At South by Southwest (SXSW), sometimes you’re so busy going from session to session and listening to such a variety speakers that you recognize themes only later on, when you look back and take stock of what you’ve seen. On my first day at SXSW Interactive this year, though, one theme already popped: the issue of money in healthcare.
In “Why Aren’t We Shopping for Healthcare?”, executives from Amino, Stride Health, GoodRx and Harvard Medical School discussed the problem that their work is trying to solve. These startups are trying to increase transparency into health costs to give patients the information they need to be empowered consumers and make informed healthcare decisions.
As they said, “Americans spend 16% of their annual income on healthcare; nearly 26 million Americans don’t take their meds due to cost; and out-of-pocket healthcare spending continues to rise and put more people in debt.”
Whether cost transparency would always lead to improved adherence is debatable, but there’s no question that this information is something that we can find for nearly all other financial decisions. It stands to reason that we’d need it here, too. As David Vivero, CEO of Amino Health said, “Healthcare is one of the biggest personal finance decisions affecting people in the Unites States.”
In “To Build in Health, Follow the $, Not the Patient,” the speakers similarly talked about how finances affect healthcare decisions. The panel was from NewCo, Calyx Health, Amino and MassHealth (Medicaid for Massachusetts). While they focused more on a startup audience than the health consumer, the points were similar — that it can be tremendously useful to understand our current healthcare system by following the money, even though that’s not always the lens we use.
Matt Klitus, CFO and chief strategy officer with MassHealth, indicated that their system is moving to a much greater percentage of fully capitated care, pushing more risk down to the provider. That in itself is interesting, but when you look at the convergence of that trend with a projection that nearly 50% of people will be in high-deductible plans, and more physicians will join health systems or large group practices rather than remain in private practice, there’s an added layer of uncertainty about what our healthcare industry will look like in a few years.
In our work as pharma marketers, we strive always to keep empathy and humanity top of mind in what we create for patients — and for healthcare professionals, too. But it’s instructive to consider how a financial focus can actually help us do this better. If we understand how to address healthcare from a profit-and-loss point of view, we can understand how to create tools and solutions that can not only help patients, but get traction in the marketplace from payers, providers and other organizations. And one thing has become very clear at SXSW: if we want to see dramatic change in healthcare with respect to controlling costs and increasing quality, we’re going to have focus on exponential innovation.