Best Price Transparency & Cost Estimation Products

As health systems compete for the commercial consumer against new entrants and big tech that are increasingly entering the marketplace, there is a heightened need to deliver a convenient route for a person who is searching online for care to schedule and access same day care. Key use cases center around consumers searching for symptoms, searching for symptoms online, trying to make an appointment online, and wanting to access same day or virtual care. In order to address this collective set of...

Due to the rise of high deductible plans and the increasing cost of delivering care, healthcare consumers are shopping for the lowest cost service from the highest quality providers. The rise of Medicare STARS ratings and Hospital Compare and other available data increases transparency of provider quality and supports consumer decision making.

Digital tools in this space help consumers to view the cost of various procedures and calculate out of pocket cost. Sites that compare procedure and medication costs can direct consumers to the most cost efficient resources. They can also help consumers to understand and feel confident in provider quality data. Improved transparency can help to attract cost sensitive consumers and consumers to the highest quality and lowest cost services enabling efficient and effective providers to create brand awareness and improve growth.

Optimizing revenue cycle processes equals a $9.5B total opportunity.

Revenue cycle management is integral to creating a financially solvent health system. However, embedded in the current process for managing the healthcare revenue cycle are many time-consuming manual processes that contribute to high administrative costs. Revenue cycle stages of securing prior authorization and financial clearance, improving clinical documentation, assigning proper codes, and managing denied claims require substantial labor resourcing. Doing these tasks manually can result in staff burnout and costly errors throughout a patient's care.

Additionally, today’s market presents many challenges—higher costs and deductibles, decreasing reimbursements, more regulatory complexity, shifting payment models, and increasing consumerism. To deal with these financial pressures, health systems are being forced to innovate.