Wanted to share an article that was recently written by Steve Krause from Bessemer Venture Partners on Techcrunch describing the Trillion dollar opportunity for investing in healthcare.
As we know healthcare is changing, albeit very slowly. We have seen disruption across the board but in a small scale. Very few companies have controlled the market in any particular space due to the long sales cycles, bureaucracy, integration, and implementation times.
Here at referralMD we have taken the approach of building the best platform to help manage the entire communication process between providers, including e-consultations (pre-referral discussions), referral life-cycle management, and pre-authorizations. Our goal is to provide a health system with the most intuitive and powerful solution to manage an outside network of providers, help lower costs, and improve revenue.
ReferralMD is excited to be included in this list under the referral management section.
Example of one of our reports that shows Out-of-Network leakage for a health system
Here is a snippet of the article…
Historically, insurance companies (including Medicare) have made separate payments to providers for each of the individual services they provide to patients for a single illness, visit or course of treatment. This payment system, called Fee-For-Service (FFS), incentivizes quantity over quality because a doctor gets paid more when they provide more services.
However, this traditional FFS payment model is experiencing massive disruption due to healthcare reform. The Patient Protection and Affordable Care Act (PPACA) advances new reimbursement models which incentivize doctors on the quality and cost of a patient episode rather than the number of services provided. This new system is called Fee-For-Value (FFV).
In an FFV system, providers take on financial risk for their patients, meaning that providers share in the burden of a poor outcome and the upside of more efficient and higher-quality care.
Since PPACA was enacted five years ago, nearly 20 percent of all healthcare payments are value-based. Healthcare industry experts expect this to increase to 75 percent or more by the year 2020. By our account, that’s easily a trillion-dollar-value shift that will take place in the next five-10 years. That’s not just a big, but a massive market opportunity for entrepreneurs and venture capitalists to pursue.
Infographic can be downloaded here: