DENVER, CO – For years now journalists, policymakers, and clinicians alike have depicted the US healthcare system as a wasteful, byzantine structure riddled with inefficiencies. And while the healthcare debate in America has historically eyed poor access to care as the main culprit of this dysfunction, recent attention has shifted to the high cost of medical treatment itself, which in the last few years has swelled to a staggering size.
To address this dilemma, many digital health startups have adopted the Triple Aim, which encourages innovations that both increase patient engagement and improve population health, all while reducing costs. Yet most digital health startups are focused on delivery-of-care innovations, with few tackling the problem of spending head-on.
In this edition of the CyberMed News Podcast, we speak with Kevin Krauth and James Dickhoner, the founders of Orderly Health, a digital health startup that’s attempting to reduce healthcare spending by giving patients a better sense of what they’re paying for. Kevin and James will discuss how a lack of transparency in medical costs is playing a decisive role in America’s excessive healthcare spending, and also share how their company is planning to save consumers money by bringing clarity to what can be a confusing and obscure market for many Americans.
Highlights from the Podcast
The Influence of Digital Health on the US Healthcare System
James: “I’m really excited about where healthcare is at in this country. Not where we’re at currently, but the fact that there’s a groundswell of conversation going on about it. If you had read your introduction ten years ago, people would have pushed back and said, ‘No, America’s healthcare system is great.’ You can go back and look at quotes from the State of the Union in the early 2000s, where the president says, ‘We have the best healthcare system in the world.’ I don’t think there are very many people who would argue that point anymore.
“There are a lot of changes that are going to have to happen that go beyond digital health. The Affordable Care Act got the conversation started, but there’s going to have to be further changes to really get us away from spending a fifth of our GDP on healthcare. These conversations are currently taking place, and I think digital health’s role is going to be to accelerate that process.”
The Origin of Orderly Health
Kevin: “I had an experience with healthcare almost a year ago now. It was a normal appointment, and I was thinking to myself as I walked out the door, ‘I have no idea how much that cost.’ I started to look into it. I logged into all of my different healthcare accounts. I had an HSA, an insurance account, a VSP, and I think I had a dental account too. I was just trying to total them all up. And there was really nothing that was out there that did that for me.
“I also couldn’t remember any of my passwords. And all of the portals I was using were so archaic and ridiculous. As a product manager, I found this pretty offensive. I started to ask around and talk to people and just see if I was the only one who had this problem. And it turned out that a lot of other consumers were facing the same issue.”
What is Orderly Health?
Kevin: “Orderly Health is ultimately a data company. We want to help transparency by aggregating different sources of consumer data, and then showing it to them in a way that makes sense, so that consumers can be better educated on their healthcare and what they’re spending. And on the flipside of that, so that payers, accountable care organizations, physicians, clinicians, and people doing research, can better understand how consumers are using healthcare.”
James: “Orderly Health is not going to be a panacea that drops medical spending across the board by twenty percent. But what it is going to do is allow people to budget and plan. We’re going to have the data that allows us to tell you relatively accurately that over the next year you need to set aside five thousand, ten thousand, or whatever the amount is for your healthcare expenses, based both on your healthcare history and by comparing you to similar users.
“What this allows our users to do is to not have unexpected medical expenses pile up, so they can accurately budget and plan until their insurance takes over.”
How Knowing The Price of Care Can Help Consumers Control Costs
James: “We want our users to be empowered by the knowledge of how they’re consuming healthcare, so that when they go talk to the doctor, they can look at the app and say, ‘Alright, my healthcare expenses are going to be $11,000. I can really only set aside $8,000.’ And they can go into the doctor and talk to them. Maybe there’s a different drug. Maybe they can hold off on doing that cardiac scan. They can start putting a way of controlling costs into that conversation that currently doesn’t happen.
“For me at least, that’s a fundamental friction with the healthcare system. As a provider, you don’t know what it’s going to cost. As a patient, you don’t know what it’s going to cost. And so you’re just making decisions in the dark. And when that happens, there are no brakes on spending. That’s how you end up with people that come into the physician’s office, and get put on the latest and greatest insulin. But they can’t afford it, so they get it for maybe a month, and then they stop taking insulin altogether. Then they end up in the hospital. That’s a very real scenario that happens across this country, and it’s hugely inefficient.”
The Future of Orderly Health
Kevin: “My hope is that Orderly will open the door for a lot of people, in terms of seeing data that they’ve never seen before, seeing the way that they spend. And instead of that becoming a negative, they turn it into a positive, and say, ‘You know what, I actually have control over this. This doesn’t feel like my healthcare is controlling me.”