Posts Tagged ‘Doug Ghertner’
This week, Change Healthcare reached another important milestone – we closed on our largest round of financing yet. The round, which was led by HLM Venture Partners, and includes new investor Noro-Moseley Partners, along with existing institutional investors BlueCross BlueShield Venture Partners, Sandbox Industries, Mitsui & Co. Global Investment, Gary and Mary West Health Investment Fund and Solidus, will infuse $15 million into our company. More importantly, it provides market validation of the opportunity and confidence in our ability to improve how Americans purchase healthcare in this country.
In recent months, there’s been a dramatic increase in our nation’s focus on healthcare cost transparency – driven largely by the federal government’s release of medical billing data earlier this year and, of course, the much-talked-about Time magazine article “Bitter Pill”. With this increased focus has come a broader understanding of what Change Healthcare has long known: Consumers not only need healthcare cost information, but also an education in what it means to be a smart healthcare shopper…how to understand basic concepts, like deductible, co-pay and health savings account…how to become engaged healthcare consumers…and how to maximize the value of their healthcare dollar. With each day that passes, we are reminded that Change Healthcare is bringing important solutions to some pretty big problems at just the right time.
For this new funding, we are tremendously grateful. Grateful for the confidence and support of our investors, both old and new. Grateful for the opportunity to continue growing and nurturing a company we believe in so deeply. Grateful to be better positioned to help consumers take control of their healthcare.
With this new funding, we will accomplish much. We will expand our sales and marketing efforts, and accelerate product development. We will bring providers more fully into the cost-transparency conversation. And, we will maintain our position as the market leader in healthcare consumer engagement.
The U.S. Senate Committee on Finance recently held a hearing to discuss the role of price transparency in curbing America’s healthcare cost crisis, recognizing Change Healthcare as an innovator in tackling the important issue. Those who spoke at the session included Steven Brill, author of the much-discussed Time magazine cover story that exposed shocking “sticker prices” hospitals and healthcare systems charge patients.
In his statement to the committee, Chairman Max Baucus (D-Mont.) noted that Change Healthcare offers price transparency tools that can zero in on meaningful pricing information: “These tools can help Americans be smarter consumers. They can help employers and plans form better partnerships with providers that can help keep costs down.” Sen. Baucus hit the nail on the head in this straightforward statement – above all else, we must proactively engage consumers to make more educated decisions about their care and, ultimately, lower costs.
The importance of price transparency in healthcare becomes even more important when you consider the growing popularity of consumer-directed health plans (CDHPs). According to a recent report by the American Association of Preferred Provider Organizations (AAPPO), CDHPs were the only type of health insurance plan that grew in 2012. An estimated 39 million people were enrolled in CDHPs in 2012, up from 33 million in 2011. This percentage will likely continue to grow as companies prepare for the implementation of the Affordable Care Act.
The proliferation of CDHPs and imminent shift toward health insurance exchanges is also increasing the use of health savings accounts (HSAs) – another reason to make cost transparency a priority. According to America’s Health Insurance Plans, enrollment in HSAs has reached nearly 15.5 million, growing by almost 15 percent since last year. HSAs place large sums of money in the hands of consumers and rely on them to spend it wisely. How are they to do this without access to complete, accurate cost information?
Price transparency is the first step to changing our healthcare system. Not only do we need to make personalized cost and quality information available to consumers, we also need to educate them on how to use it, and engage them in meaningful ways to make the best healthcare decisions for themselves and their families.
A recent New York Times article titled “The $2.7 Trillion Medical Bill” compares the costs of common medical procedures – like colonoscopies, hip replacements and angiograms – in the U.S. and other developed countries. The article’s findings are shocking, but not surprising. Increasingly we’re hearing about the extreme differences in healthcare costs between our country and others like Spain, Switzerland, France and Canada.
But what about the price variances that exist within the borders of our own country? Within our own cities…our own zip codes…even within a single provider network. Case in point, Change Healthcare’s client data shows the following price ranges for healthcare services for employees in the same geographic area on the same benefit plan:
- Diagnostic screening colonoscopy: $786-$1,819
- Type II Diabetes Screen: $51-$437
- CT Scan: $375-$3,035
“The $2.7 Trillion Medical Bill” (and data like these) reinforces the importance of cost transparency and consumerism in healthcare…the importance of individuals comparison-shopping for care with an eye for quality AND cost.
Of equal importance, the article reinforces the need for better consumer education on the basics of healthcare. Ms. Yapalater, who shares with readers the story of her routine $6,385 colonoscopy, says she has insurance, yet can’t figure out why she has to pay so much. The fact is words like these are uttered far too often – and when people don’t understand things like deductibles and coinsurance, the consumer experience can be surprising and upsetting. It’s a big part of why greater cost transparency without an understanding of the business of healthcare won’t necessarily improve the consumer experience or financial outcomes.
