HelloMD helps patients with cash jump the line for better treatment

Mark Hadfield, HelloMD CEO and founder

Mark Hadfield, HelloMD CEO and founder

Mark Hadfield makes no bones about the fact that the US is moving to a two-tiered medical system, where those with the means to pay more get better, faster treatment. His company, HelloMD helps in-demand doctors –mainly specialists– opt out of the third-party reimbursement system and serve the more lucrative, cash-paying patients.

In this podcast interview, Hadfield describes how his company is addressing the high end of the market. He explains how HelloMD fits in the broader ecosystem of concierge practices, medical tourism and high-deductible plans. And he shares HelloMD’s geographically-focused strategy to build a marketplace to serve its niche.

By healthcare business consultant David E. Williams of the Health Business Group

 

Health Business TV: concierge medicine, premium hikes, provider engagement, HIPAA and driverless cars

In this fourth episode of Health Business TV, I discuss my mixed feelings about concierge medicine, the 29.3% price hike Blue Cross Blue Shield is imposing on us for next year, Quantia’s provider engagement platform, the recent video series I recorded about HIPAA, and some non-healthcare thoughts about driverless cars and the future of Uber.

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By healthcare business consultant David E. Williams of the Health Business Group

 

Self-driving Uber: Coming your way in 10 years or so

 

I drive just like Mom and Dad!

I drive just like Mom and Dad!

I figured someone already thought of this idea, so I Googled it before writing a blog post. Sure enough, Uber’s CEO has already announced that eventually Ubers will be driverless vehicles. It makes perfect sense. The biggest cost of a taxi –or Uber ride– is the cost of the person behind the wheel.

In a world of driverless cars + uber, many people could be taxi fleet owners, or just put their own private care out to work whenever they’re not using it themselves. In urban areas it could mean not even needing to have a parking spot. Just keep the car on the road the whole day and night, making money all the while.

Although it sounds a little spooky I think it will be pretty cool. It will change family dynamics, however. For example, young kids may start to go visit their grandparents or cousins for the weekend hundreds of miles away. Parents will be able to monitor the driverless travel through video surveillance, and “Mom’s Taxi” will become a thing of the past for kids’ activities.

Just a thought.

photo credit: foilman via photopin cc

By healthcare business consultant David E. Williams of the Health Business Group

 

Provider engagement: Quantia touts the key to unlock health system and pharma success

Mike Coyne, Quantia CEO

Mike Coyne, Quantia CEO

In this podcast interview, Quantia’s CEO Mike Coyne and I discuss what it means to engage healthcare providers and why it matters so much in today’s world of employed physicians and accountable care models. Quantia’s been at the provider engagement game for several years, until recently mostly on behalf of the pharmaceutical industry, which has long understood the power of engagement.

Recently Quantia launched its Provider Alignment Platform for Health Systems, which Mike describes.

By healthcare business consultant David E. Williams of the Health Business Group

Where cash is king, what happens to patients?

How can I help?

How can I help?

I’ve started hearing more about physician practices that are opting out of the health insurance system and taking cash for services. See Cash-only looks good to doctors in Healthcare Finance News as an example. I can understand the appeal. After all, it’s an expensive and frustrating hassle to deal with health plans and Medicare, and can interfere with the doctor/patient relationship. In theory physicians should be able to offer the same level of care while reducing overhead costs and splitting some of the savings with patients. If those patients have high-deductible plans it should work out for everyone.

To some extent in primary care that’s exactly what’s happening, and it’s a trend I support. The logic is especially strong there since third-party reimbursement offers very little in the way of reward for a lot of work. A patient co-pay may equal the amount that gets reimbursed by the health plan; with a high-deductible plan the insurance company may contribute nothing. (Note that this picture is slightly changed by the Affordable Care Act, which mandates full coverage for preventive services –although in my experience the physician office often gets confused about this and ends up collecting a co-pay anyway.)

The Healthcare Finance News article cites a practice in Austin that doesn’t take insurance and has no administrative staff. Result: office visits for $30, which is about the typical co-pay. Well done.

But I do worry about other physicians in both primary care and now specialty care that are moving to more of a concierge model. If it happens in any great numbers there will be a serious capacity problem in the system. That’s because the shift is often accompanied by a dramatic reduction in the number of patients served. It’s sometimes an order of magnitude.

The same article describes a practice that cut its patient panel from 8000 to 1000. I’ve heard of primary care physicians going from 3000 to 350 patients. The big question is what’s going to happen to all the patients who lose access to those physicians –the slack will have to be picked up by other providers. In primary care, maybe the emergence of concierge practices will have a silver lining by boosting compensation for primary care in general and drawing more physicians into the field, helping to correct an historic imbalance in pay ratios between primary care and procedural specialties.

Specialty physicians opting out of insurance is more concerning, but for other reasons. As difficult as insurance companies are, sometimes they do add value by making doctors and patients jump through hoops before approving lucrative –but often unnecessary– procedures like spinal surgery. And there is a tendency to price gouge–which will be only partially mitigated by “transparency” tools that are coming into vogue.

For patients who are willing to spend more money for better care the best value may be in joining a concierge primary care practice rather than opting for cash-only specialists. The primary care doctor will have the time and skill set to consider the patient from a holistic standpoint, to refer to the right specialists and make sure the patient gets seen, to coordinate second opinions and follow-up and to offer their own views about topics such as whether to have surgery.

I’m actually considering a concierge practice for my own care, but I may be too late. A single-doctor primary care practice I spoke with is not taking new patients. Emails I sent to two other local concierge practices inquiring about becoming a patient there were ignored.
photo credit: volperic via photopin cc

By healthcare business consultant David E. Williams of the Health Business Group

Health Business TV: Medical inflation, health kiosks, Home Care Delivered, hospital clowns

In this third edition of Health Business TV, I discuss Home Care Delivered (whose board I’ve just joined), medical inflation and my appearance on Al Jazeera, health kiosks, Hearts & Noses Hospital Clown Troupe and an upcoming webinar about the small group health insurance market.

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If you’re interested in the AIS webinar on July 9, called Insurer Strategies for the Turbulent Small Group Market you can click here to register. You can use the code I mention during the show to get a $75 discount.

There will be no episode next week, since it’s the Fourth of July.

By healthcare business consultant David E. Williams of the Health Business Group