The Obama administration launched a contest among health care groups, developers, designers and tech firms to redesign a medical bill that is much simpler than the current system.
Dubbed "A Bill You Can Understand," the Department of Health and Human Services (HHS) aims to inspire concerned groups and individuals to come up with a novel approach, particularly one that is easier and cleaner that can help enhance the overall medical billing experience of patients.
The Problem With U.S. Health Care
Aside from the actual ailment, medical billing is one of the most troubling burdens that patients face in the U.S. They frequently receive bills from different health care institutions, multiple doctors and laboratories for the same medical consultation with varying scope of services, presentation and jargon-filled statements.
Patients are then left confused as to what they truly need to pay, what their health insurance plans will really cover and whether or not the bills are accurate and sufficient.
One example is a family from Las Vegas, Nevada who had to pay more than $1 million due to typographical errors made by their insurance company.
In 2014, Kynell Smith's wife gave birth to their premature daughter who needed to stay in the neonatal intensive care unit. Her wife also had two surgeries and was medically necessitated to stay in the hospital for more than a month.
When it was time for Smith to claim from his insurance, he was denied becaue of discrepancies in his wife's birthday. He pleaded for help but was told that he may have to file a court case to resolve his problem.
Smith was also told he was overpaying his insurances, among many other problems, but he was not able to see his billing information details.
"This challenge is part of HHS' larger effort to put patients at the center of their own health care," says Secretary Sylvia Burwell. She adds that with the contest, the administration is paving the way for progress by creating a medical bill that patients can genuinely understand and a process that actually makes sense. Such progress entails initiating an assembly that will involve concerned parties – patients, physicians, insurance companies, medical facilities and innovators.
Medical Institutions To Participate
Several medical institutions have expressed their support for the contest by allowing the winning designs to be tested or implemented in their facilities. Among the medical centers that agreed to do this include Cambia Health Solutions, Geisinger Health System, INTEGRIS Health, The MetroHealth System, Providence Health & Services and University of Utah Health Care.
The combined number of patient visits of these health care institutions amount to more than 10 million per year. Patients with health care insurances are approximately 3.5 million.
The group of participating centers is a combination of different types of organizations, ranging from academic medical institutions, safety net firms and unified delivery systems. Experts from these groups, together with patients and other stakeholders, will work together on an advisory committee.
Awarding The Best Designs
The contest body will give out two awards. The first one will be given to the innovator who can design the bill that is the easiest to comprehend. The second award will be given to the innovator who can design the most excellent transformational strategy to boost the medical billing system, targeting what patients actually see and do while going through the process.
The criteria for judging include comprehensibility, creativity and the manner in which the approaches address the challenges stated by patients, providers and other concerned parties.
The contest will accept entries until Aug. 10, and the winners will be declared in September 2016. Each victor will be awarded $5,000 in cash. The winning designs will be presented at the Health 2.0 Annual Fall Conference, also in September, and on the official contest website.
The announcement of the contest was made by Secretary Burwell during the annual Health Datapalooza meeting on May 9. The bill is sponsored by the American Association of Retired Persons and will be carried out by design firm Mad*Pow.