For some, a single medical crisis can spawn a financial burden that’s not only crushing, but confusing.
HealthBridge hopes to end that confusion for those with high deductible employer-sponsored healthcare.
This January, the Grand Rapids- and Traverse City-based service plans to redefine the way employer-sponsored health insurance plans work, said Amy Chambers, chief operating officer.
Every time a claim comes through, HealthBridge contacts the relevant healthcare provider, negotiating the member’s outstanding expenses. These expenses are then consolidated into one bill, which members pay off through HealthBridge. Patients’ medical expenses are itemized into a single statement.
“It’s going to feel just like your American Express bill,” Chambers said.
HealthBridge not only consolidates a patient’s medical expenses but also offers credit on a guaranteed-issue basis to every member of an employer’s plan. Terms include six to nine months of zero interest, followed by seven percent interest for the remainder of the 24-month repayment timeline.
While HealthBridge’s ramp-up plans look fast on paper, the road to get to this point has been a lengthy one. About 10 years ago, Chief Executive Officer Greg VandenBosch and Chambers noticed a shift in how employers were structuring their health insurance plans. VandenBosch says that, prior to 2000, the average employer-sponsored health plan covered almost 100 percent of member medical costs. As health savings accounts (HSAs) emerged and deductibles rose, new challenges arose. Not only were members suddenly paying more money out of pocket to cover their healthcare costs, but healthcare providers had to take a more active role in collecting payments.
At the time, both Chambers and VandenBosch were involved in separate companies, serving different parts of the healthcare niche. As healthcare affordability became an increasingly hot-button issue, the two decided to address the problem.
According to Chambers, the average American today only has $400 in savings for emergencies. The average health insurance deductible, meanwhile, is $1,500. Sixty-four percent of patients with employer-sponsored health plans will opt to forgo care because they are worried about paying the bills.
Compounding the stress, Chambers says, is how medical costs tend to pile up – especially in the case of an emergency. Patients often receive five or six different bills, for everything from ambulance transportation to radiology and blood work. When patients can’t pay all these bills at once, they need to prioritize, deciding who to pay first and negotiating payment arrangements with the other providers.
Healthcare providers are expected to benefit, too, Chambers says. Ten or 20 years ago, when deductibles on health insurance plans were lower, some 95 percent of payments on employer-sponsored plans came directly from insurers. Providers in northern Michigan, in other words, were mostly dealing with insurance companies like Blue Cross Blue Shield and Priority Health to collect payments for their services. According to projections from audit and consulting firm Deloitte, healthcare providers will receive only 60 percent of their payments from insurance companies by 2020. The other 40 percent are projected to from patients.
“Collecting 40 percent [of payments] from hundreds of thousands of people in groups of 10s or 20s is a huge undertaking,” Chambers said. “It’s not the core competency [of healthcare providers], and it shouldn’t be. Providers should have all their attention on outcomes and treating patients. They shouldn’t have to worry about collections.”
Unsuccessful collections have impacted healthcare providers financially. Chambers says that, on average, providers are collecting 50 cents on the dollar for their services. The average length of time it takes for a provider to collect a payment from a patient is 180 days. HealthBridge’s model is to save providers time, paying them an upfront negotiated rate that is as good or better than what they would collect themselves.
For the first few months, HealthBridge will be an invite-only service. VandenBosch says the team is “being very strategic about where we roll this out,” targeting about 12 employers throughout Traverse City and West Michigan, as well as a few in California, Pennsylvania and Wisconsin for a New Year’s Day launch.
Most of HealthBridge’s core team – Chambers and VandenBosch included – work from its Grand Rapids headquarters. The Traverse City office is located at 20Fathoms, a nonprofit technology business incubator, and is led by Chief Technical Officer Tim Heger, who has been building the HealthBridge software system.
Heger, a Traverse City native, was the one who pitched the idea of having a local office at 20Fathoms. He says his goal is to bring more of the company here and add several high-paying jobs to the local economy.
“My dream has always been to come back to Traverse City and help transition Traverse City from a hospitality-based town into something that is more inclusive to a larger group of people,” Heger said.
HealthBridge in a ‘Blossoming’ Health Tech NicheFor Andy Cole, the executive director of 20Fathoms, HealthBridge is not only the perfect type of business for the Traverse City-based tech incubator, but also one with the potential to push Traverse City’s economy in an exciting new direction.
“We exist to serve the entrepreneur at 20Fathoms,” Cole said. “HealthBridge fits into that extremely well, given how entrepreneurial they are, but also how they really have a huge opportunity to grow exponentially. Those are the opportunities that we’re really excited about. Having folks like that – and helping them accelerate faster than they otherwise would – really benefits the whole community.”
Cole adds that there are currently at least 30-35 companies in the Grand Traverse Area that sit alongside HealthBridge in a blossoming health tech niche. One goal of 20Fathoms, he says, is to forge connections between these businesses so that they can help one another flourish.
“20Fathoms is going to start taking a role in convening all of these groups, so that they can all grow more quickly together,” Cole said.