Healthcare Industry

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Healthcare Industry
June 12, 20190

What is People Driven Healthcare?

People Driven Healthcare (PDH) is a fundamental belief that people should be in control of their own healthcare. In this case, “people” refers to patients and providers. In today’s world, healthcare is primarily driven by formularies, algorithms, flowcharts and protocols, typically controlled by third-party companies. Confused? You’re not alone. Not one of those components mention anything about “people,” and how can you have a competitive and sustainable healthcare system without “people?” The answer – you can’t!

PDH gives power and choice back to patients and providers, putting them in the driver’s seat of their healthcare. These choices apply to everything from office visits and treatment, to health insurance coverage. The foundation of PDH is built on transparency, which is achieved through education, and this in turn allows patients and providers to make informed decisions that best suit their needs.

PDH was first envisioned in 2017 by Medvoucher, and implemented through its revolutionary Online Healthcare Marketplace. Here at Medvoucher, people are provided with price transparency as they shop for a multitude of healthcare offerings, available online or through an app (Apple Store | Google Play) on any mobile device. The Medvoucher platform was created with the core belief that patients deserve to know the cost of healthcare services up front, without the worry of surprise bills arriving in the mail weeks, or months, later. For patients, our PDH approach provides the education and knowledge necessary to make informed decisions regarding their individual healthcare needs.

For providers, our PDH approach offers the power and freedom to choose the best treatment plans for individual patients. PDH circumvents hurdles placed by traditional insurance carriers, such as requirements for pre-authorizations, peer-to-peer reviews, denials for patient services, and the uncertainty regarding reimbursement for services rendered. By giving providers the power to make choices and drive healthcare decisions, patients often receive expedited services – at a fraction of the cost. As a result of this expedited treatment, the duration of treatment is often decreased, further reducing the expense for the treatment plan.

Currently, traditional health insurance companies are vying to follow this path. There is chatter that many insurance companies are seeking to create catastrophic-type high-deductible HSA plans that will cover only a limited number of conditions, injuries, and illnesses. This trend is similar to the existing structure of automobile insurance, where consumers have the choice to obtain liability or comprehensive coverage, while managing their limits and deductibles. Health insurance is taking the first steps on a similar path, with the ultimate goal being consumer choice and price transparency, with variable deductibles and certain coverages for certain illnesses. This model minimizes monthly premiums and encourages patients to get the most from their healthcare dollars.

Unfortunately, traditional insurance companies still have a long way to go, and many hurdles to overcome, before they truly offer a healthcare alternative that benefits everyone. Thankfully, Medvoucher and its PDH approach has stepped in to fill the void by providing a free-market healthcare system powered “by the people” and “for the people.”

Healthcare Industry
May 8, 20190

Why is Healthcare So Expensive?

It’s no secret. The cost of healthcare is rising year after year – at an alarming rate. According to a recent Peterson-Kaiser analysis, the percentage of individual household budgets being devoted to healthcare costs has risen from 5.2% in 1990 to 8.2% in 2017.1  And the country as a whole is also feeling the strain of these rising costs, with U.S. spending on health care rising 3.9% in 2017 to over $3.5 trillion – that’s an average of nearly $11,000 for every person in the country!2

While the vast majority of Americans have some sort of health insurance coverage to help offset the rising costs of medical care, these plans often come with high deductibles and out-of-pocket expenses. As a result, nearly 10% of adults report delayed care, or not receiving the needed care at all, simply due to the cost.3 It is certainly a sad state of affairs when those in need of medical care can’t afford it!

Naturally, if we spend the most on healthcare we should be receiving the best healthcare possible, right? Wrong. According to the World Health Organization, the U. S. healthcare system ranked 37th in the world, and even worse, the Commonwealth Fund ranked the U.S. last among the top 11 industrialized nations in overall healthcare!4

So, what’s going on here? There are many logical explanations, from an inadequate and overworked system, to simple greed. Here are a few examples:

