Employers are struggling with rising healthcare costs, which increase annually by 17%. Many are shifting to high deductible health plans to control costs, but this shifts more of the financial burden to employees. Better MRI proposes to help control outpatient MRI costs for self-insured employers and their employees by providing price transparency and negotiated rates. They will offer employer clients an initial package to cover a set number of MRI scans at a guaranteed savings of at least 10k, or they will refund 120% of the package cost. Ongoing fees will be a percentage of total savings from directing employees to low-cost in-network MRI providers. The company projects serving thousands of MRI scans annually and generating millions in savings and revenue over 11 years.
The Latest Self-Pay Trends: New Burdens and Opportunitiesathenahealth
Let athenahealth guide you through the burdens of navigating through revenue collections from your patients to make sure your practice has access to all monetary opportunities to ensure financial success.
It's no secret that any EHR takes away essential time with the patient and doctoring in general. See what athenahealth is doing to help remedy these frustrations and to make the best out of a bad situation.
The Latest Self-Pay Trends: New Burdens and Opportunitiesathenahealth
Let athenahealth guide you through the burdens of navigating through revenue collections from your patients to make sure your practice has access to all monetary opportunities to ensure financial success.
It's no secret that any EHR takes away essential time with the patient and doctoring in general. See what athenahealth is doing to help remedy these frustrations and to make the best out of a bad situation.
Learn the relationship between physician productivity and physician pay to better understand how the healthcare system works. Factors like practice expenses and bonuses are also discussed.
Cashing in on Value Based Reimbursementathenahealth
Stay on top of changing governmental regulations and don't leave money on the table. Value based reimbursements can be tricky to navigate while managing a medical practice but not with athenahealth.
Opportunities & Challenges: A Home Health and Hospice Executive SurveyMcKesson Corporation
In the ever changing health care environment, home health and hospice organizations face enormous challenges. Discover their top challenges, such as Medicare reimbursement cuts, and other statistics on health care reform in the 2014 McKesson executive survey.
Keeping Community Hospitals Thriving and Independentathenahealth
Research showing hospitals how to best maintain their independence while conducting a thriving business model in changing times of governmental regulation.
Keeping the Pediatric Population Healthy (Steve Aen)Ashleigh Kades
Speaker Presentation from U.S. News Healthcare of Tomorrow leadership summit, November 2-4, 2016 in Washington, DC. Find out more about this forum at www.usnewshot.com.
Using non-clinical workers to prevent hospital (re)admissionsDave Chase
Data analysis done by Care at Hand using non-clinical workers such as Meals on Wheels and personal home care assistants to prevent hospitalizations and other adverse events
Population Health in 2016: Know How to Move Forwardathenahealth
Accountable care organizations (ACOs) present a significant opportunity to reduce health care expenditures and ensure quality care. Successfully managing the transition to an ACO is one of the most difficult challenges facing health organizations today. The key is to focus on the risk contract and approach population health management in a staged, incremental way.
This discussion provides an overview of the healthcare industry and some of the challenges facing the healthcare industry today.
The healthcare industry employs nearly 20 million people in the United States and generates about 10% of the private sector GDP. Jobs in this industry are in high demand and pay better than most other industries.
Rapid change is underway in the healthcare industry due to forces like the Affordable Care Act ("Obamacare") and an aging population. Many of these industry-wide changes are impacting how physicians work and who physicians work for.
An Overview of Kaiser Permanente - Integration and Information Systems in Hea...Empreender Saúde
Apresentação da Kaiser Permanente para o Brazilian Healthcare Trek: Mission Silicon Valley.
What is Kaiser Permanente?
Kaiser Permanente is committed to helping shape the future of health
care. We are recognized as the largest integrated delivery system in the
U.S. and one of the leading health care providers and not-for-profit
health plans.
Our strategy is to excel in providing high-quality, affordable health care
through our integrated delivery system, our investment in technology,
and our vision of supporting Total Health.
Our Mission and Vision
Mission: to provide high-quality, affordable
health care services and to improve the
health of our members and the communities
we serve.
Vision: To be a leader in Total Health by
making lives better.
