{"id":3197,"date":"2017-06-02T14:33:11","date_gmt":"2017-06-02T18:33:11","guid":{"rendered":"https:\/\/www.healthadvocate.com\/site\/?p=3197"},"modified":"2020-01-14T17:30:19","modified_gmt":"2020-01-14T22:30:19","slug":"american-health-care-messed-whole-industry-created-help-navigate","status":"publish","type":"post","link":"https:\/\/www.healthadvocate.com\/site\/article\/american-health-care-messed-whole-industry-created-help-navigate","title":{"rendered":"American health care is so messed up that a whole industry has been created to help navigate it"},"content":{"rendered":"

By Emma Court | MarketWatch<\/strong><\/p>\n

After his daughter was born, Ted Phillips wasn\u2019t expecting to get slapped with a $3,500 bill from the hospital\u2019s anesthesiologist.<\/p>\n

Phillips, who works in health care in Boston, Mass., soon found out that while the hospital was in-network, the anesthesiologist was not. The hospital\u2019s billing office told Phillips he\u2019d have to pay it.<\/p>\n

Undeterred, he kept making calls \u2014 to the hospital, the anesthesiologist and the insurer \u2014 and was eventually able to resolve the issue.<\/p>\n

Still, the back-and-forth did cost Phillips, albeit in a different way: he spent about five to seven hours making the phone calls, mostly while at work. Most of the offices involved \u201care open 9 to 5, which is difficult,\u201d he said.<\/p>\n

\u201cI work in this industry, I\u2019ve dealt with this back-and-forth, I\u2019ve dealt with insurance for this long now,\u201d he said. \u201cHow many people just pay that bill because they don\u2019t press it?\u201d<\/p>\n

The problem, one many consumers face, has gotten a lot easier for Phillips since then. Now, through his health benefits at work, he has access to a medical bill advocate, that helps individuals navigate their medical bills and the complex terminology of health insurance plans.<\/p>\n

Medical bill advocates and other such third-party businesses have sprung up in the gaps and blind spots of America\u2019s complicated, fragmented health care system. These services make sense of health bills for consumers and even fix errors in them.<\/p>\n

In the process, these businesses can reduce wasteful health-care spending and possibly even improve health outcomes. Their numbers have exploded. And they\u2019ve become even more important as high-deductible health plans \u2014 which put employees on the line for thousands of dollars in out-of-pocket expenses \u2014 have increased in popularity.<\/p>\n

But these services face a persistent challenge: many employees don\u2019t know that they have access to them.<\/p>\n

Though confusing medical bills are pervasive, utilization rates for professional help remains low. The ultimate success of these businesses will hinge on how well they use technology to change awareness and access, according to many in the sector.<\/p>\n

The business of medical bill advocacy<\/strong><\/p>\n

For decades, advocates have warned consumers that their medical bills could be rife with errors.<\/p>\n

That would appear to be a consumer issue, but it\u2019s also a problem for employers, since they provide health insurance to a majority of Americans and pay the lion\u2019s share of the cost.<\/p>\n

\u201cSmart employers who want to save their money and their employees money know the best way to slash health-care costs is to improve benefits,\u201d said David Chase, a health-care entrepreneur who now runs a nonprofit institute. Medical advocacy services are \u201cone piece of that,\u201d he said.<\/p>\n

Advocates like Pat Palmer, who has been working on medical billing issues for 24 years, encourage individuals to request an itemized bill and search for clear mistakes, such as being charged for more time in the hospital than you actually spent there, or for a drug that you never got.<\/p>\n

But for other, more-complex errors, most consumers find the experience of making calls to the health insurer and medical provider overwhelming. Often, the task requires specialized understanding about the health-care system and how it works, the nuances of an individual\u2019s health plan and even a level of medical knowledge.<\/p>\n

Then there are the logistics. It can be hard to even find a time during the workday, or a place at work, to make these calls.<\/p>\n

