The New Telehealth Economy

Healthcare payments are ripe for digitization

These digital platforms can integrate payment capabilities, or provide options to manage insurance coverage or reimbursement—something which can prove complicated in systems such as that of the US. Because those ecosystems bring together so many elements, payments can therefore be made more efficient, innovative and predictable, providing far greater transparency and control.

“It’s analogous to when you check in to a hotel,” says Lin. “At the hotel check-in desk, they give you an estimate of how much you think your stay is going to be, and they ask for a method of payment. In contrast, few people understand how much they may potentially owe when they go to see the doctor.”

As Lin continues, “Forty percent of consumers can’t pay a bill larger than $400. When you look at the macroconditions of the consumers, and how much they can pay, versus the reality of how large these medical bills are, you realize they may not be able to pay that $2,000, $3,000, $4,000 bill all at once. What options, or what things can you offer to be able to pay those bills in a way that is affordable, convenient, and simple for them?”

These options could include payment plans or financial products common in the retail sector, such as access to low-interest credit, or providing ‘pay later’ options where appropriate. AI-based systems could also help patients budget better and optimize their expenditure, by tracking their health needs over time and predicting potential upcoming costs.

Providing patients the ability to see all claims, what their liability is, and to easily pay their liability is a key part of Cigna’s digital front door strategy, says Scott Lambert, Treasury Managing Director and Assistant Treasurer at The Cigna Group. “It’s another place where we can remove friction,” he said.

Digital payment systems could also provide a step change in the experience of care providers. “When we talk to hospitals or doctors, they often say it takes sixty to ninety days after the patient visits to actually get paid by a patient,” Lin says. “As well as helping patients, scheduled, pre-planned payments can help health providers manage cashflow.”

Another emerging model is subscriptions. Health industry forerunners are already offering digital care services that are accessed and paid for as part of a monthly package. UK-based blood testing app Thriva, for example, provides on-demand, at-home blood testing and feedback from a general practitioner. Users can subscribe to monthly testing to track their health in both the immediate and long term.

As pricing data becomes more readily accessible, this new level of transparency could also enable users to compare pricing and select the best-value providers. As Evernorth’s Matt Bennett puts it: “We go on our smartphones and read restaurant reviews before visiting them. We book hotels after comparing the best rates. We haven’t gotten here yet in healthcare, where it’s easy and accessible to understand which options are available to you, but we should be able to.”

Data is valuable, and the concept of selling one’s own medical information, although controversial, is already being explored by startups. There are major privacy and security issues that surround the emergent field of medical-data-for-sale—but, done ethically, it could give researchers and clinicians access to valuable information.

One non-profit is now attempting to buy medical data—which is anonymized and used for research purposes—in exchange for cryptotokens. Whether this model becomes commonplace is yet to be seen, but blockchain allows information to be stored with much greater security and transparency, which could make it a useful tool for the exchange or even sale of medical data.

Virtual worlds are seen by some technologists as an enabling concept for blockchain, and certainly extended reality is already finding a role in medicine. It has been used to host therapy sessions and addiction counseling, offer consultations and train medical students. Virtual reality (VR) company Amelia, for example, provides psychotherapists and their clients with VR headsets and an electrodermal response sensor that fits on the patient’s fingers, to measure their sweat response during sessions. Data, education and feedback on therapy sessions is then accessed via a VR platform. Some believe that, in the future, there is a possibility we might pay for these virtual services with virtual currency, as that may be the most seamless way to transact in these spaces. “As you give consumers more choice and more options to get their care, they start asking about what else is out there from a digital experience perspective,” says Lin. “So you’re starting to see healthcare, telehealth, and payments all merging together at once.”

Some of these ideas may seem far away from our current experience of healthcare. But as Evernorth’s Matt Bennett points out, whole industries can transform beyond recognition in a matter of years. “Remember back in the day, when you did all your banking in-branch, you waited in line, you filled out your deposit slip, met with the teller, and so on? Today, it all happens through digital and virtual interactions. The branch is there to support you when you’ve got a major need—one that lends itself to being in-person. That’s our intent as we look to the future. Instead of bringing patients to physical sites and settings of care, how do we use digital, virtual, alternative sites of care, to bring the care to the patient?”

BY J.P. MORGAN

Better payments can help healthcare companies deliver better care. Read how payments are powering healthcare ecosystems.