Transparency in healthcare pricing is a significant challenge and companies like Turquoise are working to address it.
Cedar simplifies the medical billing process using machine learning algorithms, benefiting both patients and healthcare providers.
Headway is focused on integrating mental health into the healthcare system by connecting therapists and payers and creating a seamless experience for providers and patients.
Deep dives
The Lack of Transparency in Healthcare Pricing
One of the biggest problems in healthcare is the lack of transparency around pricing. Patients, providers, and payers often have no idea what healthcare services actually cost. Turquoise, a company building software, aims to address this issue by providing people with the cost of healthcare in advance. New laws like the Price Transparency Act and the No Surprises Act have made pricing more transparent, but it is still complex due to variations in pricing based on patient, geography, coding systems, and insurance products.
Simplifying the Complex Billing Process
Medical billing is a complicated process that poses challenges for both patients and healthcare providers. Cedar, a company focused on simplifying the billing process, aims to alleviate these issues. By personalizing the billing experience and leveraging machine learning algorithms, Cedar helps patients understand and navigate their medical bills. The simplified experience not only benefits patients but also helps healthcare providers improve revenue collection. By making it easier for patients to pay their bills, providers can increase the percentage of bills that get paid.
Building Infrastructure for Mental Health
While mental health awareness has been growing, there is still a lack of infrastructure to support the integration of mental health into the overall healthcare system. Headway, a company working in the mental health space, is focused on enabling therapists to accept insurance. By connecting payers and therapists, Headway aims to provide a seamless experience for both the providers and patients. This infrastructure gap presents an opportunity for companies to build software and create a single sign-on experience for low-income Americans to access and utilize various government benefits.
Navigating the Complexities of Medicaid
Millions of Americans are at risk of losing their Medicaid coverage, as they are unaware of the impending changes. Jimmy Chen, founder of Propel, highlights the lack of information and software solutions available for low-income communities. With the increasing prevalence of smartphones and internet access among low-income Americans, Jimmy sees a significant opportunity to develop consumer-grade software that provides critical healthcare information and facilitates eligibility for government benefits.
Value-based Care and Simplifying Healthcare
Firefly Health, a company focused on value-based virtual-first care, aims to provide affordable and engaging healthcare options. By simplifying the payment process and focusing on continuous engagement, Firefly is able to improve outcomes and reduce costs. The value-based healthcare market is growing, and with the right incentives and technology, a fundamentally different healthcare system can be achieved. Firefly envisions a future where each patient has their own personalized care team, offering comprehensive healthcare solutions.
Today’s episode is a cross-post with the a16z podcast. It features founders—Chris Severn, Florian Otto, Andrew Adams, Jade Chan, Jimmy Chen, and Fay Rotenberg—chatting with a16z podcast host Steph Smith, about how they're trying to reinvent the healthcare system, using fintech.
