Half of Your Health Insurance Premium is Wasted and How to Get It Back
Without affecting payment amounts to facilities or providers at all.
Without affecting payment amounts to facilities or providers at all.
We have all seen the headlines: “Cigna Defrauds Medicare,” “UHC Denies More Claims,” “BCBS Settles Antitrust Case for $2.7B” or “Aetna settles suit alleging claim-denying medical director never read patient’s records.” We know we are not getting good value for our money.
At Sentia, our solution is to automate the entire health insurance process. We provide the Electronic Medical Records System (EMR) to practices, price the procedures 10% ABOVE medical consumer price index, and pay for work performed in real time. This eliminates medical coding, insurance networks, adjudication, rate negotiation, the cost of a third party EMR, all the big insurance buildings in every city in the US, and the millions of people that work at the insurance company that you, as the insured, pay for.
In short, we eliminate everything that isn’t “pay for your healthcare.”
This system, that you are looking at right now, turns the entire health insurance industry into a whirring box in a cold room. Compare your insurance to a streaming service. Netflix, for example, doesn’t create the content you see, they just codify it and manage your data: what you like, where you were, what you have watched, etc. All they really do is manage data. That is how we see health insurance, it is simply managing data. For the privilege of managing the patient’s data, we charge him or her, $10 per month plus the actual cost of the risk. That alone should cut over 50% of the cost.
To that we can add:
- Integrated health and wellness – We provide patients with a portal that scientifically analyzes the annual (semiannual, quarterly) checkup and prescribes patient education on how to live healthier, better, and longer.
- Integrated Email – We give the patient the ability to contact the doctor via SECURE email.
- Self-scheduling – log in and see when your favorite practitioner is available and schedule a time to meet.
- Questionnaires – Practices have the ability to design, assign and read questionnaires online. This means you as the patient don’t sit in the waiting room with sick people filling out reams of paperwork. Additionally, this system is part of the EMR itself to customize the system for each practice, according to their own specifications.
- Reporting – Individual and Population Health Analysis: the individual gets a printable report of his or her health as it was recorded on the date of the health assessment. Population Health reporting gives the practice the ability to see how they are doing. Efficacy and compliance reporting becomes a one click report instead of a weeks long stare and compare in a spreadsheet. Estimates of patient responsibility
- Compliance – as this product matures, we will be able to differentiate between people who live a healthier lifestyle and those do not by comparing the individual’s metrics against themselves over time. Those who make demonstrably better decisions will pay lower premiums than those who do not, based on personal metrics.
- Telemedicine – speak with your doctor across the internet, and view X-Rays, MRIs and images with him or her and draw on them to highlight structures.
There will be additional savings too. First, the average practitioner in private practice spends about $30,000 per year on some kind of EMR. The average practitioner also spends about $42,000 per year on compliance an efficacy reporting. All our reporting is done in real time and automatically. They won’t have to hire some accounting firm to count the beans, just click button, get report. The billing department will shrink, if not go away. The doctors will know what is covered and for how much, and since we publish all this information to the internet and make itavailable to the patient, he or she has the ability to know the cost of a procedure before it’s performed, and pass all that savings on to you.
Further, we offer patient education based on the results of their lab tests. This happens automatically. When they read it, they get a small discount. When they follow it and get healthier, they get a large discount. This is science based measurement and based on bloodwork. This gives the system 'teeth' by incentivizing healthy living. Then we start getting back some of the 84% of monies spent on behavior based chronic disease. Getting us down to the OECD average will save $1.27 trillion, or an additional 25%. Put the immediate savings from above of 50% with this decreased chronic disease savings of 25% and we find that we can save up to 75%.
We have demonstrated a way to cut about 75% from the cost of health insurance. This is accomplished by streamlining processes and cutting out waste. We believe this is the only way to accomplish this lofty goal without completely revamping the way care is delivered in this country and we hope you share our vision. You are looking at this system right now.