In case you missed it, Catalyst for Payment Reform (CPR) and Healthcare Incentives Improvement Institute (HCI3) just released their latest “Report Card on State Price Transparency Laws,” in which they gave 45 states an “F”. Only one state, New Hampshire, received an “A” for its work over the last year to stand-up the NH HealthCost website, which has received positive reviews.
I’ll be the first to admit, I’m a huge fan of retail healthcare. I want nothing more than to see consumers rip control of their health out of the hands of an industry that is both patronizing and self-serving. The truth, however, is that for every American who is both motivated and capable of assuming the responsibility for their own health, there are fifty others who are not. It’s a strange dichotomy.
The first time I heard Par8o’s tagline “Healthcare’s Operating System,” I remember thinking to myself, “what the hell does that mean?”
I now think I have a pretty good idea.
Over the last two and a half years, my partners and I have been on a journey to transform the healthcare consumer experience. We began this journey by developing a patent-pending process for creating virtual health insurance cards. Beyond providing consumers real-time information on plan benefits, the virtual insurance cards serve as a digital token to enable smartphone-based transactions.
As a company who’s mantra is - find, connect and transact - it’s a bit surprising (and maybe a little disheartening) to realize the industry doesn’t care about two-thirds of our little jingle (at least not yet).
After all, we began this journey to transform the way consumers and providers communicate with one another. Healthcare is a transactional business and all the transactions are broken and inefficient. These inefficiencies create horrible consumer experiences for patients and make the business of medicine unmanageable for healthcare providers. If we can digitally connect consumers to the industry and the industry to itself, we could change the healthcare world.
The realization came on a flight back from San Diego. We had just met with a potential investor who was incredibly interested in our startup, but who ultimately balked when he learned how long it takes health systems to make purchasing decisions. True enough, but a little oblique of our actual business model... Ah rejection, like a pair of fuzzy bunny slippers.
I’ve spent the better part of the last two years trying to improve price transparency in healthcare. When my startup, Medlio, began down this path, we had a very simple vision - that consumers should be able to use their smartphones to find, connect, and transact with their healthcare providers. By "transact," I mean schedule appointments, submit medical forms and insurance information, receive an upfront estimate of the cost of the visit, make payment, and receive their data afterwards.
Most people recognize that their choice of medical providers is controlled by their insurance company, and in turn, their specific health plan. In my previous article, I explained how the exploding growth of high deductible health plans (HDHPs) is rationalizing the insurance market, and quickly forcing a reevaluation of the role payers play in outpatient care.
It’s understandable that so many people automatically assume that health insurance provides a benefit. After all, we’ve been conditioned for so long to think that insurance, through some arrangement with our employer, is actually picking up the tab. If that’s true, why not go with the steak instead of the chicken, and for that matter, why not throw in dessert?