7 regions serving 8 states and the District of
Columbia
More than 9.3 million members
More than 17,000 physicians and 174,000
employees (including 48,000 nurses)
38 hospitals (co-located with medical
offices)
608 medical offices and other outpatient
facilities
70 years of providing care (opened in 1945)
Dr. Mollyann Brodie: "What Soaring Drug Prices Mean for Patients," 9.3.15reportingonhealth
Dr. Mollyann Brodie's presentation from "What Soaring Drug Prices Mean for Patients," 9.3.15
http://www.reportingonhealth.org/content/what-soaring-drug-prices-mean-patients
Physician Revenue - Getting paid for the work you doRobert Robinson
Gain an understanding of the basics of how physicians are paid - fee for service, quality bonuses, healthcare insurance, revenue sharing and more are discussed in this presentation.
3 Perspectives to Better Apply Predictive & Prescriptive Models in HealthcareHealth Catalyst
In healthcare we tend to think of predictive or prescriptive model building and deployment as technical challenges. We do not put enough emphasis on the importance of change management. This disorientation leads to uneven adoption and results. In this webinar Jason Jones discusses and demonstrates three perspectives, accompanied by tools, to help you drive action and deliver better outcomes.
We develop predictive and prescriptive models in healthcare to improve Quadruple Aim outcomes—population health, patient experience, reduced cost, and positive provider work life. Successful adoption of predictive and prescriptive models heavily depends upon behavior change. This requires more than technical accuracy. While prediction algorithms abound, tools to facilitate change management remain scarce. During this webinar, we will discuss how to achieve model understanding using three perspectives: functional, contextual, and operational.
View the webinar to learn:
- Why a predictive or prescriptive model endeavor is more a change management challenge than a technical one
- How to apply three types of model understanding to a use case in your own organization
In this webinar, Jason Jones, PhD, Chief Data Scientist at Health Catalyst discusses and provides examples of our work using three perspectives of understanding to help clinical and operational leaders achieve value from predictive and prescriptive models. Investing time and effort to ensure model understanding is necessary for broad scale adoption.
Learn the relationship between physician productivity and physician pay to better understand how the healthcare system works. Factors like practice expenses and bonuses are also discussed.
Cashing in on Value Based Reimbursementathenahealth
Stay on top of changing governmental regulations and don't leave money on the table. Value based reimbursements can be tricky to navigate while managing a medical practice but not with athenahealth.
Opportunities & Challenges: A Home Health and Hospice Executive SurveyMcKesson Corporation
In the ever changing health care environment, home health and hospice organizations face enormous challenges. Discover their top challenges, such as Medicare reimbursement cuts, and other statistics on health care reform in the 2014 McKesson executive survey.
Keeping Community Hospitals Thriving and Independentathenahealth
Research showing hospitals how to best maintain their independence while conducting a thriving business model in changing times of governmental regulation.
Keeping the Pediatric Population Healthy (Steve Aen)Ashleigh Kades
Speaker Presentation from U.S. News Healthcare of Tomorrow leadership summit, November 2-4, 2016 in Washington, DC. Find out more about this forum at www.usnewshot.com.
Using non-clinical workers to prevent hospital (re)admissionsDave Chase
Data analysis done by Care at Hand using non-clinical workers such as Meals on Wheels and personal home care assistants to prevent hospitalizations and other adverse events
Population Health in 2016: Know How to Move Forwardathenahealth
Accountable care organizations (ACOs) present a significant opportunity to reduce health care expenditures and ensure quality care. Successfully managing the transition to an ACO is one of the most difficult challenges facing health organizations today. The key is to focus on the risk contract and approach population health management in a staged, incremental way.
This discussion provides an overview of the healthcare industry and some of the challenges facing the healthcare industry today.
The healthcare industry employs nearly 20 million people in the United States and generates about 10% of the private sector GDP. Jobs in this industry are in high demand and pay better than most other industries.
Rapid change is underway in the healthcare industry due to forces like the Affordable Care Act ("Obamacare") and an aging population. Many of these industry-wide changes are impacting how physicians work and who physicians work for.
An Overview of Kaiser Permanente - Integration and Information Systems in Hea...Empreender Saúde
Apresentação da Kaiser Permanente para o Brazilian Healthcare Trek: Mission Silicon Valley.
