The most time and energy consuming experience for healthcare customers is the healthcare transactions. Largely by design, the commercial payor process in healthcare is broken to the core to create friction that intentionally minimizes payment to providers and reduces the liability of payors. Consumers typically have insurance through employers which reduces the choice. The network of approved providers for the payors then dictates which providers the consumers are allowed to see. The consumers only find out much later how much the service cost, how much the payors brought the price down, what the payor covered, and what amount is left for the individual to pay. To top this, the commercial insurance model of care insulates both providers and patients.
A solution to this is to cut out the payors, and this is what cash-pay medical practices are all about. Cutting the payors, it is the answer to the years of frustration that the consumers and providers have faced. Longer appointments, more timely access to providers (off hours is usually included), and real accountability are some of the desired outcomes of the cash-pay practice in healthcare.
However, the organizations for building networks and scaling cash-pay medicine have not fared well. While QLiance and Turntable Health had to eventually shut shop, One Medical has seen a painfully slow growth. MedLion is trying to sell subscription medicine, mainly virtual care, through employers.
Converting small practices is hard and perceived as very risky, and that’s the biggest obstacle for scaling a network of cash-pay medical practices. Social media platforms like Facebook are reducing the barriers for providers to convert practices to cash pay. Simultaneously, we are seeing more digital health technologies built to help cash-based practices — Atlas.MD is a subscription-based practice HER, Hint Health manages the back office, and Spruce Health connects providers directly to patients and allows practices to easily offer new, differentiated services to patients. This year is said to witness the growth of the practice and touted to grow only bigger and better in the coming years. Keep watching this space for more such interesting healthcare technology insights.