\u201cYou\u2019re in the hallway, on the phone with the biller, the insurance company. Before you know it, an hour has gone by,\u201d said Dr. Raffi Terzian, senior vice president of clinical operations and senior medical director at Health Advocate, a leading company that works with employees to navigate health care and insurance problems. \u201cIt\u2019s a time sink. It\u2019s a time robber.\u201d<\/strong><\/p>\n

Moreover, insurance brokers and human resources departments don\u2019t have the ability \u2014 or the bandwidth \u2014 to answer all of peoples\u2019 questions, especially as high-deductible health plans increase the number of questions asked, said Jason Dzurka, director of marketplace solutions at Maxwell Health, a benefits platform for small- and medium-sized businesses that is also Phillips\u2019 employer.<\/p>\n

Hospitals are trying to make medical billing better and more affordable, said Tom Nickels, executive vice president of government relations and public policy at the American Hospital Association. He said they\u2019re working on tools for better price transparency and that they \u201cpledge to work with patients\u201d on billing issues.<\/p>\n

But in the meantime, others have picked up the slack \u2014 and are paying for it. In the individual health insurance market, services from health technology company HealthJoy come at an additional cost to the consumer.<\/p>\n

When it comes to employer-sponsored plans, the employer or even the insurance broker may pay, since \u201cthey see it as a valuable service for the cost,\u201d said Dzurka. \u201cAnd when you compare it to the cost of health care, it\u2019s substantially lower \u2014 a very small percentage.\u201d<\/p>\n

Confusing medical bills pose a problem both to worker productivity and to employee benefits more generally, said Brian Marcotte, chief executive officer of the nonprofit National Business Group on Health, which represents large employers on health policy issues in Washington, D.C.<\/p>\n

In other words: If workers don\u2019t understand their benefits, they probably aren\u2019t benefiting from them.<\/p>\n

\u201cEmployers are recognizing that the system is too complex for employees to be sophisticated enough to navigate this,\u201d he said.<\/p>\n

Beyond medical bills<\/strong><\/p>\n

Tricia Taylor\u2019s 13-year-old daughter uses an insulin pump to manage her Type 1 diabetes. That can mean testing her sugar levels as many as 10 to 12 times a day using a FreeStyle test strip, the only kind her insulin pump works with.<\/p>\n

But Taylor\u2019s insurance company wanted her daughter to use a different type, and wouldn\u2019t cover the FreeStyle strips. The expense was adding up, costing Taylor about $180 a month, she said.<\/p>\n

After working with the health-care technology company Accolade, which is offered as a benefit at the propane company she works for, Taylor was able to get the strips covered. The trick turned out to be a letter from her daughter\u2019s doctor, explaining that the FreeStyle strips were the only ones that worked.<\/p>\n

\u201cIt was a big, big blessing,\u201d Taylor said. With some time, she might have been able to figure it out on her own. But \u201cit was time that, as a working parent, I did not have.\u201d<\/p>\n

Now, Accolade is helping Taylor with something new: finding an in-network facility for her daughter.<\/p>\n

Help with chronic diseases is just one of the many services these businesses now offer.<\/p>\n

Health Advocate, which works with nearly 12,000 employers and health insurers to serve more than 40 million members, can answer \u201cnearly any question related to health care that you can think of,\u201d Terzian said, from coordinating care to helping with medical decisions, finding doctors and second opinions, providing wellness services and more.<\/strong><\/p>\n

These are available not just to the employee but also typically to their spouse, dependents and parents or parents-in-law, he said.<\/strong><\/p>\n

Folding in so many services makes these businesses more attractive to employers. And increasingly, the scope of companies with access to health advocacy services is growing beyond large employers to companies of all sizes.<\/p>\n

It\u2019s also a way to engage more people, who call in about one issue \u2014 often, about their medical benefits or understanding a medical bill \u2014 and can then find out about the other services offered.<\/p>\n