At Change Healthcare, we’re committed to ensuring consumers have the tools and knowledge they need to become engaged, savvy healthcare shoppers. See how we can help educate your employees or plan members as part of a holistic approach to consumer engagement at http://www.changehealthcare.com/product/healthcareuniversity.html.
Young families are having an increasingly difficult time staying on budget in this tough economy, where each unexpected expense can cause an uneasy shuffling of priorities – especially when it comes to healthcare. One recent survey from the National Foundation for Credit Counseling found that 64 percent of Americans couldn’t handle a $1,000 emergency. To show how the average American is handling such costs, Anna Mathews’ personal finance column in Sunday’s edition of the Wall Street Journal showed us how TaKeisha Woodson, a credit analyst, saved nearly 50% on a prescription simply by taking advantage of change:healthcare’s Ways to Save Alerts™. But there is much more to TaKeisha’s story.
First Horizon National Corporation is a self-insured employer that offers the change:healthcare cost-comparison tool to its employees. TaKeisha is married to a school teacher, has two young children, and just like most growing families, she must juggle the challenges of making smart purchasing decisions with the need for quality care. In addition to the savings referenced in the WSJ, in May of this year her ten-month-old son became sick and was prescribed antibiotics by his pediatrician. TaKeisha arrived at the pharmacy to pick up her son’s prescription and was shocked to see a $100 price tag for a basic antibiotic. Instead of simply accepting the price at the pharmacy, TaKeisha knew she had options. Once she returned home, she logged onto her computer and using the change:healthcare Cost Lookup™ tool, found the same medication at nearly half the cost at another nearby pharmacy. In addition, with the change:healthcare cost comparison tool, TaKeisha will continue to receive proactive e-mail alerts on her routine prescriptions and doctor visits, letting her know how she and her family can save money in the future.
Her story is a testament to the power of actionable cost transparency – and it is just one of many. Through access to pricing information and a proactive outreach strategy that helps consumers take advantage of savings opportunities, TaKeisha is one of thousands of employees who are able to maximize the value from their healthcare benefit.
It definitely makes you wonder how much our healthcare system could save if everyone had access to the same tools as TaKeisha. Stay tuned for more savings stories from patients and employees …
With the passage of the Affordable Care Act in 2010 and the monumental changes likely to occur in how healthcare is purchased, delivered and reimbursed, it only felt natural for me to make a change in my career.
I’ve spent the past eight years in the pharmacy benefit management industry with CVS Caremark, so I was fortunate to work with a broad cross-section of health plans and large self-insured employers who were all interested in better managing healthcare costs.
While some focused on reducing pharmacy utilization to curb costs, others took a more holistic approach by seeking to drive better adherence and higher rates of gap-in-care closure as their way to ‘bend the trend.’ Although I may have chosen pharmacy, this same debate exists in many other areas of the healthcare universe, whether you look at diagnostic imaging services, wellness programs, or disease management. Essentially, you’re either focused on the near-term or you’re focused on the future.
Regardless of the approach, there is a general lack of understanding among employees about what their care actually costs. I constantly heard from HR benefit managers, “Our employees don’t understand that their $30 co-pay is not the entire cost of the prescription!” or, “If our employees only knew what prescriptions cost us, they might make a different and less expensive choice.”
For me, this is how change:healthcare is changing the game. Not only are they making personalized, plan-specific, cost-and-quality information available to the employees, they are also highlighting savings opportunities to make them understandable and actionable.
As I started to think about this in the context of healthcare reform and what some have referred to as the “retailization” of healthcare, I was drawn to the proactive, personalized approach change:healthcare is taking.
By 2014, healthcare exchanges will likely be a reality, and the individual market will likely be a more meaningful segment of the healthcare marketplace. Whether you believe the McKinsey survey that predicts 30 percent of employers will drop coverage or the Mercer survey (PDF) that indicates only 8 percent will drop, the individual market only will continue to grow and a greater number of individuals accustomed to having their benefits chosen for them will now shop and pay for those benefits themselves.
With this change comes the need for education, information and tools to assist those individuals with how best to spend their hard-earned dollars on healthcare. As employees continue to bear a greater portion of healthcare costs each year and with the market clamoring for this information today, we are in a great position to help fill a major gap in the healthcare system.
If my first month at change:healthcare is any indication of the marketplace’s demand for healthcare cost transparency, I can’t wait to see what the future holds. And with that, all I can say is get ready – it’s going to be an exciting ride.