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VOL. 36 | NO. 35 | Friday, August 31, 2012

New cures for old maladies

Midstate companies tackle inefficiencies in health care industry

By Bill Lewis

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Ever wonder why you can bank online or at an ATM, but communicating electronically with your doctor seems out of reach?

Or why your grocery store can send you an email when it’s having a sale, but your health care provider never does?

Or why you can walk into a storefront office to file your income taxes, but getting that sort of help finding the right health insurance seems impossible?

Several Nashville health care businesses asked those same questions. Then those companies – Dabbs Computer Consultants, Change Healthcare and Bernard Health – came up with answers that are helping to show the health care industry the way to the future.

CareTracker, a Web-based electronic health record system offered by Dabbs Computer Consultants, cuts through the red tape and instantly verifies insurance coverage so patients never again have to worry about unexpected out-of-pocket expenses. It even sends secure automatic reminders of upcoming appointments and lets patients request prescription renewals or an appointment, check messages from a health care provider or pay bills online.

The banking industry has been using that sort of technology for years. It’s about time health care caught up, says Todd Dabbs, president of Dabbs Computer Consultants.

“The banking industry really cares about security of their data. But you can transfer billions of dollars around the world in a matter of seconds,” says Dabbs. “Everyone who uses an ATM card and pays bills online understands the value of electronic records. CareTracker brings that convenience, security and reliability to health care.”

Physicians’ practices are adopting CareTracker for other reasons, too. Because it is cloud-based – meaning it is supported entirely on the Web – doctors’ offices don’t have to buy and maintain computer servers, saving perhaps tens of thousands of dollars.

Old-fashioned servers also have to be taken offline and periodically updated. When that’s happening, patients might not be able to see their doctor since their records are unavailable. CareTracker keeps that from happening.

Doctors’ offices like something else about CareTracker – no more paper.

“We have no filing cabinets,” says Sherry Rich, the practice administrator for the Middle Tennessee Center for Lung Disease in Murfreesboro.

The practice plans to use CareTracker to give patients access to their charts and medical records. They also will be able to communicate with their doctor about their prescriptions, she says. That’s something tech-savvy patients expect.

“That alleviates a lot of phone calls,” Rich says. “Many older patients don’t use a computer, but as generations grow up and have more experience on a computer, we’ll see more patients use that portal.”

Most of us have seen shoppers at grocery stores or another retail outlet using an app on a smart phone to scan prices and compare them with another store. In a way, that’s what Change Healthcare does with its Transparency Messenger tool, which shops around for the best prices on health services.

Change Healthcare then delivers “Ways to Save Alerts” directly to its members’ email or mobile phone, enabling them to make the best purchasing decisions and to lower cost for themselves and employers.

“Unlike other solutions on the market, our Transparency Messenger tool delivers proactive, customized cost savings opportunities on the medical, dental and prescription services that consumers are using in their local area,” says Doug Ghertner, president of Change Healthcare.

Consumers need that help, since health care costs are expected to increase more than 7 percent this year. Businesses need help, too. Federal health care reform requires health plans and self-insured employers to cover many wellness screenings aimed at reducing chronic conditions without charging a deductible, copayment or coinsurance. Employers will pay that cost.

“The ACA (Affordable Care Act) mandates that plan sponsors must now provide a set of preventive services at no cost to the employee. But these new benefits come at a cost to plan sponsors,” Ghertner says. “As a result, many businesses are looking for ways to educate their employees on how to identify lower cost, high quality health care providers.”

About one third of consumers have health insurance with deductibles higher than $1,000. The growth of defined-contribution or high-deductible plans has created a problem for those who can’t shop for the best services at the best prices.

Prices vary widely, according to Change Healthcare’s Transparency Index. For example, it found a significant difference in costs for diabetes screenings. The lowest price was $51. The highest was $437, a 755 percent difference.

Pap smears varied by 264 percent, from $131 to $476 in the same community. Cholesterol tests varied by 219 percent, from $117 to $374. Mammography varied from $169 to $403, according to Change’s index, which is drawn from its database and protects patients’ privacy.

In today’s environment, it’s vital to have the right health insurance. But getting unbiased advice can seem impossible. That’s the idea behind Bernard Health.

You can get a health screening at a corner drugstore or find tax help at a local shopping center. Why should health insurance be different, asks Ryan McCostlin, a Bernard Health team member in Nashville.

The company has a “store” at 720 Thompson Lane, in the 100 Oaks area, where anyone can walk in, with or without an appointment, and for a small fee get personalized advice. The company also has an office in Indianapolis.

“We save time, money and give them peace of mind,” McCostlin says. “There’s so much information, so many ways to make a mistake.”

When Rachel Schaffer’s coverage from law school expired, she says she “haphazardly jumped into the cheapest coverage I could find.”

That turned out to be a mistake, so she went to Bernard Health. The company found a plan that cut her deductible in half and saved $672 a year in premiums.

“I was absolutely stunned and could not be happier. … Bernard Health’s value for their services can be summed up in three words: peace of mind,” says Schaffer.

Bernard Health also helps businesses establish health savings account policies (HSA) for their employees. Despite their tax advantages and premiums that are about 30 percent lower than traditional coverage, HSA policies have proved to be a hard sell.

At businesses that have them, just 8 percent of employees sign up, on average, says McCostlin. When Bernard Health structures the policy, enrollment averages 81 percent, he says.

Bernard Health doesn’t market itself as the H&R Block of health insurance, says McCostlin, but “people have said that about us.”

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