\u201cA client will call us for often a simple question related to their bill or benefits plan \u2014 is this doctor in network, what\u2019s my deductible,\u201d said Samantha Steinwinder, Accolade\u2019s vice president of marketing. \u201cIn most cases the health plan will answer the question and send them on their way. We use the call to find out what\u2019s going on in the individual\u2019s life… it helps us uncover what\u2019s happening with the health-care system with that individual.\u201d<\/p>\n

How it all hinges on technology<\/strong><\/p>\n

Unlike a lot of other services and technology platforms people use, customers can go months or years without interacting with a health advocacy service.<\/p>\n

This creates an \u201cout of sight, out of mind\u201d effect that is one of the industry\u2019s biggest problems, Marcotte said: \u201cIf I don\u2019t need it, I don\u2019t think about it. And when I do need it, I forget that it\u2019s available.\u201d<\/p>\n

The mission of these businesses will hinge on data and technology, and how well they\u2019re used to communicate with and engage consumers.<\/p>\n

For example, \u201cif I\u2019m contemplating surgery, there may be indications in my claim data that triggers a flag,\u201d and sends a push notification to the patient about decision support services, Marcotte said. Other data triggers could prompt similarly personalized information and resources, he said.<\/p>\n

We\u2019re \u201cat the tip of the spear of a lot of this. It\u2019s growing and it\u2019s growing rapidly,\u201d he said.<\/p>\n

Health Advocate says that of those who have access to their service, 40% have used it at least once, with the figure rising to 90% under \u201cbest practices.\u201d<\/strong><\/p>\n

Technology may also provide a lift. Maxwell Health says it sees higher utilization of Health Advocate through its platform than Health Advocate does alone, which it attributes to its technology.<\/p>\n

Since these services work best when they\u2019re both convenient and immediate, many health advocacy businesses have structured themselves for the smartphone era.<\/p>\n

HealthJoy, which aims to be the \u201cSiri for health care,\u201d is mainly a mobile application, with emails and push notifications structured to move customers into the app (although there is the option to call in). The company works with about 15,000 members from the individual market, and recently started contracting with employers, of which it now has 100.<\/p>\n

“It\u2019s really hard to be top of mind as a point solution. So we really focus on trying to say \u2018we\u2019re help for anything,\u2019\u201d said Chief Executive Officer Justin Holland. \u201cWe\u2019re trying to be air-traffic control.\u201d<\/p>\n

The company has focused more on cost-cutting moves like telemedicine and prescription drug savings than medical billing, at least for now, said Holland. That, paired with a recent move to work with employers, is reflected in the low utilization rates for its medical bill service, or about 8% of its employer membership, he said.<\/p>\n

\u201cYou\u2019re not going to use an app like ours like Candy Crush,\u201d Holland said. But \u201c80% of people just pay [a medical bill] and they remember after, \u2018Oh, I have this service I could use.\u2019\u201d<\/p>\n","protected":false},"excerpt":{"rendered":"

By Emma Court | MarketWatch After his daughter was born, Ted Phillips wasn\u2019t expecting to get slapped with a $3,500 bill from the hospital\u2019s anesthesiologist. Phillips, who works in health care in Boston, Mass., soon found out that while the hospital was in-network, the anesthesiologist was not. The hospital\u2019s billing office told Phillips he\u2019d have […]<\/p>\n","protected":false},"author":11,"featured_media":1801,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"_monsterinsights_skip_tracking":false,"_monsterinsights_sitenote_active":false,"_monsterinsights_sitenote_note":"","_monsterinsights_sitenote_category":0,"footnotes":""},"categories":[5],"tags":[56,46,59,58,55,54,57],"class_list":["post-3197","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-article","tag-health-advocacy","tag-health-advocate","tag-high-deductible","tag-insurance","tag-marketwatch","tag-medical-bills","tag-personal-health-advocate"],"acf":[],"yoast_head":"\r\nAmerican health care is so messed up that a whole industry has been created to help navigate it | Health Advocate<\/title>\r\n<meta name=\"description\" content=\"Many consumers don\u2019t have the tools to dispute 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