change:healthcare inc. is seeking a motivated individual looking to gain experience in the fast paced internet-based healthcare technology industry. Tasks for this position would range from assisting with health industry research to evaluating current and competitive products. Assist in coordinating implementation, facilitate/create new marketing campaigns, and participate in the product development process.

Distinguishing Characteristics:
Applicants should possess an interest in healthcare and its impact of society, Web 2.0, social networks, as well as the industry transition to increase quality measures, consumerism, health data exchange, and cost transparency tools. Strong social and communication skills, self-starter, entrepreneurially minded.

Email your resume and cover letter to info@changehealthcare.com.

I’m privileged to be part of the change:healthcare team. It’s been almost 8 months since I started and a day has yet to go by that I’ve not learned something new from this dynamic team. I think very highly of the group … and because I know she won’t call attention to herself, I just have to share the ink spotlighting our own Katrina Welty! Two years out of school and her wisdom (in life) and knowledge (of healthcare) is incredible.

Check out the entire story by downloading the PDF!

I have learned not to put complete blind faith in my Insurer. I do NOT blindly pay outstanding balances from providers and assume that my Insurer processed the claim properly, and neither should you as this story will show. Even though I’m a pretty savvy healthcare consumer (this IS what I do for a living – understanding the healthcare industry), this one had me confused for while.

My wife took my kids to a Clinic for their flu shots (No, I didn’t go and get mine, and that makes me far less of a person than those of you who did). Flu shots fall under “well care” on our plan, so there is no charge.

But then I got a bill from the clinic, an in-store deal – very convenient (I know, I should have gone too, stop already). The bill must be a glitch I told myself. I decided to wait and see if they figured it out rather than spend time on the phone with them and with my insurer. Then I got a statement for the bill again. Odd, I thought.

And then, I got a nice letter from Insurer asking me to confirm if I had another insurance plan. I procrastinated, was moving residences, etc. and did not answer that letter. I did not make the connection.

Doing something else entirely, I logged in to the online view of my insurance account (which I must say is a weak “silo” view of the information my insurer has). They only had two claims for the past year. That was wrong, I knew. Hmmm. Must’ve logged into the account for our previous policy (still active 2 years after moving off of that plan – can you say “we never update”). Yup. Logged out and logged in with the other username/password combo and suddenly, there are my claims for the year on my current plan.

Only then does it dawn on me. The clinic submitted the claim on the old insurance and did not confirm new insurance, or if they did, they simply accepted that my insurance info was current with them. My previous plan and this plan were with the same Insurer, so it’s an honest mistake.

So now my Insurer has denied the claim on my old insurance plan. The clinic wants their money because the Insurer denied it. Now I’ve got to go and straighten out both of them because my insurer who had BOTH policies is not able to do a simple lookup on my SSN and determine yes, I do have another policy AND LO AND BEHOLD IT’S WITH THEM!! Who’d a thunk since they only have 65% of the entire health insurance business in the state.

It’s only $60 bucks – 2 flu shots at $30 each, but it’s my $60. It’s money they planned on spending in the plan, so it’s paid in. Most folks would have simply assumed that the shots weren’t actually covered and paid the $60.

Thankfully, I called the Clinic’s 1-866 number, and Mona was very helpful and walked through things with me and resubmitted the claims.

Don’t put too much faith in your Insurer.

An individual in our office (their name shall remain anonymous) received a letter from a gentlemen who used to perform “blue collar” work (spraying for pests) on their house and property. The letter was a plea for “some kind of donation,” help may be a better word, because his heart condition has recently rendered him disabled. He has applied for SSDI and medical, but is having a hard time making ends meet during the waiting period.

What do you do in a situation like this?

Well the answer to that question is personal.  However, in reading the letter, I wondered how many people know where to turn for help when they become newly disabled.  How do we make these services more prominent?

My first thought was “why hasn’t his healthcare provider helped him?” and by helped I mean referred him to resources that may be available through his medical center.  Most larger health institutions have assistance programs to help individuals pay for healthcare costs.  Though you must qualify for this type of program, it seems in his situation he would.

Second, what not-for-profit serving heart conditions could direct him to assistance programs in his area?  I know some organizations offer premium and co-payment assistance programs to help constituents pay for care. This would be especially helpful if he is on COBRA.

Third, why are there not resources listed on the web or provided in print when individuals enroll in SSDI and medical. The program has a waiting period - five months.  Doesn’t it seem logical that some (if not a lot of) individuals enrolling in these programs would have a hard time making ends meet during this time, with no pay and potentially no health insurance coverage.  I am confused as to why resources are not suggested to these indivdiuals when they enroll in the programs. (Now I know that SSDI back pays for the waiting period, but that does not mean that individuals do not struggle during those months).

