Making the financial side of healthcare more manageable and engaging for consumers is something I?ve been passionate about for a long time. It started back in 1999, when my mother ? staring at a kitchen table covered with EOBs and medical bills ? proclaimed that she was never going to the doctor again. It was all just too much for her to digest. Now that?s a problem to solve.
Today, nearly 20 years later, it still remains this way for many. Between skyrocketing out-of-pocket costs (up 230% from 2006 to 2015 alone, according to Kaiser Family Foundation) and language and numbers that don?t always add up, patients are desperate for help. And they?re looking to providers and technology for help.
- One in five working-age Americans with insurance?has had problems paying medical bills in the past year. (Kaiser Family Foundation / New York Times)
- 77% of patients have been confused by an EOB sent by their health plan; 76% are confused by bills from their providers. (InstaMed)
- 61% of patients are either sometimes or always surprised by out-of-pocket costs. (TransUnion)
- 91% of patients say it?s important to know payment responsibility prior to a provider visit. (InstaMed)
- More than half of 18-34 year olds are willing to use a service or online solution to help them manage medical expenses; 33% of those 35-54 are willing, and 9% of those 55+ are. (PwC Health Research Institute)
What can providers (and technology innovators) glean from statistics like these? A lot.
- Now more than ever, consumers are being crushed by rising out-of-pocket costs, something that is largely attributable to the increasing popularity of High-Deductible Health Plans. This puts both patients AND providers at risk, since under HDHPs, getting paid means providers must work directly with the patient ? rather than relying on payers alone to make it happen.
- There is a tremendous need for providers and payers to work hand-in-hand to help patients better understand and estimate the cost of care before it?s consumed. The HITECH Act and Affordable Care Act have helped open the door for this to happen, but there?s much more work to be done.
- Patients want technology to help them become better consumers of healthcare ? and they are looking to their providers to deliver. Technology has permeated almost every other area of our lives (Pew Research Center says that 77% of Americans now own a smartphone!), why not make scheduling appointments, viewing medical records, communicating with clinical staff, receiving and paying bills, and assessing healthcare costs and quality measures just as accessible??
Can technology really be the answer?
At PointClear Solutions, I get this question a lot. My answer? In many ways, yes.
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While technology isn?t able to solve all problems for all people at all times, over the last 10+ years in the digital health space, our team has seen ? and helped create ? a number of software solutions that successfully help patients become smarter, happier, more responsible consumers of healthcare, while simultaneously supporting providers in their efforts to increase patient satisfaction, speed payments, and drive revenue.
Here are a few of my favorite projects that fall into this category:
Navicure ? Navicure?s combination patient payment and billing system gives physician practices two important things: 1.) ?A means for helping patients better understand and estimate cost of care, and 2.) An efficient and effective way for practice staff to process claims and collect payments. I love the emphasis on patient education and cost transparency in Navicure?s solution approach. And the time the PointClear team spent coming to really understand user workflows ? and designing a thoughtful, modern user interface ? made the project a TAG ?Product Launch of the Year? award winner.
Change Healthcare ? Before Emdeon and McKesson, there was just Change Healthcare, an independent Nashville startup dedicated exclusively to consumer engagement and cost transparency in healthcare. They came to PointClear for help in designing and developing web and hybrid iOS / Android apps to better serve their payer clients and, ultimately, to provide improved access to value-based care. The result of our work together was powerful ? an elegant, intuitive software solution that empowers patients to shop for care, weighing quality, cost, and convenience.
OrthoBanc ? OrthoBanc wanted to use technology to 1.) Educate patients on the true cost of elective dental and orthodontic services, and 2.) Help patients identify and secure financing to meet their unique needs. They engaged PointClear to design and develop a web application to achieve these goals. The intuitive interface we created enables practices to use the app in-house to easily educate patients on their?financial options. Best of all, it can also be used by patients at home ? giving them more time to evaluate and weigh their options without pressure to make a quick decision. It?s proven very successful for OrthoBanc in that it?s helped them acquire new patients and keep existing ones.
How can we help you leverage technology to aid in patient financial decision-making?
David Karabinos is CEO of PointClear Solutions, a leading technology consulting company that specializes in providing software strategy, design, development, and management services for the healthcare industry.
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