With healthcare costs higher than the GDP, what is your plan?

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Healthcare costs are at an all-time high and it’s due to prices, not utilization. Health Care Cost Institute (HCCI) has issued its annual report breaking down cost and utilization for people who have employer-sponsored health plans. The results were gleaned from data of the country’s four largest health plan providers: Aetna, Humana, Kaiser Permanente and UnitedHealthcare. HCCI analyzed roughly 4 billion claims of more than 40 million people (about 26% of the employer-sponsored insured population). Alex Kacik with Modern Healthcare reports on HCCI’s findings: “Healthcare spending has outpaced gross domestic product growth over the last five years, reaching an all-time high in 2017.”[1]

Kacik explains it well: “People are essentially paying more for the same amount of care.”[2]

The new high is over $5,600 per person in 2017, according to the study, and reported by Les Masterson in HealthCareDive.[3] HCCI’s report attributes the increase to higher prices, outpatient services and mental health and substance use admissions. Outpatient services saw the most significant spending growth with a 5.1 percent increase.[4]

HCCI breaks down the average spending per patient:[5]

  • Professional services $1,898 (33.6%)
  • Inpatient $1,097 (19.5%)
  • Outpatient $1,580 (28%)
  • Prescription drugs $1,065 (18.9%)

Employers are forced to act with the rising prices. “They are carving out narrow networks that promote the use of lower-cost services and have implemented high-deductible health plans that shifted more of the cost burden to employees.”[6]

An example of this is the Amazon, Berkshire Hathaway and JPMorgan Chase joint venture started by the four companies in an effort to control costs and help their employees. More and more companies will take this approach.

Both hospitals and employers need a sound plan to effectively lower healthcare costs.

Employers: What is your strategy to lower healthcare costs? Would you be interested in an application for your employees that helps them save money? An app that provides them with a complete list of elective procedures along with the exact out-of-pocket costs for those procedures? An app that they can use to search, select, schedule and pay for the procedure all from their smartphones?

Hospitals: Does your strategy include ways to market yourself to employers who take matters into their own hands? How are you going to compete with the hospital systems who secure these contracts? How can you get this business?

You need the right platform to compete. You need a technology infrastructure that will give people a way to find you, to see the services and procedures you offer and to select, schedule and pay for those services.

HealthQRS solves all of those problems with one, easy-to-use platform. This solution integrates into your EHR and your revenue cycle management systems. HealthQRS is an ecommerce platform that you can brand for your company or hospital and that will keep employees of 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.

Let’s use MRI as an example. Say an employee, John Smith, has doctor’s orders for an MRI. Mr. Smith, with the HealthQRS app can do the following from his smartphone:

  • Access a list of all of the MRIs in network
  • See the actual out-of-pocket he will pay for that MRI
  • Select which appointment he wants
  • Schedule the procedure
  • Pay for it right then (which means hospitals collect money upfront and Mr. Smith doesn’t get a surprise or balance bill later)
  • Arrange for transportation with Uber or Lyft right from the app

Our system includes referral management, so Mr. Smith can access his doctor’s order within our app, making it simple for him to schedule the appointment.

And if Mr. Smith has a sore throat and needs to see a doctor, but it’s not convenient? He can opt for telemedicine and see one of your tele docs, who can be accessed right from the HealthQRS app.

Our system allows hospitals to bundle prices. This eliminates surprise and balance bills for a win-win-win.

HealthQRS’ ecommerce platform provides a true retail experience for the user. HealthQRS has developed the only complete e-commerce platform for healthcare on the market. This retail experience creates a mutually satisfactory partnership for hospitals and employers and employees. HealthQRS allows employers and employees to do business with hospitals and actually complete the financial portion of the transaction from the app.

HealthQRS helps hospitals increase their volumes and employers lower their costs. HealthQRS’ ecommerce platform helps create consumerism and helps both hospitals and employers be competitive within their markets.

Not only do hospitals increase their volumes, they are able to collect money upfront. The consumer has become the 3rd biggest payer next to Medicare and Medicaid and collecting upfront is vital to long-term stability.

Our solution is not a portal. We’ve developed HealthQRS using 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. We are talking about giving consumers a complete, online retail experience that has the look and feel of shopping on Amazon. Give people a way 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.

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

HealthQRS interfaces with virtually any existing practice management system and electronic medical record. Our solution helps you comply with CMS’ price transparency rule, but we are much more than a price transparency tool. 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.

We enable telehealth connectivity as well. Our technology enables people to connect to more cost-effective, consumer-oriented healthcare options and we keep them in-network. HealthQRS integrates fully to EHRs and can also enhance existing portals and other patient engagement solutions, improve meaningful use numbers and increase meaningful use funds. Consumers can access the retail site and shop, schedule and pay for services via an easy-to-use app on their smartphones or tablets.

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.


[1] Alex Kacik, “Employer-sponsored healthcare spending reaches record high,” Modern Healthcare, Feb. 12, 2019, https://www.modernhealthcare.com/article/20190212/NEWS/190219994?utm_source=modernhealthcare&utm_medium=email&utm_content=20190212-NEWS-190219994&utm_campaign=am

[2] Kacik, “Employer-sponsored healthcare spending,” https://www.modernhealthcare.com/article/20190212/NEWS/190219994?utm_source=modernhealthcare&utm_medium=email&utm_content=20190212-NEWS-190219994&utm_campaign=am

[3] Les Masterson, “Prices – not use – drive higher healthcare costs, HCCI says,” HealthCareDive, Feb. 12, 2019, https://www.healthcaredive.com/news/prices-not-use-drive-higher-healthcare-costs-hcci-says/548184/

[4] Masterson, “Prices – not use,” https://www.healthcaredive.com/news/prices-not-use-drive-higher-healthcare-costs-hcci-says/548184/

[5] Masterson, “Prices – not use,” https://www.healthcaredive.com/news/prices-not-use-drive-higher-healthcare-costs-hcci-says/548184/

[6] Kacik, “Employer-sponsored healthcare spending,” https://www.modernhealthcare.com/article/20190212/NEWS/190219994?utm_source=modernhealthcare&utm_medium=email&utm_content=20190212-NEWS-190219994&utm_campaign=am

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