Consumer Directed Healthcare Needs All Inclusive Technology

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As employers of all sizes continue to provide healthcare benefits to employees, yet try to stay afloat, the move to higher deductible health plans is here to stay. Consumer directed healthcare (CDH) represents high deductible plans put together by health insurers for employers. It’s a formal name for what has been happening for quite some time: Raise the deductible and put more the onus on the consumer. And it’s big business. There are approximately 60 million CDH policies in the market today, according to an impact report by the Aite Group.[1]  And whether you are buying your insurance through a broker or are self-insured, these policies impact more than your bottom line. They impact your employees.

Of the 162 million Americans who have commercial insurance, 75 million, or 46% have high deductible plans.[2] That’s almost half of the consumers in the U.S. This trend has grown dramatically in the past few years and shows no signs of slowing down. The fact that so many people are dealing with large out-of-pocket sums means that they are drowning in expenses with no way to figure out their choices for making healthcare decisions that impact their wallets.

If you force people to jump off a boat into a lake, they either need to know how to swim or have life jackets if they’re going to survive. Yet many employees being pushed into higher deductible health plans don’t know how to navigate the waters. And their life jackets? Patient portals and technology applications that deliver half of what they need. Moving to high deductible plans might be necessary for your bottom line. Yet shifting employees to high deductibles sets them up for financial hardships if they don’t have tools to shop for healthcare services.

An article published a decade ago in Managed Care highlights what CDPs can do for companies, saying they “raise the stakes for consumers significantly by shifting more front-end annual expense to the member and giving him decision-making responsibility to:

  • Understand all available options
  • Identify personally relevant information and consider important factors in choosing appropriate care
  • Understand personal, financial and health implications of their daily life, health care choices and family finances (especially those elements of expense which affect cash flow).”[3]

In order for someone to understand their options and make good decisions, a tool must be available to outline those options. And yet in the 10 years since, no one company, except for HealthQRS, has been able to pull all of the key components together in an easy-to-use medical e-commerce platform.

Technology will make or break CDHs

Technology is a key driver in CDH usage and people need more than just piece-meal modules, such as price estimators or telemedicine applications. People need an all-inclusive package, a true, e-commerce medical marketplace that allows them to see the full list of benefits available from their employers, lists of participating service providers and associated, actual costs, not just estimates. Users need to be able to schedule and pay for their services from the same application and be able to access funds from their HSAs, FSAs or manage their HRAs.

Regardless of the size of the company, employees need the right tools to make better, healthier, and lower-cost choices. Whether they are Fortune 500 companies or small startups, savvy employers choosing CDH plans will insist on providing their employees a navigation tool that helps them shop for, select, and pay for the lowest cost, highest quality services and procedures. The technology to do all of that exists. HealthQRS has the platform that can partner with any size employee and provide everything an employee needs to utilize their healthcare benefits. In fact, HealthQRS has developed the only complete e-commerce medical marketplace on the market.

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. Once consumers select their procedure, they can schedule it and pay for it all from the same app. Our powerful algorithms calculate the exact, true amount, not just estimates, that they will owe. HealthQRS’ unprecedented, cutting edge technology combines metrics from provider contract rates with payers, insurance verification, patient financial responsibility, payer claims adjudication logic, and in a millisecond, calculates the patient’s exact out-of-pocket expense. No one else is doing this.

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.  And even though it’s complicated beneath the surface, it’s extremely easy for the consumer to use. Think of it like a Priceline or Expedia for healthcare, where a user simply types in the procedure or service he or she needs, and voila! A list appears on the screen complete with exact out-of-pocket costs for that specific consumer.

HealthQRS has the strategic technology for CDHs

HealthQRS has created an e-commerce medical marketplace that allows employees to shop, schedule and pay for procedures and services from their smartphones, tablets or computers. When consumers use our platform, they can instantly access their network, see a list of procedures and providers in order of least to most expensive, select a location, schedule the appointment, access their HSA or FSA and pay for it all from the app. (Our system can also manage health reimbursement arrangements.) Our built-in navigation can send consumers to telehealth services as well. In addition, our software is enabled for voice recognition.

We are ready to handle CDHs and help the people who will rely on them for their healthcare. We invite you to learn more about HealthQRS and our e-commerce medical marketplace. 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. We can have providers, payers or facilities set up in a matter of weeks at the point-of-service and online. And because we are a software as a service (SaaS), our customers don’t incur any capital expenses, only a low monthly fee. 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.

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[1] “U.S. Health Benefits Accounts: Account Spending is on the Rise,” http://aitegroup.com/report/us-health-benefit-accounts-account-spending-rise

[2] Morgan Haefner, “10 things to know about 2016 healthcare consumer payment trends,” Becker’s CFO Report, June 13, 2017, http://www.beckershospitalreview.com/finance/10-things-to-know-about-2016-healthcare-consumer-payment-trends.html

[3] “Consumer-Directed Health Plans: Built to Last Or Designed to Fail?” Managed Care, Aug. 2007,

https://www.managedcaremag.com/archives/2007/8/consumer-directed-health-plans-built-last-or-designed-fail

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