The Medical Banking Project is taking on its first test case, aiming to begin to show how the nation's banks can play a role in solving some of the most vexing issues in healthcare data exchanges.
For its first pilot effort, the project is planning to show how open standards can enable providers to determine how much a patient owes for service when those patients are covered by high-deductible health plans.
Also on deck is a proposal, expected to be announced at the groups fifth annual National Medical Banking Institute in March, to use the banking system as a way to provide consumers with access to their personal medical information.
Because these patients are responsible for most of the cost of their care, providers carry a bigger risk in providing treatment for them, said John Casillas, founder of the Medical Banking Project. Patients typically don't expect to pay for services at the office, and it's often difficult for providers to get them to pay weeks or months after a visit.
Increased risk of non-payment by patients probably will cause providers to think twice about signing up for high-deductible health plans, so facilitating the process by improving data sharing and communication is crucial to spur adoption.
The pilot effort is called the HSA Accumulator Use Case and will be used under the project's national reference architecture program known as Cooperative Open-source Medical Banking Architecture and Technology, or COMBAT. The COMBAT initiative uses existing standards and open source components to build applications.
Exante Bank, an operating unit of United Healthcare, and the parent healthcare plan company, is funding the project. Exante is beginning to implement real-time adjudication capabilities and is looking for ways to expand those capabilities nationwide and to other payers.
In March, the Medical Banking Project hopes to announce its second use case, which will enable consumers to access electronic personal healthcare information as an adjunct of consumer access to banking information over the Internet via online banking portals. Casillas said an automotive industry action group within the Medical Banking Project is spearheading this initiative.
"The banking industry isn't going to create a whole new thing to do this," he said. "We'll try to use existing build-outs, like regional health information organizations; we'll pull them all together to get access to electronic medical records.
"Banks have incredible reach – about 50 million people are doing online banking today," he added. "If we can get eight of the nation's large bank systems interested in doing this, we'll have the equivalent of a national healthcare Internet."