Will on-demand health care cure surprise billing?
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The on-demand economy is booming. More than 22 million Americans spend nearly $58 billion per year on services allowing them to get their groceries, dog walkers and wardrobe brought right to their door.
Some health startups are embracing the need for on-demand care, offering at-home doctor’s visits, urgent care services and even hangover treatments, all just a click away.
“It fits the way our economy is growing,” said Glenn Melnick, professor of health care finance at the University of Southern California. “When consumers want something, they get it quicker than before.”
Companies like Heal or Pager will send a doctor or a nurse practitioner to a person’s home to treat nonemergency problems like strep throat or a sprained wrist. The I.V. Doc provides IV treatments for hangovers and the flu. And Capsule will send prescriptions right to patients’ doors.
“From a patient perspective, we're really focused on access to care,” said Greg Drobnick, co-founder of Heal. “We are in a unique moment in time where I see the entire insurance world shifting to more and more value-based care.”
Traditionally, patients walked into a doctor’s office without knowing how much they owed, said Drobnick. Sometimes there would be a copay or an additional charge billed in the mail later.
Heal hopes to eliminate these unexpected costs by working directly with insurers to offer a set price for services. Anthem, Blue Shield, Aetna, UnitedHealthcare and Medicare cover Heal visits in many of their plans.
“We've tried to create a system that provides 100% full price transparency up front,” Drobnick said.
Keeping more patients out of hospitals and private doctors’ offices will lower overall health care costs, said Drobnick.
“It reduces the expense of a traditional brick-and-mortar doctor's office,” he said. “Doctors can truly focus on patient care and they're given technology and tools that help them.”
Drobnick believes patients will seek medical care sooner using on-demand services because it’s faster and easier than waiting for an appointment to open up at a doctor’s office. Early detection via these services could prevent a problem from becoming more serious, requiring an expensive emergency room visit. The average emergency room cost is nearly $1,400, according to the Health Care Cost Institute.
Melnick worries that an affordable on-demand health care model isn’t sustainable. Before, patients waited to see their doctors, who could see a number of patients back-to-back.
Now, “you’re substituting your time for the doctor’s time,” he said. “It cuts down the number of patients a doctor can see each day. There may be a trade-off in affordability.”
Doctors may charge more for the convenience of an on-demand service, like subscription companies.
On-demand health care may also fall short with patients with chronic diseases,, who require long-term care in multiple areas, said Nancy Nielsen, senior associate dean for health policy at the University of Buffalo.
These patients often need to regularly see a primary care doctor, who can quarterback their specialized care. That personal touch is something that may be lost with on-demand services.
“If you want your patient to tell you painful, personal things, there has to be a trusting relationship. It cannot just be a transactional encounter,” she said.
Not all insurance plans are included in many of these start-ups. It’s important to check with your insurer before booking a service. Looking for affordable health care? Check out this guide.
Image: H. Armstrong Roberts
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