What is Kaiser Permanente?
Kaiser Permanente is committed to helping shape the future of health
care. We are recognized as the largest integrated delivery system in the
U.S. and one of the leading health care providers and not-for-profit
health plans.
Our strategy is to excel in providing high-quality, affordable health care
through our integrated delivery system, our investment in technology,
and our vision of supporting Total Health.
Our Mission and Vision
Mission: to provide high-quality, affordable
health care services and to improve the
health of our members and the communities
we serve.
Vision: To be a leader in Total Health by
making lives better.
7 regions serving 8 states and the District of
Columbia
More than 9.3 million members
More than 17,000 physicians and 174,000
employees (including 48,000 nurses)
38 hospitals (co-located with medical
offices)
608 medical offices and other outpatient
facilities
70 years of providing care (opened in 1945)
Dr. Mollyann Brodie: "What Soaring Drug Prices Mean for Patients," 9.3.15reportingonhealth
Dr. Mollyann Brodie's presentation from "What Soaring Drug Prices Mean for Patients," 9.3.15
http://www.reportingonhealth.org/content/what-soaring-drug-prices-mean-patients
Physician Revenue - Getting paid for the work you doRobert Robinson
Gain an understanding of the basics of how physicians are paid - fee for service, quality bonuses, healthcare insurance, revenue sharing and more are discussed in this presentation.
3 Perspectives to Better Apply Predictive & Prescriptive Models in HealthcareHealth Catalyst
In healthcare we tend to think of predictive or prescriptive model building and deployment as technical challenges. We do not put enough emphasis on the importance of change management. This disorientation leads to uneven adoption and results. In this webinar Jason Jones discusses and demonstrates three perspectives, accompanied by tools, to help you drive action and deliver better outcomes.
We develop predictive and prescriptive models in healthcare to improve Quadruple Aim outcomes—population health, patient experience, reduced cost, and positive provider work life. Successful adoption of predictive and prescriptive models heavily depends upon behavior change. This requires more than technical accuracy. While prediction algorithms abound, tools to facilitate change management remain scarce. During this webinar, we will discuss how to achieve model understanding using three perspectives: functional, contextual, and operational.
View the webinar to learn:
- Why a predictive or prescriptive model endeavor is more a change management challenge than a technical one
- How to apply three types of model understanding to a use case in your own organization
In this webinar, Jason Jones, PhD, Chief Data Scientist at Health Catalyst discusses and provides examples of our work using three perspectives of understanding to help clinical and operational leaders achieve value from predictive and prescriptive models. Investing time and effort to ensure model understanding is necessary for broad scale adoption.
Contactous converts your organization's business cards to revenue. We uncover quality leads and relationships in your organization by providing clean and organized data from all business cards.
The business cards received by your organization are a result of various marketing programs, campaigns and handshakes. They contain valuable information. But these cards remain with individual employees and groups.
Contactous puts this important data together and works like an internal LinkedIn for your organization.
With Contactous, your business gets:
- Accurate data from all business cards which is transcripted by us manually
- Mechanism to collect business cards from remote employees, channel partners, contractors, events, trade shows and campaigns
- Full featured business contact management system which can be customized to your operations
- Quality and error free mailing lists in a short time
- Relationship intelligence of who knows who within your accounts
According to surveys, 12% of average department budget is wasted due to incorrect contact data. Contactous reduces this wastage and works towards conveting this data to revenue.
Uncover leads within your organization, rapidly constuct quality prospect and mailing database, understand organizational connections and construct relationship intelligence.
Discover Quality Leads in Existing Business Cards - ContactousContactous
Contactous's main job is to convert organizational business cards to revenue. We understand the value and importance of your corporate data, that's why we store data in very strict supervision. This is our kind effort to provide quality leads and relationships i n your organization by providing clean and organized data from all business cards.
Cypress Benefit Administrators is a full service Third Party Administration (TPA) company. We specialize in helping companies outsource Flexible Spending Accounts (Section 125), HRA, HSA, and COBRA. Additionally, we provide expertise in self-funded medical plan administration.
