Industry Trends: Health Care Simplified

Industry Trends: Health Care Simplified

Americans often use the words “confusing,” “expensive” and even “inefficient” when it comes to describing health care. And for years, it has been debated the best ways to address the issue of cost effectiveness and quality in order to ‘fix’ the health care system overall.

But perhaps now more than ever, we find ourselves in the middle of a pivotal, transformational period in health care. Private businesses and corporate America have reached the end of their rope waiting for the issue to resolve itself, and have started to take health care into their own hands using their size and leverage. The most notable is the Amazon, Berkshire Hathaway, JP Morgan health care venture recently named ‘Haven’. The employees of these organizations are part of a pilot program to test all kinds of health care system strategies. This partnership has brought excitement to the industry and will push the bounds of transformational change, driving new ways to influence consumer behavior and leveraging machine-learning and artificial intelligence for more appropriate, cost effective and better outcome-oriented health care.

Another exciting and transformational health care program that is challenging tradition is SimplePay Health, a concept Kistler Tiffany Benefits recently shared with several clients and partners.

SimplePay Health makes buying health care as simple as buying a TV—but with one major difference.  When buying a TV, more often than not, the higher the cost, the higher the quality. With SimplePay, it’s just the opposite…the lower the cost, the higher the quality. Providers that cost more aren’t necessarily poor quality—but they do represent more risk for the member or the health plan in terms of cost, treatment outcomes, or referral patterns.

This platform has the ability (based on the country’s largest claim and quality databases—data on over 80 million Americans) to identify from national networks of doctors and hospitals, the providers who deliver the highest quality and most efficient care. The difference in cost for high quality care can vary 400 percent or more.

SimplePay has combined this powerful data with a simplified insurance design and experience for patients. Health care now works like purchasing any online consumer product. Patients know the provider quality as displayed on a 5-star scale and have a single out-of-pocket cost. Also gone are surprise bills to patients and all the confusing insurance terms that patients struggle to understand and manage.

Health care is personal in ways unlike any other industry, and the stakes of getting it right are literally life-and-death. Assessing previous attempts at a health care disruption, partnering with forward-looking healthcare experts, and staying focused on the end user will allow this new and exciting organization to learn from the past mistakes and further the goal of transforming and improving the healthcare marketplace.

For more information on the SimplePay concept, check out this video.