What kinds of programs are out there, and how do you best help someone experiencing a new medical disability during such tough economic times?

Recent Updates on change:healthcare

In an effort to make the system easier to use and more effective, we are continually making changes. Yep, there will be a whole new User-Interface coming, but in the meantime because of User feedback we’ve implemented the following:

COMMUNICATIONS

A huge benefit of using the site is being able to connect with people experiencing like health issues, using the same physician, or taking the same prescription. Up to this point, reading comments has been the extent of that connection.

Well, that’s changing big time!

With the new enhancements, users can mark comments as helpful and the writer will be notified when one of their comments is marked as helpful (securely…we’re not sharing your email address). You can also reply to a comment. The original author will receive an email and the reply comment will appear indented. In the example below, Goofball replied to the MattTest comment and MattTest received an email letting him know that someone had replied to his comment.
NOTE: The count for helpful comments is not associated to replies. In this example, two other users found MattTest’s comment to be helpful.

In your profile, you can elect to accept or decline private messages from other users. If you have accepted this option, your profile bar will include a link to compose a message.

If you have received a message, you will be notified in the status bar (found on every page of the application if you are logged in). You can retrieve your message by clicking the message link or from your dashboard.

After you retrieve your message the status will change to read and move to the bottom.

SEARCH

Medical terms are difficult to understand and even more difficult to spell! The search functionality has been expanded to include a “Did you mean” suggestion to expedite your search process. This functionality is available as shown with health issues, but is also available for services, insurances, providers and prescriptions.

If you have any questions or need further clarification about these changes or any other issues on the site, please feel free to contact us at 800-655-0732 ext. 1 or email us at info@changehealthcare.com.

Be on the lookout for other changes in about 30 days! An inside source leads me to believe that activity feeds will look very different!

Just passing along that I’ll be speaking at Wharton on Feb 13th about healthcare, entrepreneurship, and a plethora of other things that come to mind (anyone who has seen me speak knows can be both comical and unnerving to a facilitator).  Please feel free to join us and participate!

The Healthcare Panel for the Wharton Entrepreneurship Conference on February 13th, 2009 in Philadelphia, PA – www.wec2009.com

Flickr @ jimfrazier

The “Last Mile“

It’s an expression that has been running through my mind for quite some time over the past year.  I think that I first heard it used to describe the frustrating gap of getting everyday consumers/households connected to high-speed internet svc with the belief that if only our Parents and the guy that works at the bowling alley could surf the internet at high-speed for a reasonable price, then people would flock to (nay… DEMAND) rich media experiences such as music, videos, pictures, etc.

There existed an ever growing fat pipe of rich content just sitting… waiting… to entertain and engage people on the internet backbone and trunk-lines that ran into the cities and across the country - If only people had faster internet than their old 56k dial-up modem via home telephone lines in order to connect at blindingly faster speeds across that figurative last mile gap of connectivity from a person’s home to the internet-backbone connection point in the community . Of course, much more expensive internet access was available but only eager techies and early adopters were willing to pay the much higher costs to access this pipe of richer information. I’m sure that i’ve botched the exact specifics, but hopefully I’ve jogged your memory enough to understand the issue of the time - that palatable yet intangible Last Mile of connectivity, of rich and engaging User experience.

Healthcare Consumerism

So what the heck does that Last Mile stuff have to do with American healthcare?  Well, i’ve begun to feel a growing sense of Deva Vu.  There has been an ever increasing explosion of healthcare technology and web-based services that was first aimed at payors, then TPAs, then employers, and now the burgeoning and highly befuddled individual consumer. And as more emphasis and focus has been placed on individuals becoming both financially and personally accountable for their health and all related costs - I am left with a seriously nagging question: As the arsenal of tools and information available to consumers grows…what is the Last Mile of healthcare consumerism?

