Under Donald Trump’s presidency, we will likely witness significant changes in healthcare reform. It’s more important than ever that insurers and healthcare organizations pay attention to cost efficiency, especially as healthcare costs continue to burden many Americans.

While healthcare became more accessible to many under the Affordable Care Act, it was not necessarily more affordable; many Americans complained that Obamacare required them to pay much more for health insurance premiums, and struggled to manage out of pocket costs. Since the Affordable Care Act works on a system of mandated benefits, it drives up insurance costs, making it difficult for many companies to provide adequate employee coverage as a benefit.

A single bill or mandate to streamline America’s healthcare system, so far, has not proven plausible or effective. Because the healthcare system is so complex, it may be beneficial for insurance plans to be customized for each individual, rather than being controlled by a single act. This is something that the private sector is very good at. Private companies can work on a smaller scale and address the real needs of those who need specialty care, or more advanced medical treatment over the course of their lives.

As a founder of a number of innovative companies designed to provide efficiencies and help plug the gaps in our health care continuum, I can name a number of examples that may serve as inspirations to entrepreneurs interested in promoting health care quality and efficiency.

While the government can play a role in ensuring all Americans have access to basic care at an affordable rate, there should be a way to mitigate the higher costs of healthcare among taxpayers and still ensure Americans are still getting the level of coverage and health care services they need. Innovations in the private sector can do just that.

Here’s one example. I am a founder of a company called Care to Care, which has been able to develop programs aimed at making diagnostic and treatment services of high-cost procedures more affordable and safer. Care to Care accomplishes this by ensuring that patients are matched to the most cost-effective and appropriate modalities, customized to their individual needs. Our expert physicians have developed protocols that help determine which diagnostic tests will solve for the missing pieces of medical information necessary to form care plans customized to the individual based on their symptoms, family history and other relevant clinical data.

Based on our programs, we have been able to arrange for care in a more timely manner while saving patients and their employers millions of unnecessary expenditures for unnecessary diagnostic tests, which can also have significant side effects such as exposure to radiation.

Care to Care helps patients save money and get focused, quality care. Many hospitals and healthcare facilities are severely lacking on this front, as they work to comply with certain standards but may not be involved with developing or implementing newer standards that would serve patients better by closing gaps in patient care, or by providing more integrated care beginning with preventative services.

Instead of standardizing healthcare, creating an almost factory-like environment where patients are in and out in the shortest amount of time possible (with minimal investment in the patient experience), innovative entrepreneurs need to focus on eliminating barriers to quality care. For the neediest and most vulnerable healthcare consumers, who are often high utilizers of the ER, this means supporting their needs holistically instead of waiting for them to get sick or have an emergency. In other words, if innovators focus on the big picture to keep patients healthy in between visits, it will lower costs overall. 

As another example, take Cureatr, a software and technology platform I support. Cureatr provides real-time mobile and desktop care transition notifications to hospitals or other care providers including a patients’ medication, major diagnoses and names of their doctors. The company delivers real-time alerts essential for avoiding preventable hospitalizations and readmissions. This type of service helps avoid medication errors and eliminates duplicate testing. It also keeps a patient’s essential care providers in the loop resulting in continuity of care, patient safety and improved patient experience. 

While quality improvements may come at a cost—purchasing new equipment and investment in technology, for example—the long-term effects of these measures will pay off since patients would require fewer hospital or doctor visits, and their health degradation will be stalled.

Achieving cost efficiency with the nation’s healthcare system is no easy feat, as some major changes will affect both taxpayers and healthcare facilities across the country in the next few years. If we can help patients achieve streamlined health services tailored to their needs, we may be able to reduce costs and ensure patients are receiving the care they deserve, regardless of their health and financial situation. 

 

2017-06-19T15:37:49+00:00 February 1st, 2017|Blog|0 Comments

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