The VisitPay Blog | Building Better Financial Relationships

Investing in Healthcare’s “Other Side of the Coin”   

The pandemic put a much-needed spotlight on healthcare. For most providers, the digital advances experienced in the first three weeks of the pandemic were not even roadmapped to occur in the next three years. And while telehealth adoption has become the face of healthcare’s shift, it’s important to not forget that there are two sides to every patient experience: the clinical and the financial. 

It has not always been this way. Ten years ago, when hospitals were first building their digital platforms, no one cared if a patient paid or not. Most revenue came from insurance companies or Medicare. But with the Affordable Care Act and Medicaid expansions, the share of revenue due directly from patients has quadrupled. Today, a patient’s financial health directly correlates to a provider’s financial health. 

We are beyond the era of treating patients and consumers differently. As an industry, we must take advantage of the once-in-a-lifetime opportunity to rethink how we structure and prioritize. We must continue to focus on fixing what’s broken to build infrastructure that supports the needs of the modern patient. 

We saw the beginnings of rebuilding in 2020—a record year for digital health investment, bearing a 103% increase in total corporate funding for digital health according to Mercom Capital Group research. We also experienced Teladoc’s massive acquisition of Livongo, Philips’ of BioTelemetry, Walmart’s of CareZone, and Hims & Hers’ merge with Oaktree. That’s just one sliver of what has happened, and of what’s to come. 

Predicting the Market’s Tailwinds 

A large determinant of healthcare’s success will be the ability to support companies that look holistically at the patient experience. The ones that build readiness and flexibility into every part of healthcare’s infrastructure. The ones that meaningfully consolidate the patient experience to better incorporate convenience into care. 

But we must strike a balance between concentration and specialization. The healthcare system will always have three players—provider, payer, and patient—each with competing needs, policies, and interests. A one-size-fits-all platform will never be sufficient. 

I predict four primary types of healthcare platforms to shape the market:  

    • The Claim Management Platform — This payer-first platform will focus on streamlining the claims process to speed up payment lifecycle. 
    • The EMR Platform — This data-first platform will help clinicians meaningfully track patient data over time, accelerating research cycles and fine-tuning treatment.  
    • The Value-Based Care Platform — This patient-first platform will manifest lasting doctor-patient relationships, encouraging better healthcare outcomes overall. 
    • The Patient Financial Experience Platform — Finally, this consumer-first platform will provide patients with the sophistication and capabilities they’re accustomed to as consumers, supporting financial health for all. 

I believe that with these four platforms—two financially focused, two clinically—we can achieve the market balance needed to accelerate the healthcare industry successfully forward. 

Facing a Platform-First Future

The platforms of our future need to be able to enable a variety of different solutions to be brought to bear for specific problems that a provider, payer, or patient faces. Look for platforms using data as an asset to improve understanding of the patient. Look for platforms that are interoperable—with open architectures that are API-driven. Be skeptical of one-off solutions, and of companies focused on their techniques and not their outcomes.

The future is digital-first, patient-first, platform-first. Moving forward, flexibility, personalization, and anytime access are new standards for care, not perks. Coupled with the rise of healthcare consumerization, we will continue to experience rapid growth and consolidation within the marketplace. It’s about time healthcare took the spotlight. 

Takeaways 

    • There are two sides to every patient experience: financial and clinical. 
    • The future of care will be digital-first, patient-first, platform-first. 
    • We are beyond the era of treating patients and consumers differently. 
    • Market consolidation will be led by consumerization and convenience. 
    • Four primary platforms will take hold of the market: insurance, data, care, and payment.
    • Platforms must use data as an asset but also be built for interoperability and flexibility.

Kent is a seasoned business leader who has delivered breakthrough results in a multitude of consumer finance and payments businesses. Prior to co-founding VisitPay, Kent was the Executive Vice President, US Card Division for Capital One Financial. Kent lives in Boise, ID with his wife of 25 years and two children.

See all posts by Kent F.