It’s been estimated that for companies to have an impact on the bloated healthcare costs (upwards of $3.5 trillion and growing every year), they should focus on removing admin-related expenses. These admin costs account for almost 30% of all healthcare spending! They generally fall into things like billing, collections, claims acceptance/rejections, or managing the intake forms (oh, the forms!) we all ‘get’ to fill out over and over and over at every doctor office we ever visit.
These are all those things we, as patients, scratch our heads and ask WHY!? when we interact with our doctors, hospitals, therapists and any other health care professional or institution. We can deposit a check, move money into our retirement account from our savings and buy as many shares in VTSAX as we want — all from our phones. But interacting smoothly from pre-doctor visit, to prescription filled, to hospital visit to major procedure to follow up meetings to payment processing? No chance is that going to be a smooth seamless process.
The smallest of challenges quickly compound into future problems that patients must endure well beyond the original, seemingly small, challenge. The interaction below highlights such an administrative area where snowball effects aren’t too hard to fathom (for the patient).
Situation: Patient on call with Kaiser Permanente about a first premium payment.
KP: Would you like me to send you your billing statement by mail or electronically?
Patient: By email please.
KP: Oh — I can’t. It says we don’t have your email.
Patient/Buyer: That’s weird. I had to give all my information when I signed up for the coverage, including my email.
KP: I’m sorry I understand. But we can’t send you confirmation of your pyament today without your email.
Patient/Buyer: Okay no problem. Let me just give it to you then.
KP: Oh, I wish I could.
Patient/Buyer: (Huh? What?)
KP: I can’t take it — you have to contact < your state healthcare market place > and they have to give it to us.
Patient/Buyer: (Frustration levels rising) There has to be a way for you to add an email into my account. Is there someone else who has authority to access the system that way?
(Sent to SuperVisor)
Supervisor: Here’s the thing. I actually can’t. I’ve said this so many times to people. Your email says n/a…. I see everything else. But I can’t load it in Kaiser’s billing system — It is in Kaiser’s medical system though….it’s not in our billing system it’s in < your state health care marketplace > system.
In healthcare services like this, why aren’t there internal practices whereby the Supervisor who admitted to seeing this “so many times” before encourage such problems to be resolved by partnering with product, engineering teams?
Who is charged with caring about and minimizing the costs; financial and [poor] brand affinity (if you can have such a thing for health insurers) that result from the smallest of interactions like this?
Are their insurers that follow SaaS-based company best practices? I’m still waiting for a podcast or article on SaaStr to appear about how healthcare is learning from SaaS based businesses. Please let me know if you see any news on that front.
For some great, albeit mind-numbingly frustrating, stories about this stuff, check out An Arm and a Leg podcast.