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CONFIDENTIAL | DO NOT COPY OR DISTRIBUTE
CONFIDENTIAL | DO NOT COPY OR DISTRIBUTE
A Clear Path To Lower
Healthcare Costs.
CONFIDENTIAL | DO NOT COPY OR DISTRIBUTE
CONFIDENTIAL | DO NOT COPY OR DISTRIBUTE
Meet
Christian
Insurance Pays
Hospital Charge
Discount
Christian’s OOP
..…. $3K
… $68K
…………. $34K
.… $31K
Insurance Pays
ASC Charge
Discount
Christian’s OOP
..…. $3K
……….. $8K
….…………. $0
…... $5K
Why Does Transparency Matter?
CONFIDENTIAL | DO NOT COPY OR DISTRIBUTE
81 Million
126%
+
52%
+
2010 2021 2009 2021
Healthcare cost
are going up
Insurance deductibles
are going up
$3,000
>
Americans have
a deductible of
$5,000
>
CONFIDENTIAL | DO NOT COPY OR DISTRIBUTE
But Why?
Health Plans
(For-Profit, MLR)
Providers
(For-Profit)
Employers
(Don’t Understand)
Employees/
Patients
(Don’t Have Tools)
CONFIDENTIAL | DO NOT COPY OR DISTRIBUTE
Price Transparency
Mandate
2019 2021
Price Transparency Timeline
January 1, 2022
Machine readable file
must be posted on
health plan website.
Price Transparency
Support
January 1, 2023
Online self-service
tool for 500 specified
services must be
provided by health
plan.
January 1, 2024
Online self-service
tool for all items and
services must be
provided by health
plan.
2022 2023 2024
CONFIDENTIAL | DO NOT COPY OR DISTRIBUTE
Economics 101
The Profit
Motive
Minimal Government
Intervention
Competition Lower Prices
=
CONFIDENTIAL | DO NOT COPY OR DISTRIBUTE
Healthcare Economics FAIL
The Profit
Motive
Minimal Government
Intervention
Competition Lower Prices
=
CONFIDENTIAL | DO NOT COPY OR DISTRIBUTE
Everything but Healthcare Healthcare
In Healthcare, Cost Does Not Equal Quality
Higher Cost Higher Quality Higher Cost Lower Quality
=
=
CONFIDENTIAL | DO NOT COPY OR DISTRIBUTE
We either figure out how to fix high costs or the government will step in.
Fix it or Forget It
CONFIDENTIAL | DO NOT COPY OR DISTRIBUTE
Smart Healthcare Platform
CONFIDENTIAL | DO NOT COPY OR DISTRIBUTE
CONFIDENTIAL | DO NOT COPY OR DISTRIBUTE
Healthcare Navigation Bill Negotiation
Mobile App
CONFIDENTIAL | DO NOT COPY OR DISTRIBUTE
CONFIDENTIAL | DO NOT COPY OR DISTRIBUTE
MDale@PointHealth.com
Matt Dale, CEO

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A Clear Path To Lower Healthcare Costs

  • 1. CONFIDENTIAL | DO NOT COPY OR DISTRIBUTE CONFIDENTIAL | DO NOT COPY OR DISTRIBUTE A Clear Path To Lower Healthcare Costs.
  • 2. CONFIDENTIAL | DO NOT COPY OR DISTRIBUTE CONFIDENTIAL | DO NOT COPY OR DISTRIBUTE Meet Christian Insurance Pays Hospital Charge Discount Christian’s OOP ..…. $3K … $68K …………. $34K .… $31K Insurance Pays ASC Charge Discount Christian’s OOP ..…. $3K ……….. $8K ….…………. $0 …... $5K Why Does Transparency Matter?
  • 3. CONFIDENTIAL | DO NOT COPY OR DISTRIBUTE 81 Million 126% + 52% + 2010 2021 2009 2021 Healthcare cost are going up Insurance deductibles are going up $3,000 > Americans have a deductible of $5,000 >
  • 4. CONFIDENTIAL | DO NOT COPY OR DISTRIBUTE But Why? Health Plans (For-Profit, MLR) Providers (For-Profit) Employers (Don’t Understand) Employees/ Patients (Don’t Have Tools)
  • 5. CONFIDENTIAL | DO NOT COPY OR DISTRIBUTE Price Transparency Mandate 2019 2021 Price Transparency Timeline January 1, 2022 Machine readable file must be posted on health plan website. Price Transparency Support January 1, 2023 Online self-service tool for 500 specified services must be provided by health plan. January 1, 2024 Online self-service tool for all items and services must be provided by health plan. 2022 2023 2024
  • 6. CONFIDENTIAL | DO NOT COPY OR DISTRIBUTE Economics 101 The Profit Motive Minimal Government Intervention Competition Lower Prices =
  • 7. CONFIDENTIAL | DO NOT COPY OR DISTRIBUTE Healthcare Economics FAIL The Profit Motive Minimal Government Intervention Competition Lower Prices =
  • 8. CONFIDENTIAL | DO NOT COPY OR DISTRIBUTE Everything but Healthcare Healthcare In Healthcare, Cost Does Not Equal Quality Higher Cost Higher Quality Higher Cost Lower Quality = =
  • 9. CONFIDENTIAL | DO NOT COPY OR DISTRIBUTE We either figure out how to fix high costs or the government will step in. Fix it or Forget It
  • 10. CONFIDENTIAL | DO NOT COPY OR DISTRIBUTE Smart Healthcare Platform
  • 11. CONFIDENTIAL | DO NOT COPY OR DISTRIBUTE CONFIDENTIAL | DO NOT COPY OR DISTRIBUTE Healthcare Navigation Bill Negotiation Mobile App
  • 12. CONFIDENTIAL | DO NOT COPY OR DISTRIBUTE CONFIDENTIAL | DO NOT COPY OR DISTRIBUTE MDale@PointHealth.com Matt Dale, CEO