Employee Engagement: Your Tool for Tackling Heath Care CostsDigital Measures
Everyone is concerned about increasing health care costs. This interactive session will review the various triggers that drive health care and insurance costs and cover the major communication and engagement strategies that companies use to reduce their trend. Case studies to be discussed include wellness, employee engagement and communication, benefit plan design and consumerism. Successful benefit incentive programs that support communication programs and have a quantifiable return on investment will also be discussed.
2023 — Focus on the Margin (Vitalware by Health Catalyst)Health Catalyst
In this webinar, we will look at pressures exerted in 2023 on the margin and explore how cost management and complete charge capture can protect and enhance the margin. We will provide details on patient activity costing versus the cost-to-charge ratio (CCR), looking at common themes for lost charges and providing an example of where patient activity cost management was able to provide insight into cost containment and practice patterns of a system provider.
In October 2014, INTEGRATED's Bill Jessee presented "Where Is Healthcare Going? And How Will We Get There?" at Iowa Hospital Association's annual meeting. The presentation focuses on the forces shaping healthcare today, the delivery system changing in response to the environment, and what this all means for hospitals and physicians.
Quality Medical Care presentation made to a major Pharm mfgr in 1998 at a national meeting. Purpose is to explain how pharm company could use gov mandates to add value to contracts with MCOs.
Presentation from HIMSS17 shares introductory findings from Navicure's first Patient Payment Check-Up™. Conducted by HIMSS Analytics and fielded in January 2017, the national survey reveals key differences in attitudes and behavior between those billing for healthcare and those paying for it.
As the financial and demographic landscape changes, our healthcare services need to provide something significantly different to meet the needs of the Scottish population. In this session Gerry Marr talks about how do we make best use of the resources we have and what are we already doing that is transforming healthcare.
Presentation delivered by Bryan Starnes, Chief Financial Officer, Affinity Living Group at the marcus evanc Long-Term Care & Senior Living Central CXO Summit, October 2016, in Chicago.
Leveraging Disruptive Technologies to Succeed In Bundled PaymentsDylan Strecker
A presentation given at the Future of Healthcare in Washington Summit. An unprecedented assembly of Washington healthcare thought and action leaders for a day of executive briefing, connection and inspiration.
Leveraging Disruptive Technologies to Succeed In Bundled Payments
2015 12-8 - MRI-final
1. “BETTER MRI”
Finding The Best MRI ForYour Patients
Ming Yang, Kathleen Brennan-Beshara, Jon Herman, Alex Bagley, Charlie Maher
Healthcare Ventures
Dec 8, 2015
4. Solution/Cost sharing with employees
• High Deductible Plans
• Average deductible for employee from
• $2000 a year per individual
• $4000 a year for family*
• True out of pocket cost >$6000 a year
• HSA help with tax free savings, but not enough.
• Most financed with credit debt
3
*Kaiser family foundation
5. Benefits / Healthcare as key recruitment
tool
• Healthy employers, more productive employees, less
absenteeism
• Adobe system reports 100k’s in savings and higher
retention by investing in enterprise healthcare
management tool to support employees
• Management to Cadillac Tax: 40% tax on most
expensive private plans
4
PSU Professor of Economics Dan Goldstein
6. Employer contracts with Better MRI to
provide price transparency on costs
• Employees resent high deductible plans as they believe they
are bearing all the burden of rising healthcare costs.
• 44% of employers considering it the only option - 18% there
already*
• Better MRI helps avoid reaching the high deductible maximum,
which shifts all the burden to you once HD achieved.
• Competitors in the field do not offer price integrity, patients
frequently disappointed with charges double what appeared on
website.
• * pwc healthcare trends 2014
5
9. John and Mary… & mgmt of healthcare
costs.
• In order to control healthcare cost, couple has chosen a
high deductible healthcare plan from their employer.
• John and Mary are responsible for first $2000 out of
pocket and need outpatient MRI.
8
10. Where do they cut costs?
9
28% avoid MD visits
24% skip Rx or take
less than prescribed
24% skip Specialists
referral
18% don’t do
reccdm f/u care ie
physical therapy
16% delayed or
cancelled
procedure,
screenings or
treatments
Health and wellness survey 2015
11. NPR One 11/30/15 radio show
Pricing Tools as ‘imperfect clue of costs’
Better MRI will offer ‘starter kit’ based on size / medical
history demographics of employee claims. For example,
upfront $10,000 package and if we don’t save at least $10k
in covered employee outpatient tests in 6 months…we will
refund 120% of the cost of starter package.
