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New EquityHealth Marketplace Gives Patients the Services They Want With Transparent Pricing
For the first time in my life, I have a high deductible plan with a health savings account. Given that I will soon be on Medicare, I thought I would experience this new type of insurance while I still can. With this plan, I have lower overall premiums and instead put roughly $4000 into a savings account. But, the first $4,000 in health care costs are basically coming out of my savings account… that’s real money!
Recently, I needed a dermatologist to surgically remove a small skin lesion; something very common for those in their mid 7th decade. I had no idea how much of my money it would cost, and there was no way to actually find the exact price. Through research online, I put the cost in a range of $100 to $2000… and did I mention this was my money?
I will receive numerous bills, from the dermatologist, the pathologist and who knows whom else! The bargain hunter in me wanted to look at the care as a product, like you would on Amazon, and compare prices and features!
Obviously there are a lot of people in my position. According to the Kaiser Family Foundation, the average deductible is now $4,955. And as this number increases, it makes transparency in pricing critically important for consumers who have no way to know the cost of care ahead of time. This lack of transparency can lead to delays in treatment as people, afraid of the cost, delay care.
Physicians are also in the dark. Imagine having a job where you do not know what you will be paid until after you do the work. Currently, physicians have to wait for the reimbursement check, which comes weeks later! I know of no other business where this occurs, aside from medical practice.
That may now change with the creation of a Nashville based company, EquityHealth, founded by Richard Jung. Jung has created what he calls a marketplace for healthcare that is designed to appeal to employers, physicians and patients.
Basically, the EquityHealth Marketplace is cloud-based platform that facilitates transparent pricing for healthcare products and services. EquityHealth treats healthcare services as “packages” or “products” of care for chronic, episodic, and conventional care needs. By doing so, EquityHealth hopes to motivate value-based medical consumption. EquityHealth also allows employees and employers to share savings compared to median market pricing. According to Jung, the EquityHealth’s solution addresses up to 65% of healthcare services consumed.
The primary financial model is transaction fee based with opt-in value-add features by subscription. Think of an “Amazon” for health care, where your employer provides a subscription for additional features.
Equity also appeals to doctors, as they will know what their reimbursement will be for any service they offer. EquityHealth’s research has demonstrated that the fee-for-service operating model is deeply engrained in the mindsets of health care providers and believes that a successful transition to value-defined care will occur when providers can selectively adapt their practice, over time, with some control on their speed of entry. The EquityHealth Market provides this transition structure.
Physicians can bundle a service into a package, set a price, and add any other condition for the care and place it on the website. As an example, think of an all-inclusive executive physical with lab, EKG, stress test. Or a sport’s physical for your child. Or a diabetes prevention package for someone with pre-diabetes lasting one year. Or an MRI for a knee injury to see if you tore a meniscus. All this would be available with a fixed price. And did I mention that the physician gets paid within 3 days of the care being provided?
The description of the care and the price is available right up front along with every physician (or facility) offering this care in your local area. This fits right into the national trend toward bundled care pricing.
EquityHealth plans to deliver patients to physicians through channel partners that include; TPA’s, pension funds, employers and brokers.
As providers experience the impact of direct pay clients in conjunction with improved financials, they will become comfortable with expanding their service offerings to migrate a larger percentage of their practice resources to bundled and value-defined solutions for services beyond chronic care. All of this, and patients will know up front what their costs will be – a win-win for all!
