Health Care In The States

Got A Health Care Puzzle? There Should Be An App!

By Elana Gordon, KCUR

March 5th, 2013, 10:25 AM

Kansas City, Mo., is looking to boost its health-tech cred.

So the city that’s home to Cerner Corp. and other health information firms seemed a natural to host something called the Hackovate Health Innovation Competition.

A mashup of innovation and old-school hacking (in its benign sense), the goal of the competition was to improve the nation’s health system and help people navigate the complexities of the Affordable Care Act.

Oh, there was a catch. They had to pull off these health care feats with an app. The top prize: $15,000.

Ten finalists made their case before a panel of five judges last week. The apps were varied. Some focused on improving personal health; others served as navigators of the federal health law; and a few made health care costs easier to find.

Liam Ryan, a 23-year-old from Dublin, Ireland, earned a runner-up prize with a program he describes as “Foursquare for health.” A user comes up with a team, perhaps of friends and family, and then competes against them on healthful behaviors. Messages pop up on the team members’ phones when someone has earned points.

“The idea is my friend went for a walk at home, got some points without me. All of a sudden I want to beat him back,” Ryan told judges, adding that he sees employers, with their growing concerns over health care costs, taking interest in a program like his.

There were a variety of apps that aimed to help navigate the Byzantine world of health care prices. What if you knew the price of that cavity before getting it filled?

That’s where finalist Touré McCluskey, from Seattle, comes in. “Today online, you can book and plan your dream vacation, you can research your home, you can buy a car. You can even get a Ph.D. But you can’t find out the price of your next dental exam,” McCluskey said.

McCluskey’s app locates medical services that often aren’t covered by someone’s insurance, such as dental or eye exams. The service allows users to compare options in an area based on price and a doctor’s credentials. In Chicago, one city where the app is live, McCluskey found prices ranging from $60 to $460 for an optometrist visit.

Scott Speranza was second runner-up with an app that audits medical bills. People scan bills into their phones, then the app searches for errors and savings.

The grand prize went to eLuminate Health. The company’s program focuses on outpatient surgeries and tests, such as mammograms or MRIs, where prices can vary by thousands of dollars.

Someone with traditional insurance coverage may not know — or care — whether a procedure costs $500 or $5,000. But the rise of high-deductible health plans means people may pay anywhere from $2,500 to $5,000, or more, before insurance starts footing the bill. “You’re thrust out into this system where you have no idea — you can’t do any type of shopping,” said eLuminate’s Peter Yates.

One day, Yates would like to see providers set and publicize their prices. “Just like a mechanic sets the price on an oil change,” he says. People who need a mammogram could then compare their options based on price and quality, much as they now shop for plane tickets on a site like Expedia.

Yates says the idea, which will be piloted in Kansas City this summer, has sparked the interest of medical groups that typically have less pricing leverage than large hospital systems. And while taking part may not appear to be in the interests of large providers that do well now, Yates thinks that could change.

“We really want to flip that around to more of a normal commercial model of ‘this is the thing I’m selling, here’s how much it costs,’ ” Yates said. “We want to make health care like almost any other consumer good that people buy today.”

The competition was co-sponsored by Think Big Partners, a business incubator, and tax giant H&R Block, both based in Kansas City.

Longtime Kansas City business leader Ned Holland, now an assistant secretary for the U.S. Department of Health and Human Services, was one of the featured guests. “This was all impressive work,” he said.

This story is part of a collaboration that includes NPR, KCUR and Kaiser Health News.

3 Responses to “Got A Health Care Puzzle? There Should Be An App!”

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  2. Megan Smith says:

    This is a great idea, very inventive. But all this focus on forcing consumers to shop around is really diverting our attention from the real issue. If someone with a high deductible plan – say $5000 – finds the cheapest source for their outpatient surgery and it ends up being a “non-network” provider, but then the costs for the procedure end up exceeding the $5000, then that person will be responsible for all those charges. In healthcare one can’t control those costs and you can’t say, hey, don’t bother to stitch me up, I need to go to a network provider for that. So how did that end up helping them in the end? Consumers cannot be responsible for controlling these unforeseen costs and can’t be left holding the bill when they have done their part. If insurers want people to play savvy shopper they have to come up with some plan where they accept a submitted estimate for the cost and agree to pay a percentage of any overage if it is performed out-of-network. Seems highly unlikely as they spend a lot of time negotiating for those network deals.
    The better question is not how can consumers be better shoppers, but why are prices so wildly different? An explanation to the American people is in order, we should start demanding an answer.

  3. Samuel Gilston says:

    2 items:

    1) Chack out the Time Magazine article: “Bitter Pill: Why Medical Bills Are Killing Us” by Steven Brill. Its a long article but well worth the read regarding medical pricing.

    2) It is often the case, that when you negotiate directly with a doctor, agree to a price, and pay cash up-front, there should not be any overage above the network allowed because you are effectively bypassing your insurance company and their network. You pay the bill directly. You can then file it with your insurance company. Your doctor benefits from rapid payment and one less claim to file and/or fight over. You, as a consumer, can benefit from getting a lower price (sometimes) or better payment plan then you would get through your insurance carrier because the doctor knows he isn’t going to have to wait 30-60 day for payment.

    I do agree that a medical “price-board” would be a benefit to the consumer.