Pittsburgh company five years ago and has further developed it to implement in the business for a number of uses. And now it's going to implement the AI platform and automate the accounting functions. That means those folks and those jobs, those jobs are getting eliminated. There's 400 jobs globally for Acrisure affected. Two hundred of them are in West Michigan in the Grand Rapids area. So, this is going forward and this will probably occur in the first quarter toward the latter half of the first quarter in 2026.
Sitting down the other day with Greg Williams, the founder and CEO who's built this company over two decades. He explained that this is, you know, you, you use AI to generate productivity efficiency. And again, this platform that they've developed and use is doing many things internally in the business. And in time, you see that productivity and this is some of the talk about AI as it's coming and beginning to filter throughout the economy. What's the effect on the workforce? What's the effect on jobs?
And in this case, the hope within Acrisure is that a lot of those folks affected locally will apply for other jobs within the corporation. They have right now about a hundred positions open in the Grand Rapids area in West Michigan. So, there's hope maybe some folks will get a soft landing. They wanted to announce this up front to the employees to give ample time to adjust and they'll have the usual severance packages, outplacement. But there's hope that folks affected will apply and maybe move into some other positions. But this is really one of the first examples we're seeing where a corporation is going to implement AI for an internal administrative function and that's affecting the jobs.
Patrick Center: Crain's Grand Rapids Business staff writer, Mark Sanchez. Thank you so much.
Mark Sanchez: Thank you, Patrick.