When Two Giants Intersect: Healthcare Meets Fintech | Summary and Q&A

TL;DR

Healthcare and fintech are emerging as an intersection of industries, offering opportunities to solve the broken healthcare system using innovative fintech solutions.

Key Insights

• 🇨🇷 The healthcare system suffers from inefficiencies, increasing costs, and complexity, creating opportunities for fintech solutions.
• ⚾ Regulatory changes, such as price transparency and value-based payment reform, provide tailwinds for innovation in healthcare.
• 🤩 Data transparency, financial management, and insurance coverage are key areas where fintech can address challenges in healthcare.
• 💨 Collaborating with incumbents and bridging the gap between fintech and healthcare institutions can drive faster adoption and transformation.
• ❓ Solving the complex challenges at the intersection of healthcare and fintech requires hybrid expertise and understanding of both industries.
• 😨 Large opportunities exist in areas such as employer-sponsored health insurance, preventative care coverage, and connecting provider data with financial workflows.

Transcript

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Questions & Answers

Q: How is the healthcare system broken?

The healthcare system suffers from high costs, decreasing outcomes, and administrative waste. Issues include surprise medical bills, lack of price transparency, and complex payment processes.

Q: What regulatory changes are driving the intersection of healthcare and fintech?

Regulations like price transparency and value-based payment reform are creating opportunities for fintech innovation in healthcare. These changes aim to improve cost transparency and align incentives between providers and payers.

Q: How can fintech address the challenges in healthcare?

Fintech solutions can improve data transparency, financial management, and insurance coverage in healthcare. Startups can leverage technology to streamline payment processes, provide financial services to healthcare providers, and develop user-friendly insurance products.

Q: What are the key opportunities at the intersection of healthcare and fintech?

Some key opportunities include building tech-native health insurance products with improved user experiences, developing financial operating systems for healthcare providers to streamline revenue cycles, and creating platforms for better data sharing and underwriting of healthcare expenses.

Summary

In this video, healthcare and fintech experts Julie Yu and David Haber discuss the intersection of healthcare and fintech. They address the challenges within the healthcare system, such as high medical debt, unpaid claims, and lack of transparency in pricing. They also explore the role of regulation and technology in driving innovation in this space. From regulatory changes like the price transparency law to the adoption of value-based payment models and the use of fintech infrastructure, they discuss how these factors are enabling entrepreneurs to make a positive impact in healthcare.

Questions & Answers

Q: What are some words that come to mind when you think of buying something with the click of a button or tapping your card to pay?

Words like seamless, clean, and easy come to mind. These are the affordances that the world of fintech has granted us.

Q: What words come to mind when you think of the healthcare industry in America?

Words like confusing, clunky, and broken often come to mind when thinking about the healthcare industry in America. The system is not seamless or easy for consumers.

Q: What are some challenges within the healthcare system?

There are several challenges within the healthcare system, including increasing medical debt, billions lost in unpaid claims, and hospitals operating at a deficit. Service prices can also vary greatly, creating confusion for consumers.

Q: How does the three-party system of payers, providers, and consumers contribute to the challenges in healthcare?

The three-party system creates a misalignment of incentives. Providers deliver the service but are not directly involved in the payments flow, causing surprise bills and lack of cost awareness. Consumers also struggle with transparency and agency in choosing healthcare services.

Q: What is the role of regulation in driving innovation in healthcare?

Regulation can be a positive force for innovation in healthcare. For example, the meaningful use law encouraged the adoption of electronic health records. More recently, the price transparency law requires hospitals and insurance companies to publish their contracted rates, increasing transparency in pricing.

Q: What regulatory changes have had an impact on the healthcare industry?

The no surprises act limits surprise out-of-network billing, protecting patients from unexpected bills. The Cures Act enables patients to easily access their medical records and reduces the cost of access. These changes have a direct impact on the healthcare experience.

Q: How has fintech infrastructure contributed to the intersection of healthcare and fintech?

Fintech infrastructure has opened up opportunities for entrepreneurs to build within the healthcare and fintech intersection. Companies can embed financial products like lending, payments, and banking-as-a-service, offering new solutions to healthcare providers and consumers.

Q: Can you provide an example of a company that is leveraging fintech in the healthcare space?

Juniper is a company that automates the revenue cycle management for healthcare providers. By streamlining the claims process and understanding the cash flow of practices, they can offer working capital solutions and advance payments to providers, improving their financial stability.

Q: What are some other gaps where healthcare and fintech can intersect?

One gap is in the employer-sponsored healthcare space. Companies like Thatch are building cards that understand healthcare and can pull from healthcare savings accounts, making tax-advantaged payments. This allows employers to provide healthcare benefits more efficiently.

Q: How can fintech help improve transparency and cost awareness in healthcare?

Fintech solutions can provide tools and platforms for consumers to compare prices and make informed decisions about healthcare services. By leveraging data and technology, fintech companies can bring transparency to a traditionally opaque industry.

Takeaways

The intersection of healthcare and fintech holds great potential for innovation and addressing the challenges within the healthcare system. Regulatory changes, such as increased price transparency and value-based payment models, are providing opportunities for entrepreneurs to make a positive impact. Fintech infrastructure is also enabling the development of solutions that improve financial efficiency, transparency, and cost awareness in healthcare. By leveraging technology and data, fintech companies can bridge gaps in the three-party system and drive meaningful change in the healthcare industry.

Summary & Key Takeaways

• The healthcare system is broken, with inefficiencies, increasing medical debt, and lost revenues. Consumers, providers, and payers are all impacted.

• Regulatory changes, such as price transparency and value-based payment reform, are creating new opportunities for fintech solutions in healthcare.

• Fintech infrastructure and technology advancements enable startups to address gaps in healthcare, such as data transparency, financial management, and insurance coverage.