Industry leaders need to stop pointing fingers and embrace consumerism in healthcare

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A massive study on medical bills by InstaMed yielded trends – some alarming – among US providers, payers and consumers. The findings paint a somber picture of an industry that can’t seem to embrace consumerism in an age when almost every other industry allows people to conduct business from their smartphones.

Specifics from the report, as outlined by Becker’s Hospital Review include: [1]

  • InstaMed used quantitative data from more than $396 billion in healthcare payments processed on the InstaMed platform between 2015 and 2018, along with qualitative, proprietary, independently gathered survey findings from U.S. consumers, providers and payers in 2018.
  • Survey respondents represent 100,000 U.S. healthcare providers, more than 3,000 U.S. payers, and a representative sample of thousands of consumers who paid a medical bill and were insured last year.

Consumers:

  • 70% of consumer respondents are confused by medical bills
  • 61% received a bill for more than expected in 2018
  • 50% received an unexpected bill
  • 56% cannot afford a medical bill of $1,000 or more

Providers

  • 90% of providers use paper and manual processes to collect payments
  • 69% saw patient responsibility climb in 2018 compared to 2017
  • 77% said collecting any payment takes more than a month

Payers

  • 75% think members can locate needed information without making contact
  • 70% allow patients to pay premiums through member portals
  • 39% said direct-to-consumer solutions are a top priority this year

With providers using paper and manual processes to collect payments, consumers consistently confused by medical bills and unable to pay bills of $1,000 or more, and payers believing consumers can locate necessary information on their own, it’s no wonder that healthcare’s financial situation is bleak for just about everyone.

And yet, instead of addressing their own issues, providers and payers blame each other for healthcare’s woes. When it comes to lowering hospital costs, hospitals say payers need to do more. Payers say it’s up to the hospitals. Tara Bannow, with Modern Healthcare, recently set about finding what the industry players are actually doing to bring down costs. She found that quest harder than she imagined. “Gail Wilensky, an economist and senior fellow at the international health foundation Project HOPE, said my first mistake was trying to get straight answers from parties with personal stakes in the issue,” writes Bannow.[2] “’That everybody says, ‘It’s the other guy that’s the problem,’ isn’t exactly a surprise, said Wilensky, who served as administrator of the predecessor agency to the CMS for several years under President George H.W. Bush.”[3]

One take, from the payer side, could very well help the entire industry: integrating systems to work together.  As reported by Modern Healthcare: “’When you have an integrated system – a plan, hospitals and doctors – all in a single entity or working in these close collaborations, you naturally see savings and you see greater value,’ said Ceci Connolly, CEO of the Alliance of Community Health Plans.’ Her organization’s membership is made up of provider-aligned plans collaborating with health systems.”[4]

Simply stated, partnerships and integrated systems will be key to turning around the healthcare situation, lowering costs, and helping consumers know what their out-of-pocket costs will be before the fact, which will help with collections.

In fact, a system that allows collections at the time of scheduling would be ideal. HealthQRS has that. HealthQRS is the e-commerce platform that allows for cost effective partnerships and an Amazon experience for the consumer.

HealthQRS offers the technology that allows providers and payers to partner and integrate systems. HealthQRS allows patients to see what their actual out-of-pocket expenses will be before they schedule services. Not estimates. Actual prices.

HealthQRS is not a portal. Think of it like Expedia for healthcare. It is an expansive system that works behind the scenes to provide you with a way for people to search for providers and services in network, access quality scores, see the actual out-of-pocket expense, select a provider and service, schedule appointments, pay in full or at least set up payment plans and even arrange transportation. All from an app on their smartphones.

HealthQRS allows you to offer an entire online retail experience with one, easy-to-use platform. And we have developed the only complete e-commerce platform for healthcare on the market. HealthQRS is an e-commerce platform that you can brand for your company or hospital and that will keep consumers in-network. Our ecommerce platform gives people a full, rich retail experience in healthcare. When they login to the app on their smartphones, tablets or PCs, they see your logo and they think you are providing this experience. And you ARE providing the experience … HealthQRS is providing the platform.

How do we do all of this?

Our solution is built with complicated algorithms that use real-time data: the actual payer contracts by provider + insurance verification information + charity + other business rules to provide consumers with a true out-of-pocket per patient per procedure. HealthQRS interfaces with virtually any existing practice management system and electronic medical record. We have over 30 modules that work independently or all together depending upon your needs 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.

Our solution is simple to use. We invite you to see for yourself with this 2-minute video of the HealthQRS price transparency tool. Click on this link, then you’ll be instructed to download and watch: https://s3.amazonaws.com/hqrs.media/_misc/Screen+Recording+2018-11-29+at+17.30.45.mov

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.

In fact, 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 also invite you to watch our user-friendly app video that you can use to win consumers as well as our point-of-service solution video that may interest you. You can also check out our E-Commerce Medical Marketplace Flyer for more information.

Contact us right now to schedule a personalized demo. We can get you entire system set up in a matter of weeks. Looking forward to helping you soon.

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[1] Kelly  Gooch, “How consumers, providers and payers view healthcare payments,” Becker’s Hospital Review, Apr. 17, 2019, https://www.beckershospitalreview.com/finance/how-consumers-providers-and-payers-view-healthcare-payments.html?origin=rcme&utm_source=rcme

[2] Tara Bannow, “Industry leaders share ideas, point fingers on limiting hospital prices,” Modern Healthcare, Apr. 13, 2019, https://www.modernhealthcare.com/finance/industry-leaders-share-ideas-point-fingers-limiting-hospital-prices?utm_source=modern-healthcare-am&utm_medium=email&utm_campaign=20190415&utm_content=article1-readmore

[3] Bannow,”Industry leaders,” https://www.modernhealthcare.com/finance/industry-leaders-share-ideas-point-fingers-limiting-hospital-prices?utm_source=modern-healthcare-am&utm_medium=email&utm_campaign=20190415&utm_content=article1-readmore

[4] Bannow,”Industry leaders,” https://www.modernhealthcare.com/finance/industry-leaders-share-ideas-point-fingers-limiting-hospital-prices?utm_source=modern-healthcare-am&utm_medium=email&utm_campaign=20190415&utm_content=article1-readmore

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