Ongoing cost will be a % of the total savings realized by the
employees for using Better MRI network
10
14. Value Proposition and Revenue
0
100
200
300
400
500
600
700
800
Yr 1 Yr 2 Yr 3 Yr 4 Yr 5 Yr 6 Yr 7 Yr 8 Yr 9 Yr
10
Yr
11
Value Proposition
Unit of MRI Scans covered(in thousands)
Savings brought by using our service(in millions)
13
-5.00
0.00
5.00
10.00
15.00
20.00
25.00
30.00
35.00
40.00
Yr 1 Yr 2 Yr 3 Yr 4 Yr 5 Yr 6 Yr 7 Yr 8 Yr 9 Yr
10
Yr
11
Revenue
Revenue from self insured employer(in millions)
Operating Income(in millions)
Yr 1-5 Yr 6-10 Yr 11-
Savings per scan(in thousands) 5 3.5 3
Growth in Volume 100% 20% 5%
Charge 5% of cost savings
15. Validation on value proposition
• Companies offering self-insurance to their employees are
struggling to control costs of outpatient MRI for
employees & families.
𝟑𝟎 𝐦𝐢𝐥𝐥𝐢𝐨𝐧 𝐌𝐑𝐈𝐬 𝐩𝐞𝐫 𝐲𝐞𝐚𝐫
𝟑𝟎𝟎 𝐦𝐢𝐥𝐥𝐢𝐨𝐧 𝐩𝐨𝐩𝐮𝐥𝐚𝐭𝐢𝐨𝐧
At least 1 in 10
Americans need MRI
scan each year
3,000
Private MRI facilities
$1k-7k at hospital
$500 at private
facility for scan of
extremity
$5.5B
per year
14
Better MRI helps to save the
self-insured employer
approximately 50% of the
total cost of scans
(extremities to outpatient /
more complex to hospital)
16. Risk Assessment
• Market Risk
• Geographic
distribution/scalability
• Rely on contracts with
imaging centers to limit
competitors
• Adoption by self-insured
companies
• Reimbursement for non-
MRI services
• Financial Risk
• Low initial capital will allow for
lower profits in early stages
• Technology Risk
• EMRs and payment models in
flux
Courtesy of Zen
Self insured market is growing rapidly and due to high cost of health insurance, many are moving to the only option offered to employee is the high deductible plan (some included Health Savings accounts to allow for tax-free money to address the out of pocket cost to employees)
As deductibles continue to climb / example deductible $1500 in 2009, 29% US consumers reported foregoing medical care; rise to $2500 in 2015 where 40% report foregoing medical care source PWC 2015 Health & Well Being/ touchstone survey, Gallop Poll Most high deductible plans heading in the $5000-$8000 range where people report major expenses would have to be financed by credit cards.
PWC health and wellness survey 2015
Starter kit pricing suggested from Catherine Tucker’s pricing class to ‘hook’ skeptical customers and once value established, employers confident of ROI
Price transparency is difficult to access in the healthcare market. Early attempts have had mixed results (no price guarantee and for most part are advertising portals)
100,000-200,000 ACL injuries per year
200,000 rotator cuff injuries per year
(examples of ‘uncomplicated’ orthopedic injuries)
5.5 Billion $ market in US annually and rising
IMV Medical Information - 2012 Radiation Therapy Market Summary Report
Med Care. 2008 May;46(5):460-6. doi: 10.1097/MLR.0b013e31815dc5ae. Data: data from a large private insurer in California Utilization trends for advanced imaging procedures: evidence from individuals with private insurance coverage in California.
5.5 Billion $ market in US annually and rising
Private MRI facilities (non-hospitals) handle ~60-70% of all MRIs annually (in one private insured CA study)
64% Americans own a smartphone
High deductible plans – 15.5 million patients in 2013, growing 15%/year; 51% under age 40; 66-80% of companies with >1,000 employees offered at least 1 such plan in 2013
Analysis that consumer-driven health plans reduced health care spending by 5-14 percent; mainly from outpatient care