GM and Disney are going direct to health providers – are you ready?

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In nature the strong survive. Same goes with competition in the marketplace. When companies produce and market goods and services that consumers want, they win. If competition makes the marketplace thrive, consumers keep the marketplace alive. Competition – and consumerism – in healthcare is heating up as large employers decide to go direct to providers. This approach could change the game forever for payers and providers alike.

Just last week, the National Business Group on Health (NBGH) published the results of its annual Large Employers’ 2019 Health Care Strategy and Plan Design Survey which was conducted between May and June 2018 and surveyed 170 large employers. According to NBGH, “Collectively, respondents represent a wide range of industry sectors and offer coverage to more than 19 million employees and their dependents. More than 60% of respondents belong to the Fortune 500 and 53 belong to the Fortune 100.”[1]

Health care benefits are expected to approach $15,000 per employee in 2019. According to NBGH, the survey found that “large U.S. employers are increasingly playing an activist role in changing the health care delivery system and reexamining existing models.”[2] NBGH reports that “the survey also found a majority of employers believe virtual care and technology will play a major role in how health care is delivered in the future and that new entrants will be necessary to disrupt the market in a positive way.”[3]

Companies going direct is expanding from 3 % in 2018 to 11 % in 2019, according to the NBGH release. Interestingly, “Direct contracting between employers and Centers of Excellence (COEs) is also rising sharply, from 12% this year to 18% next year.  Cancer, cardiovascular and fertility COEs are experiencing the greatest growth,” according to NBGH.[4]

General Motors is one of those companies. GM just signed an agreement with Detroit-based Henry Ford Health System, bypassing traditional arrangements with payers to lower costs and improve care for its employees. According to the Wall Street Journal, the arrangement “covers everything from doctor visits to surgical procedures. By signing a contract directly with one health-care provider, as other companies have done, GM says it can offer a plan that costs employees less than other options while also promising special customer-service perks and quality standards.”[5]

WSJ reporter Anna Wilde Mathews also noted: “GM is the latest of a growing list of employers that are choosing to negotiate their own terms with health-care providers. Some, such as Walmart Inc., have crafted limited direct deals with hospital systems to perform a particular type of procedure, such as back surgeries.”[6] Mathews adds: “A smaller number of companies, including Walt Disney Co. , Boeing Co. and Intel Corp. , have taken the more-ambitious approach of having the health-care provider manage nearly all of the care of enrolled employees.”[7]

To play the game in this new environment, you must adopt and embrace the consumerism model. Because other providers are. But when you do, be sure to provide a full retail experience for the consumer. For example, one vendor only offers estimates and does not have access to all aspects of a patient’s journey from scheduling to receiving services to paying for those services.

If you provide a consumer experience such as the Amazon experience to your patients, not only will you be the preferred provider, you can set yourself up as a local center of excellence and attract even more employers and their patients. In addition, you will have access to reports that help you determine which areas of your business are profitable and which need to be reviewed.

HealthQRS’ offers a complete e-commerce platform. We collect and track data on appointments, procedures, amount paid, and much more. Every touchpoint with the transaction is captured by our system, so we can provide extremely rich reporting on every aspect of what the consumer is doing as well as how it touches your hospital system and the employer’s business. This gives the you – and the employer the infrastructure and reporting to see what the actual cost savings are. Our analytics show actual numbers, not estimates.

We are a software-as-a-service (SaaS), so you have no capital investment, just a low monthly fee. We also have a smartphone application that consumers can use to shop, see actual costs, schedule and pay for services with a few finger taps.

Our e-commerce medical marketplace platform is the perfect vertical application for integrated delivery networks. Our solution provides regulation compliance and serves as a marketing tool for your services. At the same time, we will solve your bad debt issues caused by not collecting from consumers, and many other benefits. In addition, HealthQRS allows you to be compliant with the new CMS transparency rules beginning Jan. 1, 2019.

HealthQRS can also enhance your existing portals and other patient engagement solutions. Our user-friendly app points them to your portals which will improve your meaningful use numbers and increase meaningful use funds.

HealthQRS has over 15 years of experience developing healthcare retail experiences for people and our founders have over 50 combined years of e-commerce experience. We invite you to watch our user-friendly app video that you can use to win consumers. We also have a point-of-service solution video that may interest you. You can also check out our E-Commerce Medical Marketplace Flyer for more information. Why not contact us right now to schedule a personalized demo? We’re ready to help you gain market share and secure your financial outlook.

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[1] Ed Emerman, “Large U.S. Employers Eye Changes to Health Care Delivery System as Cost to Provide Health Benefits Nears $15,000 per Employee,” National Business Group on Health Press Release, Aug. 7, 2018, https://www.businessgrouphealth.org/news/nbgh-news/press-releases/press-release-details/?ID=348

 

[2] Emerman, “Large U.S. Employers,” National Business Group on Health Press Release, Aug. 7, 2018, https://www.businessgrouphealth.org/news/nbgh-news/press-releases/press-release-details/?ID=348

[3] Emerman, “Large U.S. Employers,” National Business Group on Health Press Release, Aug. 7, 2018, https://www.businessgrouphealth.org/news/nbgh-news/press-releases/press-release-details/?ID=348

[4] Emerman, “Large U.S. Employers,” National Business Group on Health Press Release, Aug. 7, 2018, https://www.businessgrouphealth.org/news/nbgh-news/press-releases/press-release-details/?ID=348

[5] Anna Wilde Mathews, “GM Cuts Different Type of Health-Care Deal,” Wall Street Journal, Aug. 6, 2018, https://www.wsj.com/articles/gm-cuts-different-type-of-health-care-deal-1533582121

[6] Mathews, “GM Cuts Different,” Wall Street Journal, Aug. 6, 2018, https://www.wsj.com/articles/gm-cuts-different-type-of-health-care-deal-1533582121

[7] Mathews, “GM Cuts Different,” Wall Street Journal, Aug. 6, 2018, https://www.wsj.com/articles/gm-cuts-different-type-of-health-care-deal-1533582121

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