5,000 Physicians


$100 Million

negotiated increases

180 Years


“Our practice of 55 radiologists has proudly and successfully worked with Fulcrum Strategies for many years. Fulcrum has provided us with valuable insight into the mindset of payer process and payment methodology resulting in better understanding on both sides of the payer-provider equation.”

Robert E. Schaaf, MD

Managing Partner, Wake Radiology

“Integrity, competence, efficiency, professionalism, loyalty, accessibility. These are qualities that Ron Howrigon and his team project each day. It has been our good fortune to have Ron assist our OBGYN practice for nearly the past decade. You really can’t do much better than Ron and his staff. I’d give them six stars out of five."

Michael Smith, MD, Kamm McKenzie, OBGYN

Explore Ron Howrigon's book: Flatlining

The unsustainable rate of inflation in the cost of health care - and the "market adjustment" that could send the U.S. economy into a tailspin.

The three economic factors that explain why healthcare costs keep rising, and the changes necessary to reverse that trend.

How "Repeal and Replace" could set the stage for a meltdown of the U.S. healthcare system.

A novel with a title that reads Flatlining

The Affordable Care Act, six years on, its unanticipated effects on the healthcare system, and why the exchanges are failing.

The prescription for the cure - seven areas where decisive action is needed to create a more sustainable model for health care.

How physicians and hospitals need to prepare for the "tectonic shift" in how they get paid.

News and Media

Flatlining Podcast