It was an interesting experience to be a healthcare “insider” in a room full of people trying to figure out how they can fit into the healthcare industry.
Maybe “insider” is the wrong choice of a word. Certainly, I’m not an expert. Perhaps I’m just a grizzled observer. Over the past 20 years, I’ve seen a number of companies, even whole industry segments, look at healthcare as an economic oil gusher just waiting to be tapped. Surely, there’s money for one more player in healthcare, they reason.
Those in healthcare don’t see it that way at all. Margins are thin (as the newcomers soon discover), and those on the inside of the industry don’t see much room available for new players who want to join the “party.”
That, and bad things always happen to healthcare from outside its borders. Congress wants reform, big employer groups start flexing their economic muscles, and the popular and business press take potshots at the industry’s problems and inefficiencies.
Ironically, the healthcare industry also is one that often looks to other industries for financial help. Over the last half-dozen years, the financial wherewithal of the payer segment or pharma often has been suggested as the way to fund expensive healthcare initiatives.
Enter the banks, or at least they’re getting more interested in entering. They already have a small supporting role in providing electronic lockboxes to providers. Now, they’re beginning to make plans to offer their infrastructure to healthcare.
The Medical Banking Project is discussing a couple of different approaches for facilitating processes in healthcare. One initiative would help help providers and payers by communicating patients’ balances in their healthcare savings accounts. Other concepts are more seminal and radical, such as using banking customer portals as the entry point for accessing personal healthcare records.
I attended its Medical Banking Institute last month in Georgia, and while sitting in on an action group on the personal health record concept, you could see that participants were realizing the immensity of the task they were contemplating. While using the banks’ electronic platform is good in theory, there are daunting problems that would have to be solved, many of which are related to the lack of interoperability among healthcare systems.
Could any of the medical banking ideas really play in healthcare? As a grizzled observer, I’d say there’s little chance for success unless healthcare reaches out and gets into an active, ongoing, energetic dialogue with those in banking.
Folks, we’re already spending $1.7 trillion or so annually on healthcare, and the cottage industry nature of the industry doesn’t lend itself to reducing that spending. In fact, it encourages multiplicity of almost identical services in the name of business competition. Take consumer-patient portals – hospitals will offer them, insurers will offer them, personal health record providers will offer them. Each portal will suggest that if a consumer chooses it as a healthcare home page, it will aggregate all of the consumer’s healthcare information. However, as everyone vies for that coveted consumer, the same portal concept will be individually created and developed by each entity.
In another competitive approach, payers are beginning to offer providers real-time services, such as eligibility information or adjudication. The catch? The provider has to go to an insurer’s Web site to type in the information and get a response. So how likely will it be that a provider will go to multiple payers’ Web sites during the day to get real-time information?
This is, of course, the American way. Everyone is fighting for competitive advantage and some degree of ownership, whether it’s of consumer or provider allegiance. But can healthcare really stand to invent the same thing several times over in the name of pure capitalism? Especially when each of those inventions has little chance of working together seamlessly, without the massive gnashing of teeth in the background?
The banking industry has been down this road. They’ve managed to cooperate on building the ATM system and other electronic financial functions to enable a seamless exchange of data, and then they fight like dogs for customers during the day.
The healthcare industry should be intrigued by the possibility of talking to the banking industry about the role it could play in healthcare. It does have a fine set of electronic “rails” and it seems to have financial resources that could help answer some vexing data exchange issues. Maybe there’s a proof-of-concept that could show whether banks could facilitate a small but problematic aspect of communication between providers. payers and consumers.
That will take courage and a response that’s radical and nontraditional. It’s time for the healthcare industry to learn to cooperate to achieve savings for all, and then compete when and where it matters.