Unfortunately, I don’t have a clear ‘answer’. I’m just not that smart. But as I think about it, I thought that I’d lob some characteristics of the Last Mile of Healthcare Consumerism out to the blog-o-sphere to ponder and see what you guys throw back:

The 6 Things Needed to Shorten the Last Mile of Healthcare Consumerism

(e.g. the ingredients needed to cause Joe Average to actually care about and desire to get the best value for the his dollar spent on healthcare services received)

In no particular order, make ‘it’…

1. Relevant - People just don’t care about information or services unless it relates to them directly and to the specific issues that they face NOW.  A 30yr old male doesn’t care about and becomes miffed when he gets a flurry of emails reminding people of the importance of mammograms. Actually, I think that Relevance AND Specificity go hand-in-hand.  One big challenge of keeping communication and tools relevant to individuals is that something that IS relevant now, may not be relevant 3 months from now. Just as something that isn’t relevant now, may be relevant 2 months from now.  Yep, us healthcare consumers are a fickle lot.
2. Timely - It seems like people have a loosely defined horizon of what conversations and information are ‘timely’.  Any communication beyond two weeks of when I needed it just seems worthless. And printed materials that are more than a month old, seem out-dated and irrelevant.  Timeliness, fortunately, is a dimension of communication that falls into the ‘perception is reality’.  It’s not that the information or communication has to be newly created but rather that it is presented within close proximity to when the person needed it.
3. Simple - Yep, often the hardest thing to do is make complex things simpler and less confusing. I like the adage of ‘Keep It Simple Stupid’  and yet healthcare consumers are overwhelmed by the complexity of rules, plans, choices, communications and multitude of various entities involved in a basic healthcare service transactions. It’s sad when an insurance company has to create for its members an Explanation of its Explanation of Benefits.
4. Easy - Just because something is Simple… doesn’t mean that it is Easy (as in nearly effortless or without much thought).  Just as people can use Mint.com to gain insight into their finances and GoodRec.com to review/find what people say about local restaurants - the tools available and services accessed should require minimal effort to get started with. As a general rule of thumb, the more effort or interest that is exerted, then the derived insight and resulting value should dramatically increase. Honestly, this is one aspect that we (change:healthcare) continued to struggle with but are making some significant strides (and announcements) in the coming months to overcome this barrier. Healthcare data has been historically locked up in separate or proprietary silos but soon, we’ll be breaking it free!  Viva Consumers!
5. Trustworthy - Without trust, consumerism will stall and wither.  I know that many of you have thoughts about where, when and how a trusting relationship is established and perpetuated… but i’ll summarize it as my Dad did once for me, “Trust is earned, often fragile, and hard as hell to earn back once lost.”  What are the qualities of sites/Brands that you trust with your healthcare information, transactions, and tools?
6. Controllable - I’d argue that when it comes to healthcare data and information, that people are actually LESS concerned about being secretative or isolated BUT RATHER care more about controlling who or what other parties has access to or sees their healthcare issues and related data. In fact, my guess is that the more control individuals are given over their own data, the likely people will begin to share and exchange personal information that can help others… aka healthcare transparency of choices made, perceived quality and experiences, and the costs thereof.

Final Questions

Went for the third of the four surgeries for varicose veins in my legs. Tweeted the whole procedure again (see below). And since this procedure was soooo much more graphic, I got the pix and video to go with it. To bring everyone up to speed, the first two surgeries were laser ablation from the front and back of the legs. That sealed off the problem veins. The last two are the actual removal of visible veins which have proven to be painful. The pain was the result of phlebitis. As Dr. Bonau removed the veins, he asked if I had ever had phlebitis. The veins showed signs of it and the pain that I have had would be consistent with that diagnosis.

Fair warning: the pix and vids are pretty graphic. Not for the squeamish. All pix and vids were shot by me personally while they did the work on my legs. The areas were deadened so I felt nothing, but it was still a bit unnerving to watch the doc tugging on my body like he was.

Thanks agin to all of you following along and thanks for the supportive messages before, during and after surgery. A special shout out to @MindofAndre twitter and blogger trailblazer.

We are sooooooooo excited!  Chris McIntyre (of Podcast Alley, PodShow.. aka Mevio fame) is joining the change:healthcare team as Director of Product Management and Making Stuff Useful.

If any of you listen to podcasts or work in San Francisco, then you know Chris’ work and understand why we are so freak’n thrilled to add his integrity, experience, focus, insight, and personality to the team — He’s an A+ rock-star who understands development, community engagement, and building products and services that are intuitive, collaborative, support millions of Users and scales to meet demand. Most importantly, Chris knows how to listen to Users, respond, and get stuff done!

Please welcome Chris (sometimes referred to as ferf, theFerf or cmac), his wife Amy (who has a fitness book and video podcast), and their 100lb. golden retriever ‘Cason’ to the change:healthcare family and Nashville.

The change:healthcare team is growing and preparing for some more significant announcements that will DRAMATICALLY shift and improve how everyday people try to deal with the healthcare system as consumers.

More to come, but we thought you might want to know about Chris.