  1. Administrative Costs. According to some economists, this is the number one reason for skyrocketing healthcare costs. Our existing system needs an extensive support staff to deal with the cumbersome paperwork and billing requirements imposed by multiple insurance carriers. More administrative responsibilities = higher costs.
  2. Drug Costs. In many other countries the government negotiates the costs of drugs for its population. But here in the U.S., Congress created Medicare Part D, which specifically prevents Medicare from negotiating drug prices on behalf of its patients. Medicaid, on the other hand, is allowed to negotiate prices, and thus they pay much less. No negotiation = higher costs.
  3. Defensive Medicine. Due to fear of litigation, many doctors here in the U.S. will order multiple (and often unnecessary) tests during a patient’s care, even when the diagnosis seems obvious. More tests = higher costs.
  4. Expensive Mix of Treatments. The frequent use of advanced testing such as mammograms and MRIs, which require a continual investment in up-to-date technology and functionality drive up the cost of individual healthcare. And maybe even more so, the desire of patients here in the U.S. to be seen, and treated, by “specialists,” who are paid more than primary care providers. More “advanced medicine” = higher costs.
  5. Wages and Work Rules. As mentioned previously, a large and dedicated staff is needed in many locations to deal with the burdensome paperwork that comes with patient care. Of course, this is passed along to the patient in the form of higher prices. More employees = higher costs.
  6. Branding. Perhaps not as obvious at first glance as some other reasons for rising healthcare costs, but have you ever noticed that many patients want to be seen by the hottest new specialist, or be treated at the biggest hospital in town? More demand = higher costs.

It’s clear that our current healthcare system is broken. Is there a solution on the horizon for patients? While many believe the solution is for our government to take a more active role in negotiating healthcare costs on behalf of patients, there are an equal number of people who believe (and always will) that government is already too involved in our everyday lives. And of course, we can’t forget all of the “special interests” and lobbyists who may be looking for work if we ever get a healthcare system that actually works to the benefit of the people!

Thankfully, there is Medvoucher. We work directly with providers to offer the best healthcare services and products at reasonable, affordable, and transparent prices. Our marketplace provides patients the power to control individual healthcare without jumping through hoops imposed by traditional insurance carriers.

For a few helpful tips that may help you avoid excessive debt from surprise medical bills, click here.

 

 

Sources

https://www.healthedeals.com/blog/save/why-is-healthcare-so-expensive/

https://www.investopedia.com/articles/personal-finance/080615/6-reasons-healthcare-so-expensive-us.asp

https://www.bankrate.com/credit-cards/preventing-debt-from-surprise-medical-bills/

1 https://www.healthsystemtracker.org/indicator/access-affordability/spending-relative-household-budgets/

2 https://www.cms.gov/research-statistics-data-and-systems/statistics-trends-and-reports/nationalhealthexpenddata/nationalhealthaccountshistorical.html

3 https://www.healthsystemtracker.org/chart-collection/cost-affect-access-care/#item-about-1-in-10-adults-report-that-they-delayed-or-did-not-get-care-because-of-its-cost_2017

4 https://www.investopedia.com/articles/personal-finance/080615/6-reasons-healthcare-so-expensive-us.asp

Healthcare Pricing – No Longer “Clear as Mud”
Healthcare Industry
January 7, 20190

Healthcare Pricing – No Longer “Clear as Mud”

Did you know the actual costs prior to your recent hospital visit or surgical procedure? If you answered “No,” you’re not alone. Healthcare pricing is a gray (very dark gray) area for most patients. Thankfully, as we head into 2019, there are steps being taken to make healthcare pricing more transparent.

Based on a new federal rule that took effect January 1, 2019, all hospitals are required to post a list of standard charges for any service they offer. Hospitals are required to posts these lists online, and in a format that is easily downloadable and accessible for patients. While hospitals were always required to have a “price list” available for patients, in most cases those lists were only available to patients that “asked” for them. Under the new rule, hospital pricing is now available to everyone, at any time, at the click of a button.

This new rule will give patients a better understanding of the financial implications of any service they receive at a hospital, and will also allow them to “price shop” among multiple facilities in their area for the best value for the care they need.

It probably comes as little surprise that most hospitals are not welcoming this new rule with open arms. According to a recent poll (https://bit.ly/2DktwvS), 92% of providers are concerned about the new hospital price transparency requirement. It seems the basis for these concerns is “public perception” – or simply put, “sticker shock.” In other words, providers are worried that patients now have easy access to how much they are being charged for services!

In another, much needed, step towards providing transparent pricing for patients, the Centers for Medicare & Medicaid Services (CMS) launched a new tool in late November that allows patients to compare Medicare payments and copayments for certain procedures performed in hospitals or ambulatory surgical centers (ASC). This “Procedure Price Lookup” tool displays the national averages for the amount Medicare pays the hospital or ASC and the national average copayment amount a beneficiary with no Medicare supplemental insurance would pay the provider.

According to CMS Administrator Seema Verma, “the Procedure Price Lookup will help patients with Medicare consider potential cost differences when choosing where to have a medical procedure that best meets their needs.” The Procedure Price Lookup tool is available here.

For too long, the majority of patients have been kept in the dark when it comes to healthcare prices. How much is this going to cost me? How much is my insurance going to cover? Is there a cheaper alternative? Thankfully, some of these questions are now being answered, and as a result, the power of personal healthcare is being returned to the people – where it belongs!

Sources:

https://www.nola.com/news/2018/12/all-hospitals-required-to-post-prices-online-starting-jan-1.html

https://www.aha.org/news/headline/2018-11-27-cmss-online-tool-shows-cost-differences-certain-surgical-procedures

https://www.cms.gov/newsroom/press-releases/new-online-tool-displays-cost-differences-certain-surgical-procedures

https://revcycleintelligence.com/news/92-of-providers-concerned-about-hospital-price-transparency-rule

Healthcare Industry
October 6, 20180

Why easy access to patient record increases patient care and patient satisfaction

Why easy access to patient records increases patient care and patient satisfaction

There is an ever increasing need for healthcare information in the community. This is why 52% of the patients are using patient portal to access their health records. The importance of a healthier nation has pushed the government to introduce legislations such as the MACRA Act; which specifically focus on the quality of healthcare administered. MACRA has introduced four quality measures through the Merit-based Incentive Payment System (MIPS) program which include the following:

  • Quality,
  • Cost,
  • Improvement activities
  • And Advancing Care Information measures

Such programs help in improving the overall quality of healthcare delivered.

The entire health architecture is transforming rapidly, bringing along benefits one could only imagine. Let’s go through some of the perks which the patient portal has to offer:

More control over their health:

Patients remain updated with their progress, since they can view their lab results, immunization histories etc. They can take steps to improve on their health, remember the important dates and do so much more. Reviewal of allergy lists enables them to be involved in preemptive care, and take caution of the unexpected triggers by themselves.

Effective engagement:

Research suggests that about 51% of patients use the patient portal to obtain their physician’s opinion on the most concerning health issues. 24 hour access prevents the proliferation of symptoms to something sinister in the longer run. People might send an email or an IM to contact, but that only adds to the confusion. Through the communication channel provided by the patient portal, conversations are more structured and providers have the option to add clinical notes to the messages.

Swift patient registrations:

Before the introduction of the patient portal facility, people had to wait for hours just for registration purposes. Now, easy scheduling of appointments facilitates patients in the entire checkup process. Whenever the need arises, patients can simply use the portal to obtain effective care.

Reduced last time cancellations:
Some of the EHR solutions available in the market allow physicians to send text messages to their patients. Multiple reminders are sent to the patients in the form of messages. This feature prevents patient absences from scheduled checkups.

Secure means of communication:

Patient portal acts a gateway for patient-physician engagement, allowing the sharing of information with different labs, insurance companies and other stakeholders of the industry. Patients can book appointments, ask for physician’s opinion and view clinical notes.

Better Outcomes:

Through the 24/7 access of patient data, people can view health histories and act in accordance with the necessary actions. This helps in adherence to medications and administration of vaccinations, with the option of constant monitoring of health statistics.

Booking an appointment

Getting an appointment hadn’t been this easy. Patients simply have to select the time of their choosing and visit the practice. Now they don’t have to wait as they had to do before.

Integration with EHR systems:

Patient portals go hand in hand with EHR systems, enabling providers to make better decisions due to availability of first hand data. Provider notes are seamlessly shared with patients, pushing them to achieve a healthier lifestyle.

Author Bio:

Alex Tate is an expert health care marketing and consultant who specializes in promoting tools and resources so physicians can do better care.

https://www.nursingtimes.net/increasing-access-to-patient-records/5062710.article

https://patientengagementhit.com/features/how-patient-health-data-access-drives-patient-engagement

https://patientengagementhit.com/news/patient-portal-access-use-reach-52-of-healthcare-consumers

 

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