I found an article titled “Healing Health Care” and thought it was a perfect fit to go along with chapter 13 because it talks about reengineering the health care market. I also did the Medicaid system case study questions so this article fit right in with both of those readings. The article starts out stating, “One of the greatest inefficiencies the U.S. faces is the $250 billion a year that it spends on health care administration, trying to resolve the information flow between providers, patients and insurers. Archaic systems and processes cause disputes, paper pushing, numerous phone calls and injustice.” This number is staggering and could be drastically cut if reengineering combined with the proper technology were implemented.
The article goes into a couple of companies that have been trying to revamp the health care industry such as Athena Health. This company offers a software-based subscription service to doctors' offices that helps them collect reimbursements from insurance companies. Athena Health does about a billion claims per quarter and is so efficient that doctor’s offices have seen a decrease in the amount of days it takes to receive reimbursements from 75 to 45. The company does not charge upfront costs for their services but do take a percentage of the claims per year. In 2007 they managed $2 billion in claims and made a profit of $100 million. In the next few years they are expected to continue to grow at a rate of about 30% per year.
The article also gave a great example of three MIT engineers who really took advantage of this market. Each of these three founders had a personal experience with Lou Gehrig's disease. They decided to start an internet community called PatientsLikeMe. It is designed to cater to patients, doctors and organizations for various diseases. The more people who joined this group the more information and personal contact could be gained between parties. Doctors or researchers could now have direct access to specific patients for studies. Patients could have a direct line to other like them and also to doctors that could potentially help. It was a very ingenious idea. The article talks about communication and connection being the future of health care and this is a great start.
In closing the author states, “Overall, the health care industry is a significant problem area that encapsulates many dormant opportunities for entrepreneurs and venture capitalists. And yes, health care needs to create a bubble comparable to the dot-com, telecom, Web 2.0 and Green Tech bubbles we've experienced in the last decade. Those bubbles drew attention, energy and investment, and they created companies, jobs and wealth. So let's blow it up!” I think this last paragraph in her article is very motivational. We all know that there is a huge problem out there and a lot of money to be made. All you need to do is have the motivation to solve it and you’ll potentially be set for life. I guess we should all start getting to work!
Works Cited
Mitra, Sramana. (Novemeber 21, 2008). Healing Health Care. Retrieved June, 05, 2009, from http://www.forbes.com/2008/11/20/mitra-healthcare-innovation-tech-enter-cx_sm_1121mitra.html
Mitra, Sramana. (Novemeber 21, 2008). Healing Health Care. Retrieved June, 05, 2009, from http://www.forbes.com/2008/11/20/mitra-healthcare-innovation-tech-enter-cx_sm_1121mitra.html
I love when patients take charge of their own healthcare in this case by driving the sharing of information. I think this is good when it is used as an information source. However, when bad information get published or when someone uses it to falsely diagnose a symptom it can get a little out of hand.
ReplyDeleteOur health care system is mess and this is one of the hot topics that many people is debating about how to solve this problem. In your blog, you mention that the biggest inefficient that cost billions is the failure of information flow between providers, patients and insurers. I always wonder, how come they won't follow the auto insurance industry model on how claims are being handle? Granted that these two industries are not exactly the same but I think that in many aspects, they are similar enough. For example, in healthcare, you have in network and out network doctors which is similar to prefer and non-prefer auto shops in auto insurance. The patients are just drivers, the providers are just like body shops and the insurance companies are just insurance companies.
ReplyDeleteI'm surprised that there wasn't already a website like PatientsLikeMe but I love that those 3 guys came up with it. This will really help the good fight.
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