Earlier this year Doctella was selected to participate in the prestigious Healthbox Florida Studio in Partnership with GuideWell Innovation (owner of Florida Blue), an eight-week studio at the new GuideWell Innovation CoRE™ (Collaborative Resource Ecosystem) space in Lake Nona Medical City (Orlando, Florida.)
The eight-week program provided Doctella with seasoned mentors and workshops within the healthcare industry. We were very fortunate to be chosen. After graduating the program, I am summarizing our learnings and thought it would be beneficial to share some key insights that I found valuable to digital healthcare companies focused on improving quality of care.
First, I learned that the current business of healthcare / hospital / provider sales is entirely driven by insurance reimbursements and regulation. The concept of selling products based on operational efficiency and ROI typically does not work. Why? The reason is because operational efficiency in not part of the culture of hospitals. Till very recently hospitals only got paid for services billed to the government (medicare) or private insurers. From a pure business incentive the goal of providers is to do more work so they can bill more services for more money.
Because of Healthcare’s culture to do more to bill more the concept of ROI for operational efficiency does not resonate with hospitals CFOs and IT teams. If you are re-reading the last sentence again, yes I just said that! It sounds crazy! How can a business survive without caring about ROI around operational efficiency. Unfortunately this is the current reality and one of the primary reasons we have ever increasing cost of healthcare. Insurers are trying to change this culture with the move to value based payments.
So what does this mean for Doctella. Today, if we want to sell something to hospitals we need to show ROI around the opportunity to increase billing for hospitals. The Government, the largest payer (40%) recognizes the current culture of healthcare and has created billing incentives for hospitals based on quality and process metrics. For example if a hospital shows they gave a patient some education the hospital can bill the government. This measure is called meaningful use. For Doctella we are adding features and reports that help hospitals increase billing while keeping true to our mission of improving quality of care and increasing operational efficiency.
In summary the business of healthcare is different from every other business because of the business model. This is slowly changing, the move to value based care and risk contracts is a revolution in healthcare that is forcing healthcare to be just like any other business and review ROI on operational efficiency and outcomes but the cultural transition is happening very very slowly.
Written by Amer Haider, Co-Founder & CEO of Doctella