Aetna, Humana, UnitedHealth and now Anthem pulling out of healthcare markets will drive consumerism

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Aetna. Humana. UnitedHealth. All have pulled out of many insurance exchanges under the Affordable Care Act (ACA) also known as “Obamacare”. Now Anthem, who has pulled out of several states, has just announced it will pull out of Maine. We could be looking at a bare market soon and the risk is growing with uncertainty about the fate of ACA.

As insurers exit markets, consumers, employees and businesses suffer. And so do health systems. Becker’s Hospital Review quotes Charles Ayscue, senior vice president of finance and chief financial officer of Asheville, North Carolina-based Mission Health, who has said that Mission Health is taking proactive steps to prepare for the influx of patients with high deductible health plans, with a focus on revenue cycle improvement: “I’m really worried about the future of the ACA and how much bad debt we’re going to have. We’re going to see a lot more self pay and we don’t have the workforce to handle that self pay,” said Ayscue.[1]

With self pay comes heavy reliance on the consumer. And to keep the consumer happy, you need a great consumer experience. Think Amazon. The Amazon consumer experience is the standard for today’s shopper.

Keith Lohkamp, senior director of industry strategy at Workday, a provider of cloud-based applications for finance and human resources, agrees that the patient experience is important in Becker’s article: “On the flipside, you have to change your strategy and innovate. You have to invest in the patient experience and the physician experience.”[2]

Insurance companies pulling out of the state insurance exchanges will drive insurance premiums up. Some analysts expect rate increases by 18 percent next year. Astronomical premiums impact everyone: consumers, employees and especially small and medium-sized businesses. Consumerism will be the default as people try to find the highest quality healthcare for the lowest out-of-pocket costs.

As more and more people search prices, hospital systems need more than a bricks and mortar strategy. They need an online strategy as well because when people shop prices, they look online. Consumers are looking for the Amazon experience and the first set of providers who give them a true e-commerce experience will win.

A true e-commerce experience means giving people a way to shop, schedule and pay for healthcare procedures and services from their smartphones, tablets or computers. Give them a way to instantly access their network, see a list of procedures and providers in order of least to most expensive, select a location, schedule the appointment and pay for it all from the app. Help people choose the least expensive method that’s appropriate for their condition. In some cases that could be telehealth, and our built-in navigation system is set up to direct employees to those types of services. Our software is also enabled for voice recognition and can easily be integrated to allow those with Echo devices to ask Alexis to book their appointments.

HealthQRS has all of this ready to go for you right now. We can have providers, payers or facilities set up in a matter of weeks at the point-of-service (bricks and mortar) and online (e-commerce marketplace). And because we are a software as a service (SaaS), our customers don’t incur any capital expenses, only a low monthly fee.

What really makes HealthQRS stand out from everyone else is our platform. We have put together over 30 modules all working together to provide a holistic, seamless, total experience for the consumer from start to finish. We combine navigation, the capability to make an appointment, referral management (if needed), payment management and so much more than we can list here. HealthQRS has developed the only complete e-commerce medical marketplace platform on the market.

Developing a solution of this magnitude didn’t happen overnight. We started with the consumer experience in mind and spent years drawing on the knowledge of best-of-breed experts to perfect, fine tune and put together this complicated, yet complete solution for medical e-commerce.

Now is the time to get your infrastructure in place to provide an easy-to-use shopping experience for consumers, businesses and their employees. We invite you to learn more about HealthQRS and our e-commerce medical marketplace and how we can help you. We have over 12 years of experience developing healthcare retail experiences for consumers and our founders have over 50 combined years of e-commerce experience. Why not  contact us right now for more information or click here to schedule a demo? Or click here for a quick, 6-minute video about our e-commerce strategy.


[1] Ayla Ellison, “4 financial, strategic, and revenue cycle issues health systems are facing,” Becker’s Hospital Review, Sept. 27, 2017,

[2] Ibid.

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