What’s preventing digital healthcare? The costs for healthcare and healthcare insurance have ballooned out-of-sight. This is because costs are fueled by the fee-for-service business model – one that rewards providers (and their business partners) based on the idea that the more care they deliver, the more they get paid. This is a prescription for healthcare services that is unsustainable, regardless of the tax increases planned. https://www.americanprogress.org/issues/healthcare/reports/2009/07/20/6453/too-sick-for-health-care/

A digital health platform connecting patients with doctors and cost-transparent services should work to alleviate the out-of-control fees. This model for cost-transparency has controlled costs in several clinical sectors, such as cosmetic healthcare, and could be expanded for use in routine, non-emergency healthcare. Such a platform, that connects consumers with producers, has worked well for nearly every other industry in this digital age. 


The benefits of a digital health platform

The value of digital healthcare to the patient is cost-transparency, choice and a 24/7 as-needed availability. This platform is particularly valuable to those without health insurance, like part-time workers, the self-employed or those who want to budget and manage their own healthcare needs. This way, they can bypass the cost of the health insurance plans and their endless restrictions and limitations.

The value to the physician/provider is fast payment, no claims review, no claims denial, no lost claims, no need for pre-authorizations and, reduced billing and scheduling costs. Currently, physicians are dealing with increasing overhead costs and drowning in a sea of pointless rules.

Insurance companies control almost everything in healthcare – from medications to testing and treatments. Now, customers and providers are eager to reclaim their independence and get rid of the profiteering gatekeeper.

Health laws benefiting health insurance plans and companies

Although the benefits of digital healthcare are obvious, eliminating health insurance companies will be no easy task. The healthcare insurance arena is severely impacted by a minefield of State and Federal laws creating many potential legal pitfalls. Furthermore, despite illnesses and treatments being the same, there are significant differences between the various States’ healthcare laws – from HIPPA to corporate practice laws, fee-splitting, self-referral, anti-kickback and patient inducement laws, the list goes on and on. Commonly, lobbying is used by insurance companies to buy influence and protection for their industry. https://www.nationalaffairs.com/publications/detail/the-health-insurance-solution
Many of these legal issues represent significant barriers to enacting digital healthcare innovation and, come at the expense of patients, physicians and employers. Regardless of the fact that a cost-transparent healthcare model can help rein in the runaway costs of medical care – ultimately, nothing will change if there is no reform on the current laws dictating healthcare.

Written by HEALTHdrum